What does the biological clock do?

From brainhealth.com

By Dawn Fallik

Why circadian rhythm is important and how to keep it healthy

For years, the biological clock was thought of as a single master timekeeper in the brain, keeping us awake and sending us off to sleep roughly synchronized with the 24-hour day.

But now researchers believe that there is not just one biological clock. Instead, almost every organ system—hormonal, metabolic, and digestive—works on its own schedule. Each system is regulated by different triggers, including light, food, and social activity. When those triggers are not working properly because of shift work, travel, or a sudden change in schedule, it can cause more than just a bad night’s sleep.

“The way I see it, circadian rhythms and sleep sort of evolved in parallel, and so we've done a lot of great sleep research, we've done a lot of great circadian research, and we're finally starting to look at the [connection] between the two of them,” says Sabra Abbott, MD, PhD, an associate professor of neurology and director of the Circadian Medicine Clinic at Northwestern University’s Feinberg School of Medicine in Chicago, IL. You can’t only focus on your brain clock, you need to have all the other internal clocks working and aligned with each other, she adds.

The main biological clock resides in the brain, in an area called the suprachiasmatic nucleus (SCN). It is controlled by the clock gene mechanisms, which keep the body on a 24-hour cycle. The clock gene mechanisms aren't present only in the SCN. They are almost everywhere throughout the body, causing problems in the body when a trigger sets off a system at the wrong time.

How light affects circadian rhythm

Part of the challenge in addressing issues with the biological clock is that humans don’t work on a 24-hour internal cycle; it’s actually a little longer, up to 24.2 hours, explains Beth A. Malow, MD, MS, FAAN, professor of neurology at Vanderbilt University Medical Center in Nashville, TN.

Light is the main environmental cue that keeps the body’s circadian rhythms in alignment, she says. Naturally, we’re more awake when it’s light out and start feeling sleepy as it gets darker.

Miljan Zivkovic/Shutterstock.com

Jet lag is one example of what can happen when changes in light exposure put the body’s internal clock out of alignment. “Part of it is the fact that we’re getting light at different times of the day and night than when we were at home, but it’s also food timing,” Dr. Malow says. “When we eat, it aligns us with where we are in the day. That’s why we recommend eating small meals if you have jet lag, because a big lunch or dinner could be a signal to your system about what time it is, and it could throw you off.”

Can shift work affect your biological clock?

Sometimes the body's internal clock doesn’t match a person’s work schedule. If sleep is disrupted enough, it can lead to a circadian rhythm sleep disorder.

A shift work disorder occurs when a person’s work schedule conflicts with the body's biological timing. This could apply to many different jobs, whether it’s a janitor working a regular overnight shift or a physician in training who works 80 hours a week. Just as the work schedule varies, so do people’s reactions.

“Most shift workers don’t fully flip and become nocturnal, where they are fully active at night and fully asleep during the day, and that leads to all sorts of problems,” Dr. Abbott says. “Their sleep is usually poor quality because they are trying to sleep during times that are out of phase with the biological clock.” This leads to problems with metabolism because a person’s metabolic clock is naturally prepared for food during the day, but they eat during the night when they are at work.

Helping anybody with a shift work disorder is an individualized process because it’s about that person’s particular schedule, their symptoms, and their responsibilities outside of work, she says.

The biological clock changes with age

The body’s biological clock changes throughout life, which influences sleep and wake patterns from adolescence through older adulthood. Research following teenagers through puberty has shown that their circadian timing shifts. They naturally stay up later and wake up later than children.

As people get older, they often sleep less, but that does not necessarily mean they need less sleep. Pain, gastrointestinal problems, and snoring can all affect sleep in older adults. Depression can be associated with either too much or too little sleep, while anxiety can make it difficult to fall asleep.

Rather than assuming that somebody is getting less sleep simply because they're older, “I always look for why they may be getting less sleep, and whether there's anything medical that we can address,” Dr. Malow says.

Menopause can be another cause of circadian rhythm disruption because of hormonal changes and night-time warmth or hot flashes. Responsibilities in midlife, like caring for aging parents or raising children, can add to this, too.

