Hamilton Herald Masthead

Editorial


Front Page - Friday, December 2, 2011

CDR’s; DCR’s - what makes you tick?




Most people have problems sleeping.  What’s yours…can’t go to sleep?  Waking up at 2:30 in the morning or at 4 a.m.?  Maybe it’s that you can’t go to sleep before 12 or 1a.m., and then you just can’t seem to wake up and get moving the next morning.

Usually, I am very tired and sleepy around nine o’clock at night, and asleep by ten or ten thirty; then at four in the morning, I’m up.

However, tonight (or rather morning) it is just barely two a.m., and I’m wide-awake. I was sleeping before a dream rudely interrupted me. I was speeding downhill backwards because the brakes were out on my car. I was pushing on the brake pedal with both feet, looked at the speedometer only to see that I was traveling at 70mph. Backwards! This is when I woke up. Whew! I’m glad!

The dream before that found me over in Iraq looking for my son. I didn’t find him, but I did find several other young men and women missing their mom. I was trying to console them all.  I guess I needed to wake up. No, I didn’t eat anything strange before I went to bed that would have caused such strange dreams - just a few M&M’s. Ok, dreams aside (that’s another story) let’s study sleep habits. There are hundreds of sleep disorders, most all of them have a name, and have been studied intensively. One fourth of all chronic sleep disorders are the result of a mismatch between the body’s internal clock and the external 24-hour schedule. 

These sleep-timing problems are called circadian rhythm sleep disorders.  Circadian describes the body’s daily sleep/wake hormone regulation (Circadian is Latin for ‘about a day’). The National Institute of Health estimates that over 35 million Americans suffer from circadian rhythm disorders. (This could explain road-rage!) What is the body clock? Our daily activity and sleep rhythms are regulated by a control center in the hypothalamus region of the brain called the Suprachaismatic Nucleus (SCN) or - the body clock. 

Our body clock receives signals to tell it when to shut down and sleep or when to produce active waking hormones. The most powerful signaler or ‘zeitgeber’ is bright light such as sunshine. When the body clock cannot receive these signals correctly, it malfunctions, causing circadian rhythm disorders. Two of the most prevalent circadian sleep disorders are the Delayed Circadian Rhythm Disorder (DCR) and the Advanced Circadian Rhythm Disorder (ACR).   As young adults, our body clocks tend to run slower, and so when they don’t get the right signals, they cause DCR. As we mature, our body clocks speed up, causing ACR. Women suffer with these two to three times more than men, and experience the disorders earlier in their teens. Women’s body clocks also speed up sooner than men do, usually in their early 40’s. Most men’s clocks don’t start speeding up or advancing until they reach the 60’s. 

Delayed Circadian Rhythm Disorder DCR means your body clock runs slower than the normal circadian rhythm (24-hour period). Your body can’t ‘wake up’ until later in the morning or day, and you may have difficulty getting started in the morning. You usually will also experience a second wind later in the evening. Those with DCR are often referred to as night owls, and then “oversleep” in the morning. Because your daily cycle, or circadian rhythm is running slow, the nighttime hormone, melatonin, is released late, causing you to fall asleep late. So, when you need to get up, your body clock thinks it is still night and continues to produce melatonin. Treatment Recommendations: Light therapy is the most effective treatment. You should use bright light in the light in the morning. However, timing is very important, and you may need to use a ‘shifting’ schedule for the first few days.

Dawn Simulation has also been proven to help. Dawn simulation helps you maintain a consistent circadian rhythm by sending a properly timed signal of light through the retina of the eye to the brain’s body clock. The light signal slowly increases in intensity, just like a morning sunrise. Advanced Circadian Rhythm Disorder: ACR means your body clock is running faster than a normal, melatonin is released prematurely, and consequently, you run out of energy before the day is through. ACR also compresses the sleep portion of your daily cycle, causing you to lose valuable sleep. ACR sufferers often sleep less than 8 hours per night, and awaken early. Treatment Recommendations: Specialized bright light (2,500 - 10,000 lux intensity) is the only effective treatment for ACR. Since bright light will suppress melatonin for approximately three hours, it should be used in the late afternoon and or evening while, at the same time, avoiding bright morning light before nine am. If you need to be outside or in bright light before this time, you should wear sunglasses. Also, try to make your night as dark as possible, and avoid using light when getting up during the night. Well, it’s 3:30 a,m. now, and I think I will try going back to bed, hopefully with sweet dreams!  Goodnight!