Insomnia Treatment Option: Chronotherapy

Delaying Sleep Periods Treats Circadian Rhythm Problems

If you are having trouble falling asleep at your desired bedtime, a common symptom of insomnia, what role could a treatment called chronotherapy have? How is chronotherapy done? Where is the best place to undergo chronotherapy?

To answer these questions, let’s review an excerpt from UpToDate - a trusted electronic medical reference used by healthcare providers and patients alike. Then, read on for additional information about what all of this means for you.

"Chronotherapy is also used in people with circadian rhythm sleep disorders. It involves intentionally delaying going to sleep by two to three hours on successive days until you are able to fall asleep at the desired bedtime. This can be difficult to do at home and is sometimes done in a hospital setting. After this, you must strictly enforce this sleep-wake schedule."

Chronotherapy is a helpful therapy for those who have difficulty initiating sleep. Insomnia may have many causes; sometimes it is due to a problem with the timing of the desire for sleep. There are many biological processes, including sleep patterns, that follow a circadian rhythm. Problems with this can lead to one of the circadian rhythm sleep disorders, most commonly delayed or advanced sleep phase syndrome.

As a means to reset the timing of sleep, chronotherapy can be very effective. As mentioned above, it involves the delay of sleep by several hours on successive days.

What may not be clear, however, is that this delay continues day after day, with the sleep period moving around the 24-hour clock. This may be illustrated with an example: If you have delayed sleep phase syndrome, you may find yourself falling asleep at 3 a.m., when you really wish to be in bed by 11 p.m. instead.

You may follow the following schedule as you adjust your sleep timing with chronotherapy:

  • Day 1: Bedtime 6 a.m.
  • Day 2: Bedtime 9 a.m.
  • Day 3: Bedtime 12 noon
  • Day 4: Bedtime 3 p.m.
  • Day 5: Bedtime 6 p.m.
  • Day 6: Bedtime 9 p.m.
  • Day 7 and thereafter: Bedtime 11 p.m.

Such a regimen must be strictly adhered to, and often it is necessary to undertake the chronotherapy treatment in a controlled setting, such as in a hospital. In some cases it may be necessary to make adjustments in smaller intervals, advancing your bedtime by only one to two hours. Slight variations or lapses in the schedule will leave you returning to your old ways. Once the new timing of the sleep period is established, it should be strictly observed.

Want to learn more? See UpToDate's topic, "Insomnia treatments," for additional in-depth medical information.

Source:

Bonnet, Michael et al. "Insomnia treatments." UpToDate. Accessed: October 2011.

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