Circadian rhythm disorder treatment in Fort Lauderdale
When your body clock and your life keep pulling in different directions, from shift work to being a lifelong night owl, Dr. Camilo Ruiz helps you understand why and builds a plan that fits your schedule.
Camilo Ruiz, DO · Board-certified in sleep medicine and internal medicine
How are circadian rhythm disorders treated?
Treatment aims to move your body clock closer to the schedule you need. The main tools are a steady sleep and wake schedule, bright light at the right time of day, avoiding light at the wrong time, and in some cases low-dose melatonin taken at a set time. Timing matters more than strength. A sleep doctor first confirms the type of problem, often with a sleep diary or a wrist activity monitor.
Does this sound like you?
- I can't fall asleep until 2 or 3 a.m., and then I can't get up for work.
- I get very sleepy by early evening and wake up at 4 a.m. no matter what.
- I work nights and I can never get good sleep during the day.
- My sleep is broken up into short naps around the clock.
- My bedtime keeps drifting later and later each week.
- After flying across time zones, it takes me days to feel normal.
How Dr. Ruiz evaluates and treats body-clock problems
A careful sleep history
Dr. Ruiz asks when you naturally get sleepy and wake up, how that changes on days off, your work hours, travel, light exposure, and the medicines you take.
Sleep diary and actigraphy
You may keep a sleep diary for a week or two. Dr. Ruiz may also have you wear an actigraph, a small wrist device that records movement, to show your real sleep and wake times over many days.
Ruling out other sleep disorders
Insomnia, sleep apnea and other conditions can look like a body-clock problem. If your history points to one, Dr. Ruiz may order a sleep study.
Timed light
Bright light, from daylight or a light box, can shift your clock earlier or later depending on when you get it. Dr. Ruiz explains when to seek light and when to avoid it.
Timed melatonin
For some types of circadian rhythm disorders, a low dose of melatonin taken at a specific time may help shift the body clock. Dr. Ruiz advises on timing, dose and whether it is right for you.
A schedule you can keep
Dr. Ruiz helps you plan sleep, meals, naps, caffeine and light around your work or travel, then follows up to adjust the plan.
Is it insomnia or a body-clock problem?
Many people who say they have insomnia are really fighting their own clock. A true "night owl" with delayed sleep-wake phase disorder may lie awake for hours at 11 p.m. but fall asleep easily at 2 a.m. and sleep well until late morning if allowed. Their sleep is fine. It just happens at the wrong time for their job or school.
An early bird with advanced sleep-wake phase disorder has the opposite problem. They fight to stay awake in the evening and wake up long before dawn.
The difference matters because the treatments are not the same. Sleeping pills do not move your clock, and light at the wrong time of day can push it the wrong way. A sleep diary or actigraphy record, kept on both workdays and days off, often makes the pattern clear. That is why Dr. Ruiz looks at your timing before recommending any treatment.
Shift work and sleep
Nurses, police officers, firefighters, airport and port workers, and restaurant and hotel staff often work hours that go against the body clock. Some people adjust well. Others have shift work disorder: trouble sleeping during the day and strong sleepiness while on the job.
There is no single fix, but planning helps. The National Heart, Lung, and Blood Institute lists steps such as a short nap before a shift, light-blocking glasses for the drive home in daylight, a dark and quiet bedroom for daytime sleep, and limiting caffeine close to bedtime. Light at the right time can help some people shift their clock. Some people are also prescribed medicine to help them stay alert at work.
Dr. Ruiz looks at your shift pattern, commute, family schedule and health, then helps you build a sleep plan you can follow on work days and days off.
What to know about melatonin and light
Melatonin is a hormone your body makes in the evening. When it is used to shift the body clock, the time you take it matters more than the dose. Taken at the wrong time, it may do little or may move your clock the wrong way. The American Academy of Sleep Medicine supports timed melatonin for some circadian rhythm disorders, such as delayed sleep-wake phase disorder. In the United States, melatonin is sold as a supplement, and the National Heart, Lung, and Blood Institute notes that the amount and purity can vary by brand.
