People with circadian rhythm sleep/wake disorders are not lazy or avoiding you. It may be difficult for someone with a delayed clock (DSPD) to be on time for an early appointment. Similarly, someone with an advanced clock (ASPD) may simply be unable to stay awake to socialize in the evening. Trying to live outside their body’s rhythm often results in sleep deprivation, which in turn is associated with chronic tiredness, lapses in attention and greater risk of mental and physical health problems. SRBR researchers are currently working to understand the biology behind sleep and circadian disorders, and how to better treat them. However, a greater social understanding may already go a long way to making the life of people with a circadian rhythm disorder easier! On this page, you’ll find practical tips on how to support someone with a circadian rhythm disorder. For more information, visit the Circadian Sleep Disorders Network’s website.
Flexible working hours
Trying to achieve a 9am-5pm working schedule may not be achievable for someone with a circadian rhythm disorder. Flexible working hours allow people to work with their body’s schedule and avoid the sleep deprivation that comes with forcing themselves to wake up early or stay up late. Allowing employees to work according to their chronotype reduces the mismatch between circadian and working time, increasing productivity and reducing health risks. Some companies limit meetings to “core hours” (for example, between 11am and 3pm) to accommodate employees’ various schedules, including sleep-wake cycles and family commitments. Check your company’s policy on working hours, and raise the issue with your human resources department.
For children with delayed sleep phase disorder (DSPD) and Non-24, education is a significant problem due to the conflict between the early school start times and their naturally late rhythm. This can result in chronic lateness, fatigue, reduced alertness (particularly in the morning), and lower academic performance. Whilst adjustments are made for other medical conditions, e.g. ADHD (attention deficit hyperactivity disorder), circadian rhythm disorders are so far not as well accommodated in the school system. Similar provisions, such as a later school start time, a lighter or more flexible workload, and additional time during exams would also be beneficial for students with DSPD and should be discussed with teachers and support staff.
In addition, because the majority of teens experience delayed sleep during adolescence, there is a global effort to start schools (especially high school) later. Students, particularly teenagers, tend to fall asleep later and wake up later than adults. This means that early school hours force students to wake up much earlier than their natural rhythm, resulting in sleep deprivation and a negative impact on academic performance. Later school start times will help teens study, and flexible exam times will allow assessments to be taken at times of greater concentration.
What not to say to someone with a CRSD
“Can’t you just go to sleep earlier?”
People with delayed clocks may be able to fall asleep earlier if they are very tired, but even if they do this rarely provides a restful sleep. Have you ever tried to make yourself sleep earlier?
“You can make up sleep on the weekends.”
Whilst it is true that many delayed sleepers (including adolescents) ‘sleep in’ on the weekends or free days, this is not as effective as it may seem. First, trying to repay the sleep lost over 5 working/school days in just 2 days is very difficult. Second, the disruptions caused by lack of sleep may not be fixed by simply sleeping longer on a weekend. In fact, a recent study showed that the disruption to metabolism (weight gain, reduced insulin sensitivity) caused by insufficient sleep was not improved with weekend recovery sleep.
“You could sleep earlier if you were not so nervous / depressed / anxious.”
Sleep and mood are linked, but it goes both ways – mood can affect sleep but sleep also affects mood. Persistently living against your clock to fit in with a work schedule can certainly make someone feel more nervous, depressed or anxious. Whilst you might mean well and be concerned for the person’s mental and physical wellbeing, statements like this are unhelpful and further stigmatize the disorder. Instead, try to accommodate their sleep-wake patterns in your activities and listen to their concerns.