Can you fix your sleep-wake cycle?

Researchers are finding ways to manage sleep-wake cycle disturbances, but not every approach works well for everyone. Wearable trackers, mattresses that record sleep movements, and other devices can provide people with detailed-looking information about how they slept. But people can become so focused on their sleep scores that the tracking itself becomes a source of anxiety.

It’s important to care about your sleep quality, but be careful how you interpret the numbers. The devices estimate sleep and wake activity based on rest and movement. A tracker that relies on movement and rest can mistake movement during sleep for wakefulness. The technology is improving, but the results should not automatically be treated as a definitive measurement of sleep quality.

Some patients come to an appointment feeling concerned because their device told them their sleep was not sufficient even though they felt fine. “That’s when we coined the term ‘orthosomnia,’ which [is] basically that pursuit of perfect sleep,” Dr. Abbott says. “People would develop insomnia because they were worried about what their sleep scores would look like the next day.”

Although perfect sleep every night isn’t realistic, there are ways to have a healthy biological clock:

• Keep a regular schedule. Try to maintain consistent bedtimes and wake times. Regularity is important to healthy sleep because the body is designed to function in a 24-hour environment.
• Pay attention to when you eat. Food helps regulate the body's clocks. Eat small meals throughout the day. Eating a large dinner when your body is expecting breakfast can make jet lag worse.
• If working shifts, stick with one schedule as much as possible. Constantly switching between days and nights can be very hard on your body because your internal clock is out of sync with the environmental clock.
• Don't assume every sleep problem means your biological clock is broken. Sleep and circadian rhythms are influenced by multiple factors. If sleep changes, you should consider other causes rather than simply thinking it’s due to age or a “bad” biological clock.
• Get plenty of light during the day—and dim lighting at night. Light is the body's strongest timing cue. It’s important to get plenty of activity and light during the day and minimize light exposure in the hours before bed.

https://www.brainhealth.com/explore/neurology-explained/what-does-the-biological-clock-do/

Orthosomnia: When Sleep Tracking Makes It Harder to Sleep

From healthcare.utah.edu

It’s nearly midnight, and you’re still wide awake. You glance once again at last night’s low sleep score and feel your body snap into higher alert. At this rate, how will you ever beat last week’s high sleep score?

If you’re losing sleep over your sleep data, you may be experiencing orthosomnia, a term coined by Kelly Baron, PhD, professor in the Department of Family Medicine and Public Health at University of Utah Health.

Baron and her research team at U of U Health have been observing the behaviour pattern for years as sleep-tracking wearables have surged in popularity.

What Is Orthosomnia?

Orthosomnia is an unhealthy preoccupation with achieving “perfect” sleep scores.

While sleep trackers can help you learn about your sleep habits, checking sleep data can become a source of stress.

Nearly half of adults have used a wearable device to monitor their sleep quality and duration, creating a growing trend of sleep optimization.

“It seems to be a mix of perfectionism and sleep‑related anxiety,” Baron says. “The trouble is that the more anxious you become about getting ‘perfect’ sleep, the harder it is to actually sleep. And when you start trying to tightly control every aspect of your sleep, it often backfires, making the whole experience even more difficult.”

To better understand the pattern, Baron and her research team developed the Bergen Orthosomnia Scale, the first validated tool to measure orthosomnia.

 The tool identifies two common patterns:

• Interference: Worrying about sleep affects daily life, relationships, or social plans.
• Rigidity: Following strict sleep rules, such as believing you can’t function without exactly seven hours of sleep, with little room for changes in your routine.

These patterns often overlap with sleep anxiety and sometimes insomnia, but orthosomnia is its own distinct pattern.

Signs Your Sleep Tracker May Be Causing Stress

Tracking your sleep shouldn’t make you feel worse about it. Some warning signs of orthosomnia include:

• Feeling anxious when checking sleep data
• Letting a low sleep score affect your mood
• Skipping social events to achieve a high sleep score
• Obsessing over sleep stages or awakenings

Who Is More Likely to Experience Orthosomnia?

