News ArchivesRead News
Sleeping (or Not) by the Wrong Clock
Thursday April 22, 2010
AARPBulletintoday - Despite his best efforts, Cliff, 28, could not get to sleep until about 7 a.m. It had been this way since he was a teenager. He was a healthy and successful young scientist — except that he didn’t arrive at the lab until 5 p.m., just as his co-workers were preparing to leave.
Although he got his work done by pulling all-nighters, he became isolated from the group. Sleeping pills didn’t work. Nighttime alcohol bouts got him to sleep sooner, but only by two to three hours — a bummer on many levels. Significantly, Cliff was not depressed.
George, a 34 year-old paralegal, had a much more common experience. He could rarely sleep until 1:30 a.m. Inured to sleeping pills, he would get into bed at midnight, hoping for the best. He had to be awake at 7:30 in order to make it in by 9, but it was a losing battle. Almost always late, he remained foggy until afternoon, and suffered headaches. Unlike Cliff, George was mildly depressed.
Cliff and George, whose names have been changed here to protect their privacy, are two of hundreds of patients we’ve treated at the Center for Light Treatment and Biological Rhythms at Columbia University Medical Center (where I serve as clinic director), and in research trials supported by the National Institute of Mental Health and the Sleep Research Society Foundation at the New York State Psychiatric Institute (where I have been a principal investigator).
Both Cliff and George were treated using chronotherapeutics — methods designed to reset the internal circadian clock.,  George was dealing with sleep onset insomnia, a problem for millions of people. We inferred clinically that his circadian clock signal for sleeping was delayed relative to local time. People sleep best when the internal clock is in sync with the workday rest/activity cycle. When there is a mismatch, the likely results are insomnia, depressed mood and daytime fatigue.
An unbalanced circadian rhythm can be returned to equilibrium through the application of light to a sleeper’s retina near the end of a person’s “internal night.” Internal night? Yes — it may be night outside, but if your circadian clock is not prepared for sleep, internal night may not start until late and last well into morning. Biologically, it coincides with the secretion of melatonin by the brain’s pineal gland. It is difficult to know where your internal night lies if you artificially force sleep earlier, for example with sleeping pills. You can estimate internal night with a quick chronotype questionnaire  that helps determine when light exposure will be most effective for syncing your circadian rhythm with external reality.
George began therapy at 8 a.m every day with 30 minutes of 10,000 lux bright light.  This had no effect. But when we switched the timing to 7:30, he immediately started getting to sleep an hour earlier, by 12:30 a.m. However, he began waking up far too early, before 6 a.m. This indicated an overdose of light. When we reduced light exposure to 15 minutes, still at 7:30 a.m., he began falling asleep at midnight and waking up just before alarm (a few minutes before the scheduled light exposure). Within a week of starting treatment, his depression lifted, he was more alert in the morning and his headaches vanished. Lesson learned: just as with drugs, light therapy needs to be individually dosed, which may require a clinician’s guidance.
Recent NewsNov 17 - 'Moving Day' participant is not letting young-onset Parkinson's disease stop him
Nov 17 - Focused ultrasound shows promise for treating Parkinson's tremor
Nov 17 - New research to target air pollution as a potential trigger for Parkinson’s
Nov 17 - This device will let you feel what it's like to suffer from Parkinson's
Nov 10 - How does Parkinson's disease influence depression?
Nov 10 - House votes to repeal ObamaCare's Medicare cost-cutting board
Nov 10 - Microsoft shows off watch that quiets Parkinson's tremors
Nov 3 - Utah group battling Parkinson's disease with boxing
Nov 3 - UVA-LED STUDY EXAMINES POTENTIAL OF SOUND WAVES TO MANAGE PARKINSON’S DISEASE
Oct 27 - Herbicide's link to Parkinson's disease
Oct 27 - NTU Singapore, KAIST scientists discover new mechanism that causes Parkinsonian symptoms
Oct 27 - 70,000 Washingtonians face higher insurance costs after Trump order, officials say
Oct 18 - Brain disconnections may contribute to Parkinson's hallucinations
Oct 18 - Fighting Parkinson's disease through dance
Oct 17 - Scientists Identify Structure of PINK1, Key Parkinson’s-protective Protein
Oct 17 - Diabetes drug cuts Parkinson's risk by 28 percent, study finds
Oct 10 - Advances in Brain Pacemaker Reduces Tremors, Helps Parkinson's Sufferers Live a More Normal Life
Oct 10 - Medical History Could Help Predict Parkinson's Disease Risk Long Before Diagnosis
Oct 3 - Changes in Olfactory Bulb Explain Loss of Smell in Early Stages of Parkinson’s Disease, Study Finds
Oct 3 - Sleep Disturbances May Worsen Motor Symptoms in Parkinson’s Disease, Study Suggests