Advanced Sleep-Wake Phase Disorder

Last updated: April 6, 2019

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

Advanced Sleep-Wake Phase Disorder (ASP) is a disorder that belongs to a group called Circadian Rhythm Sleep Disorders. When a person has this disorder, he sleeps at a time that is earlier than what is “normal” for others. This is the exact opposite of what Delayed Sleep-Wake Phase Disorder (DSP) does to people. A person afflicted with ASP has a Circadian Rhythm that is set earlier than others. People with ASP sleep several hours earlier than people with normal Circadian Rhythm. Because of this earlier sleeping time, they also wake up earlier than most people do.

What are the signs and symptoms of Advanced Sleep-Wake Phase Disorder?

A person with ASP may experience one or more of the following:

  • An uncontrollable urge to sleep during the late afternoon or early in the evening. A person with ASP typically experiences a strong and often irresistible urge to fall asleep especially between 6 PM to 9 PM. This, coupled with the early arousals, lead to a disruption in the Circadian Rhythm. Once a person’s Circadian Rhythm or Sleep-Wake Cycle gets disrupted, that person will experience restless sleep and fatigue. These will make staying awake until bedtime even more challenging.
  • Waking up early in the morning and being unable to go back to sleep. It is typical for a person with ASP to fall wake up between 2 AM and 5 AM. Since they are often unable to go back to sleep after waking, they tend to start their days earlier. This can disrupt not just their sleep pattern but the sleep patterns of those around them especially their bed partners.
  • Falling asleep while performing passive activities like watching TV, driving, or eating. This is another offshoot of the fatigue caused by the disrupted Circadian Rhythm. It is because of this symptom that doctors sometimes confuse ASP with narcolepsy.

The signs listed above points to the possibility of having ASP. However, it is important to ensure that the said symptoms are not because of another factor. A consultation and thorough diagnosis conducted by a doctor or a sleep specialist can rule out other causes such as:

  • Another medical condition
  • Other sleep disorders
  • Mental health issue
  • Medication

Risk Factors

Some people are more prone to getting ASP compared to others. This disorder is more prevalent in the elderly. As a person gets older, his natural response to light gets weaker. More so for those who have cataracts because problems with the lens of the eyes weaken a person’s ability to take in light.

Genetics is another factor that needs to be considered. Advanced Sleep-Wake Phase Disorder is more common to some families. ASP is associated with the mutation of the genes, particularly the casein kinase gene (CKI- delta and CKI- epsilon) as well as hPer1 and hPer2.

Children with developmental disorders are also more prone to ASP. These include autism and Down Syndrome.

How is ASP treated?

ASP is a disorder caused by the change in a person’s body clock. In the treatment of ASP, the body clock gets reverted to its normal schedule. There are two treatments that can help reset the body clock: melatonin supplements and light therapy.

Melatonin is the hormone of sleep and can help reset the body clock. A doctor can prescribe the recommended daily dose of melatonin supplement depending on the age and health condition of the patient.

Light therapy uses bright lights as visual stimulants. This is done before going to bed. A sleep specialist will determine the brightness of the light and the duration of exposure that a patient will use for the therapy.

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The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.