Anyone who tracks their sleep can develop unhealthy habits around sleep data. But some people may be more likely to experience orthosomnia, including those who:

• Already have trouble sleeping, especially people with insomnia
• Enjoy optimization, biohacking, or performance metrics
• Set high standards for themselves
• Feel competitive about their health data

How Accurate Are Sleep Trackers?

Sleep trackers can offer useful information, but they don’t tell the whole story.

Although trackers have become more advanced over the years, they still aren’t entirely reliable.

For example:

• Trackers often underestimate sleep by about 15%, making people believe they slept worse than they actually did.
• Sleep stages are frequently misinterpreted, especially “light sleep,” which is normal and makes up roughly half the night.
• Nightly scores don’t provide a clear picture of overall sleep patterns, causing more stress and sleepless nights.

Five Ways to Stop Stressing About Your Sleep Score

If checking your sleep tracker is creating more stress and sleepless nights, changing how you use it may help.

1. Take a break from tracking. Put your device aside for two weeks or longer to see whether your sleep worries improve.
2. Focus on how you feel. Pay attention to your energy, mood, and ability to get through the day instead of the metrics on your watch.
3. Check your data less often. Review your sleep data after one to two weeks—not every night.
4. Consider sleep therapy. If anxiety or insomnia persists, cognitive behavioral therapy for insomnia (CBTI) may help.
5. Ask for help when you need it. Talk with a clinician if you’re unsure whether you have a true sleep disorder.

https://healthcare.utah.edu/healthfeed/2026/10/orthosomnia-when-sleep-tracking-makes-it-harder-sleep 

Back pain, dry skin and insom­nia... ‘work­ing from bed’ is a flat-out dis­aster

From pressreader.com

By Alice Smellie

NOW that I no longer have school runs, I don’t have to live by my alarm clock.

Every morn­ing I let the dogs out at around 6.30am and then snuggle back down in bed for two or three hours with my laptop and my dead­lines.

This seems per­fectly sens­ible to me and I’m pleased to learn that, although I may be phys­ic­ally alone, I join mil­lions who’d rather work from bed than head down­stairs to a desk.

Mat­tress­nextday recently sur­veyed 1,000 UK adults and found that nearly half (48 per cent) of people who reg­u­larly work from home do so from bed.

And with chilly morn­ings mak­ing crawl­ing out from under the cov­ers even less appeal­ing, I sus­pect many more will be temp­ted to join us.

Unfor­tu­nately if, like me, you WFB (work from bed), you’ll be dis­ap­poin­ted to learn that there are poten­tial, and occa­sion­ally con­cern­ing, con­sequences for our health. From dry skin to heart­burn, here are some of the unin­ten­ded con­sequences of using our beds as an office exten­sion.

‘Bof­fice’ worker: Alice Smel­lie risk­ing her health as she types on her laptop in bed

INSOMNIA

SLEEP expert Dr Neil Stan­ley, author of A Sleep Divorce, is clear that doing even part of a day’s work from the com­fort of your bed is a ter­rible idea for qual­ity of sleep.

‘If you work in bed, your brain will start to asso­ciate bed with being awake and think­ing that it’s admiss­ible to be so,’ he says.

The only thing worse than WFB dur­ing the day is, Dr Stan­ley adds, WFB in the even­ings, something I’ve also been known to do.

He did a study show­ing that if you work in the hour before bed you’re going to have lower qual­ity sleep.

‘It’s not rocket sci­ence but it is sci­ence. The 35 to 45 minutes before bed should be spent relax­ing, not work­ing.’

That sounds famil­iar... whenever I’m stressed about work I front­load the night before, type frantic­ally till 10.30pm and then – sur­prise! – can’t drop off, and feel exhausted the next day.

DRY AND PUFFY FACE

SPENDING more time between the sheets can con­trib­ute to poor skin on the face and body.

Aes­thetic expert Dr Christine Hall points out that being in bed for long peri­ods of time is sub-optimal for your skin.

