The clock has an immense significance in human lives. It schedules their day to day activities. Besides the exterior clock, there is also a biological clock ticking inside us that sets our bedtimes, eating intervals and hours of wakefulness. This is also called the circadian rhythm of the body. Sometimes this rhythm gets desynchronized which causes the person to sleep late at night. This is called the Delayed Sleep Phase Syndrome (DSPS). A lot of clinical procedures are in place to reset the lost circadian rhythm. One of these is chronotherapy.
Scheduling Chronotherapy
In chronotherapy a person’s sleep hours and waking hours are moved systematically each day until the desired bedtime is reached. This can take over a week’s time. Usually sleep hours are postponed by three hours every day. Here is an example of chronotherapy. If a patient, with usual sleep hours at 2 a.m. starts this therapy from the first day of the week, then his bedtimes would be,
• Monday: 5 a.m. to 1p.m.
• Tuesday: 8 a.m. to 4 p.m.
• Wednesday: 11 a.m. to 7 p.m.
• Thursday: 2 p.m. to 10 p.m.
• Friday: 5 p.m. to 1 a.m.
• Saturday: 8 p.m. to 4 a.m.
• Sunday and henceforward: 11 p.m. to 6 a.m.
There is another type of chronotherapy which is called controlled sleep deprivation with phase advance (SDPA) or reverse chronotherapy. In this the sleep phase is advanced instead of being postponed. Here, the patient has to stay wake one whole night and day. Thereafter he goes to sleep 90 minutes earlier than usual. He maintains this schedule for a week. After a week the process is repeated till the normal bed time is reached.
B-Sides of Chronotherapy
Unlike other clinical procedures to treat DSPS, chronotherapy requires strict discipline on the patient’s part to reach the goal. Patients have to take a break from their day-to –day job because of their peculiar waking hours, when under the therapy. Many patients walk out of it being unable to maintain the set routine. Reverse chronotherapy is often used in treatment of patients where the bedtimes is shifted to later times of the day. However, a circadian rhythm is usually of 24 hours, so the usefulness of this procedure is yet to be established. Although chronotherapy has successfully restored the circadian rhythm of patients, a deviation in subsequent period may shift it again. Moreover the absolute number of sleep hours for humans to be fully functional is not known. Some may do with 3 to 5 hours while others may need 7 to 8 hours. As a result, the application chronotherapy remains arbitrary by and large. Cases have been reported where patients undergoing chronotherapy have contacted Non-24-hour sleep-wake syndrome. The therapy slowed down the body’s internal rhythm to such an extent that 24hours become insufficient.
Final Words on Chronotherapy
I hope this article on chronotherapy was useful to patients of DSPS and wish them luck in knocking out insomnia and waking up energized.
