Do you have a hard time staying awake in the afternoon or early evening?
An especially hectic schedule or a physically challenging work day can make us tired earlier than normal, but if you are falling asleep early on a regular basis, it could be a sign of a sleep disorder.
Advanced Phase Sleep Disorder
Falling asleep too early is a symptom of Advanced Phase Sleep Disorder, and it often goes hand-in-hand with Sleep Maintenance Insomnia. Both are problems that disrupt your sleep cycle and affect the quality of sleep.
What typically happens with this pair of sleep issues is this: you go to bed early, say before 9 p.m., but around 2 to 4 a.m., you wake up and cannot get back to sleep.
Humans have been waking up in the middle of the night for a very long time. At least since the 15th century, historical documents refer to the concept of “first sleep” and “second sleep,” noted Michael Stout, clinical sleep medicine technician, with Samaritan Pacific Communities Hospital in Newport.
“People would go to bed when the sun went down, which was their first sleep, and then awake around 2 a.m., have tea, visit their neighbors, and then go back to sleep for their second sleep,” Stout said. “Rather than treating the issue, they learned to embrace it, but in our modern era, that practice no longer works for us.”
Causes & Prevention
What causes this cycle of disrupted sleep and how can we try to prevent it?
“Our sleep-wake cycles are governed by our internal biological clock, or circadian rhythm. The human body loves consistency, and when that consistency is disrupted, our sleep can be impaired,” said Stout.
“That disruption can be caused by ways that we unintentionally sabotage our sleep, or by fluctuations in the balance of hormones and neurochemicals in our bodies,” he said.
Behaviors that can lead to sleeplessness include using caffeine, nicotine or alcohol just prior to bedtime, as well as exposure to blue wave light late in the day. Blue-wave light is the type of light found in electronic devices, LED lights or the curlicue-style light bulbs.
“Try to avoid using electronic devices right before bed, including television, and to lessen the effects of blue-wave light. Consider ways to soften the light, like adding a red shade to your lamp, or dimming the lights closer to bedtime,” he said.
If changing these behaviors do not help, your clinician may recommend several treatment options, such as light therapy, chronotherapy, melatonin supplements or medication.
Light therapy involves timed and consistent exposure to a high-intensity light box in the morning hours, soon after awakening, to help reset one’s sleep-wake cycle.
“The special light box, which mimics outdoor light, may work for some people to help adjust circadian rhythm,” Stout said. “A sleep medicine clinician can help you determine how best to use this therapy for your specific condition.”
Clinicians also treat sleep-wake disorders with chronotherapy, which involves stretching out the time a person falls asleep.
“If you typically go to bed at 8:30 p.m., stay up until 9:30 p.m. or later,” Stout suggested. “Forcing yourself to stay awake longer enables you to fall asleep immediately and can help you stay sleeping through the 2 to 4 a.m. timeframe.”
Sometimes this can be difficult to do on your own, but a health professional can help.
Additional options for sleep therapy can include the use of melatonin supplements or sleep-related medications. While you can purchase melatonin supplements over the counter, a sleep medicine professional can help you determine the right type and the best timing to take the supplement.
Track Your Habits
One way to prepare for a conversation with a sleep specialist is to keep a sleep diary over the course of several weeks. Track the times you go to bed, the times you awake, and how you feel upon waking. You may also include foods and substances you ingested prior to bed for additional understanding of your condition.
“All in all, sleep is the most effective way to treat sleeplessness,” said Stout. “What I mean by that is that the more we are diligent at making good quality sleep a priority, the better. Keep good habits, have a set sleep schedule, be mindful of how your behaviors sabotage sleep and make changes — all of that will go a long way in getting you a good night’s sleep.”
If you have tried these behavior changes and still have problems sleeping, talk with your clinician about whether medication is an option, or whether you are a candidate for a sleep study to rule out more dangerous sleep disorders.
Attend Michael Stout’s class about insomnia coming up in early September in Newport.