Circadian Rhythm Disorders

This group of disorders involves a disruption of the inherent circadian pattern of wakefulness and sleep. y Jet lag arises from transmeridian flights of long duration, usually through at least three time zones, and reflects the adaptation necessary to reset the internal rhythm to the day-night cycle of the destination. Jet lag is enhanced by the sleep deprivation that usually occurs before a prolonged trip, loss of sleep, and altered conditions during flight. Depending on the distance traveled, recovery may take as long as 7 days, especially for eastward travel.

In contrast, shift workers are required to change their major sleep period without the reinforcement of external light-dark cycles and in the absence of social patterns that conform to their new sleep schedule. Following a single change in shift, 2 weeks may be needed for readjustment. However, often shift workers are required to change their schedules every 2 to 4 weeks, and frequently are progressively

changed from night to afternoons to morning shifts. Thus, they may have a chronic desynchronization with their circadian clock.

Finally, there are so-called natural night owls and morning larks who are most comfortable with their major sleep period either later or earlier than can accommodate socially acceptable daytime activities, such as work or school.

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