Common conditions

If you get sleepy or fall asleep before your desired bed time, you may have advanced sleep phase syndrome (ASPS). People who have ASPS experience early evening tiredness. They go to bed earlier than planned and wake up earlier. 

People with ASPS get the amount of sleep they need. They just get it at undesired times.

Unlike other sleep disorders, people who have ASPS do not experience problems with concentration or performing their jobs and tasks; however, they have less time in the evening to complete tasks. They have less time to spend with family and friends because of going to bed early.

Treatment for ASPS may include bright light therapy or chronotherapy. Bright light therapy involves being exposed to a strong light for 15 to 30 minutes in the early evening. Chronotherapy involves “resetting” your circadian rhythm by changing the times that you go to bed, every day, until you reach your desired bedtime.

Delayed sleep phase syndrome (DSPS) is when a person wants to go to bed, but cannot fall asleep for two or more hours. 

People who have DSPS are considered night people, meaning they function better and feel more alert in the evening or at nighttime. They fall asleep around the same time every night, generally at a very late hour.

DSPS is different than insomnia. Unlike people with insomnia, people with DSPS can fall asleep; however, the time they fall asleep is delayed from regular bed times. This can make it difficult to get up for school or work. 

DSPS is very common among school-age adolescents. Many schools across the country are considering moves to later start times to fit adolescents’ internal time clocks.

Symptoms of DSPS include:

• not able to fall asleep at desired bedtime
• not able to wake up at desired wake time
• depression (occurs in nearly half of adults who have DSPS)
• daytime sleepiness or tiredness
• difficulty concentrating

Treatment for DSPS may include bright light therapy, chronotherapy or medication. Bright light therapy involves being exposed to a strong light for 15 to 30 minutes in the early evening.

Chronotherapy involves “resetting” your circadian rhythm by changing the times that you go to bed, every day, until you reach your desired bedtime. Medication may be a short-term option for treating DSPS, and may consist of prescription sleep aids, vitamin B-12, melatonin or over-the-counter sleep aids.

Insomnia is the most common sleep complaint, affecting 20 percent to 40 percent of all adults (especially women and the elderly). Difficulty falling asleep and staying asleep may be caused by psychological, physiological or environmental problems. One factor is a change in sleep patterns as people age. Older people may find it more difficult to fall asleep and may awaken more often.

Learn more about insomnia causes, treatment and self-care.

People with narcolepsy have a sudden, uncontrollable tendency to sleep at inappropriate times. In addition to periods of overwhelming sleepiness during the day, narcoleptics may suddenly lose muscle control or have vivid dreams. These symptoms are sometimes brought on by an emotional situation.

There is no cure for narcolepsy, and treatment focuses on controlling narcoleptic episodes. Treatment may include planned daytime naps, diet and medication.

Naps may be planned throughout the day to cut down on the number of episodes. Prescription medications may be used to help you control episodes. These medications may include certain antidepressants and stimulants.

When people wake up several times a night because they have stopped breathing in their sleep, it is called obstructive sleep apnea (OSA). People with OSA experience breathing lapses of greater than 10 seconds during sleep. It is not uncommon to document apneas of 30 to 90 seconds. These episodes can occur up to 100 times a night, even causing blood oxygen levels to drop.

Symptoms of sleep apnea include loud habitual snoring, high blood pressure and excessive daytime sleepiness. People with sleep apnea may not be aware of their symptoms or may minimize their severity. Often, a family member, employer or co-worker will first recognize the symptoms.

While it simply may be an annoyance to others, it could be life-threatening to you. Untreated, OSA can put people at risk for serious health issues, including heart attacks, high blood pressure, weight gain and acid reflux.

One common prescribed treatment is the use of continuous positive airway pressure (CPAP) equipment. Learn more about sleep apnea causes, treatment and self-care.

People who have restless leg syndrome (RLS) describe a very unpleasant, restless feeling in their legs during or before bedtime. People who have periodic leg movement disorder experience leg jerking or twitching at regular intervals throughout the night.

Symptoms consist of creeping, crawling or uncomfortable sensations only relieved by moving the affected parts of the body. In addition to excessive daytime sleepiness, people with these disorders may have difficulty falling asleep or staying asleep. People who have RLS also can affect others around them, if they share a bed.

Treatment for RLS may depend on whether RLS is caused by another illness or condition. Treating the other condition often resolves RLS or makes it less severe. If RLS is the only condition, medication may be used to help control symptoms.

A range of prescription medications is used to treat RLS, from antiseizure medications to those used to treat Parkinson’s disease. Other self-care methods for treating RLS include exercising, losing weight and limiting or stopping tobacco, caffeine and alcohol use.

In our 24-hour society, not all jobs can be day jobs. As a result, shift-work sleep disorder has become more prevalent. Shift work sleep disorder (SWSD) refers to any shift outside standard hours of 9 a.m. to 5 p.m.

Shift workers include firefighters, customer service employees, commercial drivers, health care employees and many others.

Shift workers are more vulnerable to illness and chronic health problems involving the heart and digestive system. Symptoms of SWSD include:

• insomnia
• sleepiness
• accidents and errors at work
• difficulty concentrating
• irritability or depression

SWSD treatment may involve medication, lifestyle changes and bright light therapy.

Medications that may be used include stimulants for staying awake during your shift and hypnotics for sleeping during the day. Lifestyle changes include cutting down on or eliminating caffeine, tobacco and alcohol. Using bright light therapy during your shift may help reset your circadian rhythm to your shift-work schedule. 

You also should make sure your room is dark and noise-free when you are trying to sleep. Keep the same sleep schedule, even on your days off.

When a person crosses more than two time zones because of travel, his or her internal clock is affected. Travelers who have gone through three time zones may need up to three days to “reset” their internal clocks.

Symptoms include fatigue, irritability, difficulty sleeping, loss of appetite, difficulty concentrating and feeling disoriented.

There are self-care methods you can do to make time-zone change syndrome less severe, which include:

• eating light meals (nothing heavy or fried)
• drinking plenty of fluids, especially when flying
• exercising
• simulating a new time zone (meal times, sleep) before your trip
• taking melatonin as a supplement
• taking sedatives or sleep medication

Good sleep practices also help speed recovery from time-zone change syndrome.

Unlike a lot of other sleep disorders, time-zone change syndrome resolves itself once your internal clock resets. It usually does not require medical help.