Circadian Rhythm Sleep Disorder

Persistent or recurrent pattern of sleep disruption leading to excessive sleepiness or insomnia, that is due to a mis-matching between the sleep/wake schedule required by a person's environment and their circadian sleep-wake pattern. The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The disturbance does not occur exclusively during the course of another Sleep Disorder or other mental disorder and the disturbance is not due to the direct physiological effects of a substance. General characteristics are:

There is a persisting or repeating mismatch between a person's sleep-wake pattern and the sleep-wake demands of that patient's environment.

The mismatch leads to excessive insomnia or sleepiness.

This problem causes clinically important distress or impairs work or social life.

It doesn't occur solely during another mental disorder or Sleep Disorder.

It is not directly caused by a general medical condition or substance use, including medications and drugs of abuse.

Specify:

Delayed Sleep Phase Type. The patient repeatedly has trouble getting to sleep and trouble awakening on time.

Jet Lag Type. Alertness and sleepiness occur at inconvenient times of day after traveling across more than one time zone.

Shift Work Type. Because of night shift work or frequently changing job shifts, the patient experiences excessive sleepiness during major periods of wakefulness or insomnia during major sleep period.

Associated Features: 

Learning Problem.
Depressed Mood.
Hyperactivity.
Addiction.
Dramatic or Erratic or Antisocial Personality.

Differential Diagnosis :

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

Oppositional Defiant Disorder.
Attention-Deficit/Hyperactivity Disorder.
Manic Episode.
Adjustment Disorder.
Child or Adolescent Antisocial Behavior.
Antisocial Personality Disorder.

Circadian Rhythm Sleep Disorder causes periods of insomnia, sleepiness, or both, depending on the time of day and how much time the person has to make up for the insomnia. Only in severe cases of disruption would a person with this type of difficulty seek treatment. The relative normalcy of this disorder is indicated by its subtypes, which include "shift work type" and "jet lag type," along with "delayed sleep phase" and "unspecified" types. Difficulties with adapting to changing work shifts and jet trips are so universal that they hardly deserve to be called disorders, and are so classified only if they cause significant distress or impairment, as with all disorders.

Treatment:

Treatment is varied depending upon the cause of the disorder. This may involve behavioral therapies and drug treatment.