‘Being act­ive has a pos­it­ive effect on skin,’ she says. ‘Lack of move­ment and there­fore reduced cir­cu­la­tion will con­trib­ute to fluid reten­tion and puffi­ness.’ Bed­ding is key too: ‘The warmth of a duvet or stay­ing in bed increases trans epi­dermal water loss, lead­ing to dry­ness around the body,’ she says. ‘Should you have an exist­ing skin con­di­tion such as acne, get­ting hot and sweaty in bed may well exacer­bate this.’

There is, she points out, a big dif­fer­ence between stay­ing in bed and being in bed for sleep. ‘Sleep is import­ant for skin because it repairs itself at night. Lack of sleep means your skin doesn’t have so much time to optim­ise its own health.’

It’s hard to say if my drier skin is down to WFB or age­ing but, either way, I might con­sider spend­ing less time between the cov­ers and more time mois­tur­ising.

POOR MOTIVATION

TO my dis­ap­point­ment, I learn that what we wear may affect our motiv­a­tion.

Once I bother to get out of bed I always get dressed in clean and reas­on­ably smart clothes and do my hair and make-up. Till then, it’s comfy pyja­mas.

But cog­nit­ive beha­vi­oural research shows that the mind uncon­sciously shifts into a more pass­ive state when the body is hori­zontal. And by the same mech­an­ism, wear­ing pyja­mas is likely to make it even harder to focus. Stud­ies show we are more pro­duct­ive if we are dressed, and espe­cially if we’re smartly dressed.

One report observes that cloth­ing choices, even for home­work­ers, are ‘psy­cho­lo­gic­ally and organ­isa­tion­ally impact­ful’.

HEARTBURN AND WEIGHT GAIN

BREAKFAST is my favour­ite meal and best enjoyed from under a duvet; from eggs to por­ridge to yoghurt and ber­ries.

However, our digest­ive sys­tems work best when we’re upright, says Emma Bard­well, nutri­tion­ist and author of The 30g Plan

Cook­book. ‘Eat­ing in bed while work­ing might feel cosy but it’s not doing your diges­tion any favours,’ she says.

‘Lying down too soon after eat­ing, or half-lying in bed, can increase the like­li­hood of reflux and heart­burn because stom­ach con­tents are more likely to move back up towards the oeso­phagus.’

Oh dear. I am more than cap­able of lying down almost fully, laptop bal­anced on knees, and stom­ach acid going good­ness knows where.

What’s more, move­ment plays an import­ant role in diges­tion and blood sugar reg­u­la­tion.

‘Even light activ­ity after meals, such as walk­ing around the house or head­ing out­side for a short stroll, can help stim­u­late gut motil­ity, encour­aging food to move through the digest­ive tract more effi­ciently,’ says Bard­well.

‘Your muscles also act a bit like gluc­ose sponges after eat­ing, help­ing clear gluc­ose from the blood­stream and improv­ing blood sugar con­trol.’

As if all the above wasn’t bad enough, being sedent­ary may also con­trib­ute to weight gain.

‘You may think that the short walk from desk to the kettle makes no dif­fer­ence, but small exer­cise “snacks” really count and minutes add up,’ says author of the Feel Good Fix, Lav­ina Mehta MBE.

BACK PAIN AND POOR POSTURE

POSTURALLY, WFB is a bit of a dis­aster.

Physio­ther­ap­ist Nat­alie Gum­mer­son, at Pure Sports Medi­cine, says that the bed simply isn’t designed for being sat in upright for long peri­ods, even if you plump a mass of pil­lows behind you, as I love to do.

‘When we work from bed, we nat­ur­ally tend to slouch or round for­wards, pla­cing strain on the lower back and neck and encour­aging what’s known as a sus­tained flexed pos­ture. Over time, these pos­i­tions can con­trib­ute to disc irrit­a­tion, muscle strain and increased back pain risk.’