Light works the same way. Morning light tends to move your clock earlier. Evening light tends to move it later. Light boxes can cause headaches, eye strain or nausea in some people. If you have an eye condition or take medicine that makes you sensitive to light, ask your doctor before using one.
What are the types of circadian rhythm disorders?
| Type | What it looks like | Approaches often used |
|---|---|---|
| Delayed sleep-wake phase | Can't fall asleep until very late and has trouble waking in the morning | Morning light, timed evening melatonin, avoiding bright light at night, steady wake time |
| Advanced sleep-wake phase | Gets sleepy early in the evening and wakes very early | Evening light, steady schedule |
| Shift work disorder | Poor sleep during the day and sleepiness at work because of night or rotating shifts | Planned sleep and naps, managing light before and after shifts, a dark bedroom |
| Jet lag | Trouble sleeping and daytime tiredness after flying across time zones | Timed light based on direction of travel, adjusting schedule before or after the trip |
| Irregular sleep-wake rhythm | Sleep broken into short pieces through the day and night, with no main sleep period | Daytime light and activity, regular routines; more common with some brain conditions such as dementia |
| Non-24-hour sleep-wake rhythm | Sleep times drift later day by day; seen most often in people who are totally blind | Timed melatonin or a prescription medicine, steady schedule |
What to expect
- Step 1
Request a visit
Call the office. We'll find a time and tell you what to bring.
- Step 2
First appointment
Dr. Ruiz goes over your sleep, your health history and what you've already tried.
- Step 3
Testing, if needed
A home or in-lab sleep study, or blood work.
- Step 4
Treatment and follow-up
You leave with a plan, and come back to adjust it.
Related conditions and care
Patients come to our Fort Lauderdale office from Las Olas, Wilton Manors, Dania Beach, Oakland Park, Lauderhill, Plantation, Hollywood, Hallandale Beach and across South Florida.
Common questions
What is a circadian rhythm disorder?
It is a sleep disorder in which your internal body clock is out of line with the schedule you need to keep. You may be able to sleep well, but not at the times your work, school or family life require.
Can I just take melatonin on my own?
It is better to ask a doctor first. For body-clock problems, the timing of melatonin matters a great deal, and the wrong timing may not help. Melatonin supplements are not regulated like prescription drugs, so dose and purity can vary. Talk with your doctor if you are pregnant or take other medicines.
How is a circadian rhythm disorder diagnosed?
Diagnosis is mainly based on your sleep history and a record of your sleep times over several days or weeks, using a sleep diary, a wrist activity monitor (actigraphy), or both. A sleep study may be ordered if another sleep disorder, such as sleep apnea, is suspected.
Is being a night owl a disorder?
Not always. Many people simply prefer later hours and do fine. It becomes a disorder when your natural timing keeps you from getting enough sleep before work or school and causes problems during the day.
Should I drive after a night shift?
Not if you feel drowsy. Signs include heavy eyelids, frequent yawning, drifting out of your lane, or missing exits. If possible, take a short nap before driving, use a ride share or carpool, or have someone pick you up. Pull over somewhere safe if you start to feel sleepy.
Written by Sleep & Internal Medicine Specialists. Last updated . This page is general information, not medical advice for your situation.
Sources
- American Academy of Sleep Medicine. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders (2015)
- National Heart, Lung, and Blood Institute. Circadian Rhythm Disorders: Treatment
- National Heart, Lung, and Blood Institute. Circadian Rhythm Disorders: Types
- National Heart, Lung, and Blood Institute. Circadian Rhythm Disorders: Diagnosis
Schedule an Appointment
Send a request any time, or call Monday to Friday, 9:00 am to 5:00 pm. 1319 S.E. 2nd Avenue, Fort Lauderdale.