Circadian rhythm sleep disorders

Circadian rhythm sleep disorders (CRSDs) include shift work disorder (SWD) and jet lag disorder (JLD). These differ to insomnia in that the sleep disturbance is due to changes in the circadian system or a misalignment between the individual’s circadian rhythm and environmental factors, such as light and social cues, that affect the timing or duration or sleep. 

Impairment in social or occupational functioning is common, and distinctive in nature from the difficulty falling or staying asleep or frequent awakening that defines insomnia. 

For SWD, occupational health should ideally be involved to minimise the impact, and there is also advice available from the Health and Safety Executive. 

Similarly, adhering to sleep hygiene measures will help someone with JLD – note that the evidence for the use of melatonin is limited and conflicted in terms of benefit, with NICE’s Clinical Knowledge Summary advising against it. 

Jet lag can also have implications for medication regimens, with one of the most significant being diabetes. Advice on this has been published by Diabetes UK.