I cur­rently have a pil­low short­age, thanks to my three chil­dren pil­fer­ing loads to go to uni­versity, and I have noticed my middle back fre­quently feels stiff and sore.

Sad to say, I think it might be time to get out of my ‘bof­fice’. 

https://www.pressreader.com/uk/daily-mail/20261026/281960319746799

Dealing With Stress-Induced Insomnia? A Sleep Doctor Shares 8 Ways to Prevent It

From realsimple.com

By Sara Delgado

When stress keeps your brain on high alert at bedtime, small daily habits can help it power down 

Key Takeaways

• Stress can trigger our fight-or-flight response, which can make it harder to fall asleep and stay asleep, and worrying about sleep can become its own cycle.
• Daytime habits matter as much as bedtime ones. Wake up at the same time every day, even after poor sleep. Get morning sunlight, move your body, and limit caffeine and alcohol.
• Spend 20 to 30 minutes relaxing before bed and jot down worries earlier in the evening. If you’re awake and frustrated, get up and do something calm until you’re sleepy.

With the change of seasons in full swing and the clocks falling back soon, sleep is one habit that changes the most. Whether you’re struggling to wake up or fall asleep, many factors can affect a good night’s rest—and some of them aren’t even external. Case in point: stress.​

If you feel like your mind is your worst enemy when it comes to winding down and getting the proper rest your brain and body deserve, you might be dealing with stress-induced insomnia.​

“Stress often plays a big role in insomnia,” says Angela Holliday-Bell, MD, board-certified physician and certified sleep specialist. “When we’re stressed, our bodies activate the fight-or-flight response, increasing alertness and releasing stress hormones like cortisol and adrenaline. While this response is helpful when we’re facing a threat, it can interfere with sleep, especially when it stays activated.”​ To help you work through it—and still get adequate sleep during the cold, dark months—we asked a sleep doctor for some preventative tips.

How Stress Can Impact Sleep

Credit:

Alvaro Medina Jurado / Getty Images

Stress keeps our brains on high alert, so instead of naturally winding down as the day ends, we can feel just as alert as we are during the day. “It can make it harder to fall asleep, cause more frequent night-time awakenings, and make it difficult to fall back asleep,” Dr. Holliday-Bell explains. “Over time, people can even begin to associate bedtime with stress and frustration, creating a cycle where worrying about sleep becomes another reason they can’t sleep.”​

If you naturally stay awake during stressful spells, try to avoid frustration. “Some people have a naturally higher level of what we call sleep reactivity, meaning their sleep is more sensitive to stress,” Dr. Holliday-Bell says. “Genetics, a history of insomnia, anxiety, and certain personality traits (like excessive worrying) can all increase someone’s vulnerability. One of the easiest ways to recognize whether you’re at risk is to pay attention to how your sleep responds to stressful situations. If even relatively minor stressors consistently cause you to have trouble falling asleep or staying asleep, you may have higher sleep reactivity.”

Dr. Holliday-Bell says another warning sign to pay attention to is noticing whether “sleep difficulties continue even after the original stressor has resolved,” as that “can indicate that you’ve developed habits or thought patterns that are keeping the insomnia going.”

The good part? No matter where you fall, a handful of easy tips can help you combat stress-induced insomnia. “The goal is to create habits that help your mind and body transition into sleep more easily, even during stressful periods,” Dr. Holliday-Bell says. Below, we break down eight expert-backed tips that can help improve your sleep journey.

8 Tips to Prevent Stress-Induced Insomnia

Create a Consistent Sleep Routine

Even when you’re having trouble falling asleep, the first step toward fighting insomnia is creating a consistent sleep and wake-up routine that signals to your internal clock when to wind down and when to become active again.

“[An] important habit is waking up around the same time every morning, even after a poor night of sleep,” Dr. Holliday-Bell says. “This helps regulate your internal clock and makes it easier to maintain a consistent sleep pattern.”

If you have had a particularly bad night and feel the need to stay in bed all day the next day, try to fight it. “Resisting the urge to spend extra hours in bed trying to make up for lost sleep is key [to] building a routine,” Dr. Holliday-Bell adds.

