Behavioral Treatment of Circadian Rhythm Disorder Circadian rhythm disorder refers to a group of disorders characterized by sleep that is out of synch with one's natural rhythm or what is considered a healthy sleep cycle. Jet lag causes temporary disruptions to a person's circadian rhythm, while other types - routinely falling asleep at 4 a.m. and waking up too early, a phenomenon seen in many adolescents -- cause disrupted sleeping and waking patterns that can lead to chronic insomnia. If you suffer from a sleep problem associated with a disruption to your biological clock, there are a number of treatment options to consider, including behavioral modifications and medications.

Behavioral treatments include:

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• Chronotherapy. This behavioral treatment consists of gradually shifting the sleep time in accordance with your desired schedule. For example, if you have trouble getting to sleep at your desired bedtime, you would delay your bedtime by a few hours each night until you reach your desired bedtime hour. The reverse would be true if you are falling asleep earlier than your desired bedtime; you would then advance your bedtime by a few hours each night until the desired bedtime is achieved. Once your desired bedtime has been established, you must adhere to this schedule on a regular basis.
• Bright light therapy. People who have a circadian rhythm disorder respond well to light therapy, especially bright light therapy. A sleep specialist will advise you on the appropriate timing, strength and duration of the light therapy, as it will vary based on your individual needs.
• Enhancing environmental cues. Keep a dark and quiet room during sleep and a well-lit room upon awakening. Avoid bright light exposure in the evening and enforce regular hours for eating and other activities.

Tips to Promote Sound Sleep

As always, maintaining good "sleep hygiene," or sleep-promoting behavior, is important to treating any sleep problem, including circadian rhythm disorders. Here are some tips:

• Go to sleep and wake up at the same time each day.
• Avoid napping.
• Use the bed only for sleeping and being intimate.
• Try to avoid stress, fatigue, and sleep deprivation.
• Avoid vigorous exercise at least four hours prior to bedtime (but do exercise earlier in the day).
• Avoid cigarettes, alcohol, and caffeine.
• Avoid large meals and excessive fluids before bedtime.
• Control your sleeping environment, keeping it dark, quiet, and at a comfortable temperature. A controlled sleeping environment is especially important for shift workers and night workers.