Circadian Rhythm Disorders | Riley at IU Health

The minds and bodies of adults, children and practically all living organisms on the planet follow the 24-hour day-night cycle of the earth and sun. Called circadian rhythm (circadian means “around the day”), it affects when we sleep or rest and when we are awake or active.

Circadian rhythm sleep disorders may occur when a child’s biological clock gets out of sync with standard time. The child may have difficulty falling asleep at his or her usual bedtime, have difficulty waking up in the morning or be sleepy at unusual times during the day.

Symptoms of circadian rhythm sleep disorders include:

Daytime sleepiness
Difficulty falling asleep
Difficulty staying asleep
Excessive sleepiness
Lack of daytime alertness
Poor concentration
Sleep that is not restful

The most common pediatric circadian disorder is known as delayed sleep-wake phase syndrome. With this syndrome, a child can function normally when he or she sleeps on a delayed schedule, such as 1 am to 10 am, but has trouble sleeping on a more typical schedule, such as 10 pm to 7 am. It can be more problematic during the school year.

Diagnosis of Circadian Rhythm Disorders

Evaluation by a sleep specialist at Riley at IU Health can help determine the presence of a circadian disorder. Diagnostic methods include:

Sleep diary. You or your child will keep a daily log of times when he or she is awake and asleep over a specified period of time.
Actigraphy. Your child will wear an actigraph, a wristband like device that makes 24/7 measurements of sleep-wake times over a period of one or two weeks.

Treatments

Treatment usually involves behavioral modification, sometimes in conjunction with timed bright light therapy or medicine. Treatment for circadian rhythm disorders includes:

Sleep scheduling. Going to bed at night and waking in the morning at the same times every day helps your child better adapt to a desired schedule.
Light therapy. Timed exposure to bright light can help shift the sleep-wake schedule.
Behavioral plans. A sleep medicine specialist will help you develop plans to resolve behaviors such as bedtime refusal and night waking.
Chronotherapy. This is a gradual planned shift of your child’s bedtime, a little each day, until the optimal bedtime is reached.
Medicines. These may include melatonin, a hormone that helps regulate sleep.

Key Points to Remember

Circadian rhythm sleep disorders may occur when a child’s biological clock gets out of sync with standard time.
A sleep specialist can diagnose a circadian rhythm disorder.
Delayed sleep-wake phase syndrome is the most common childhood circadian rhythm disorder.
Circadian rhythm disorders may be more problematic during the school year.
Therapies and medicines can treat circadian disorders.

Support Services & Resources

For more information on circadian rhythm disorders, please visit the trusted resources below.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

Circadian Sleep Disorders Network

This independent nonprofit organization is dedicated to improving the lives of people with chronic circadian rhythm disorders.

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.

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Departments Treating This Condition

Sleep Medicine