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  • Updated 03.28.2021
  • Released 11.22.1993
  • Expires For CME 03.28.2024

Advanced sleep-wake phase disorder

Introduction

Overview

In this article, the author discusses the pathophysiology and treatment of this circadian rhythm sleep disorder. Hallmarks of this disorder include an advance in the habitual bedtime and wake time by several hours. The early morning awakening seen in this disorder may be mistaken for insomnia or depression. This is the first circadian rhythm sleep disorder for which a genetic cause was demonstrated. Current treatment primarily depends on the use of evening light therapy. Timed melatonin may theoretically be efficacious, but further trials are needed.

Key points

• Advanced sleep-wake phase disorder consists of stable, advanced, habitual sleep and waking times, which can be seen more frequently in elderly individuals.

• Several large kindreds with autosomal dominant familial advanced sleep-wake phase disorder have been described.

• In some families, various missense mutations in clock genes were found.

• This is the first hereditary circadian rhythm variant described in humans.

• Treatment is largely empirical; timed light and melatonin may be tried.

Historical note and terminology

This disorder was initially referred to as advanced sleep phase syndrome, then was later classified as circadian rhythm sleep disorder, an advanced sleep phase type. Throughout this article the current formal name advanced sleep-wake phase disorder, established in the third edition of the International Classification of Sleep Disorders will be used (01). The preferred common name is advanced sleep phase disorder.

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