Chronotherapy for Delayed Onset Sleep Disorder

Some success has been claimed for chronotherapy for treating delayed onset sleep disorder. A person suffering  delayed sleep onset insomnia may be treated by phase shifting the individual's rhythms, this involves the person following a progressive delay of three hours each day until a suitable sleep time for the individual has been reached.

Application of this system would require the individual to be free from the demands of work and family life, at least until the chronotherapy treatment had taken effect. Each new day the sleep time would begin 3 hours later than the previous day, each day the person would sleep for 8 hours, this lasts for 7 days, for the following 7 days bedtime is set for 11p.m. and waking time for 8 hours later at 7a.m. The difficulty here might be to maintain this schedule, failing to follow a disciplined approach to the new program would result in the person soon returning to the previous delayed sleep onset  problem. 

The adverse effects associated with shift rotation have been alleviated by the use of schedules which minimize disruption to circadian rhythms. Rapid shift rotation has been found to be the least disruptive to circadian rhythms, rotation schedules of one or two days have been found to be insufficient to allow for any disruption to the circadian rhythms. A disadvantage of rapid shift rotation would be that workers never managed to adapt to the night shift , and for this reason  it may not be possible to implement such a shift rotation due to the type of work involved. A more realistic approach from a chronotherapeutic point of view would involve slow shift rotation greater than one week and less than 5 weeks.

Reference: Virginia Carrier-Kohkmanm Ada M. Lindssy, Claudia M.West. Pathophysiological Phenomena in Nursing 2nd edition, Published W.B.Saunders company, Philadelphia 1993.