Get in the Right Mindset to Go to Bed

If you want to go to sleep, you need to signal your intention to your body and mind. If you tend to stay super active until the minute your head hits the pillow, your brain is still hyperaroused.

As part of the aforementioned routine, Dr. Holliday-Bell says you should pay attention to the “wind-down” process and dedicate an entire portion of your night routine to it. “Spending even 20 to 30 minutes doing something relaxing before bed, like reading or listening to calming music, can help signal to your brain that it’s time for sleep,” she says.

Create a Safe Environment

If you’re having trouble falling asleep, it might be because you don’t feel comfortable where you are. Dr. Holliday-Bell says one thing people overlook the most is their sleep environment. If your room is particularly messy or stuffy on any given day, it can affect you more than you think.

“Keeping your bedroom cool, dark, and quiet can help minimize unnecessary sleep disruptions,” she adds. Another factor to consider, especially in rental spaces, is your mattress. “An uncomfortable or unsupportive mattress can contribute to physical discomfort and frequent night-time awakenings,” Dr. Holliday-Bell says. If you can’t find a comfortable position, consider investing in a mattress that “provides proper support and helps maintain a comfortable sleep temperature,” she suggests.

Get Things Out of Your Head Before Bed

If you have long to-do lists or things weighing you down, your brain can easily hyperfocus on them while you are trying to sleep, leaving you feeling wired (even if you’re tired). If you know you are prone to overthinking, set aside time to get anything that might disrupt your sleep out of the way before you try to unwind for the day.

“I recommend setting aside about 10 to 15 minutes earlier in the evening to write down anything that’s worrying you, along with what you can do about it tomorrow,” Dr. Holliday-Bell says. “This can help reduce those racing thoughts that tend to show up as soon as your head hits the pillow.”

Try to Actually Relax

I know this sounds like the most cliché tip ever, but Dr. Holliday-Bell confirms that trying to stay as relaxed as possible throughout the day can actually help when it’s finally time to go to bed.

“Practicing techniques like deep breathing or progressive muscle relaxation can help calm your nervous system, especially when your body feels tired but your mind won’t shut off,” she says. “Taking short breaks throughout the day to practice deep breathing or mindfulness can help prevent stress from building up until bedtime.”

Move More During the Day

“One of the biggest misconceptions about sleep is that improving it starts at bedtime,” Dr. Holliday-Bell says. “In reality, what we do throughout the day plays a major role in how well we sleep at night.”

If you want to help your circadian rhythm to auto-regulate and create a clearer distinction for your brain and body at bedtime, the best thing you can do is move throughout the day.

“I always recommend getting natural sunlight in the morning because it helps regulate our internal clock, while regular physical activity can reduce stress and improve sleep quality,” Dr. Holliday-Bell says.

Avoid Known Sleep Disruptors

If your brain already acts as its own sleep disruptor, you don’t need any other external factors that could potentially make it even harder to fall asleep. “I’d recommend limiting caffeine later in the day and avoiding alcohol as a sleep aid,” Dr. Holliday-Bell says. “Several factors in our environment and daily routines can interfere with sleep, including irregular sleep schedules, excessive caffeine, alcohol consumption, and even exposure to bright lights before bed.”

Don’t Blame Yourself

Last but definitely not least, it’s important not to be too hard on yourself. “If you’re lying awake at night feeling frustrated, don’t force it,” Dr. Holliday-Bell says. “It’s better to get out of bed, do something quiet and relaxing in dim lighting, and return when you feel sleepy. This helps prevent your brain from associating your bed with wakefulness and frustration.”

“It’s also important to recognize that certain medications, chronic pain, hormonal changes, and underlying sleep disorders can contribute to insomnia,” she adds. “If someone continues to struggle with sleep despite making changes to their habits and sleep environment, I recommend speaking with a healthcare professional to identify the underlying cause.”

https://www.realsimple.com/how-to-prevent-stress-induced-insomnia-12190188

Scientists Have Identified a New Type of Depression Responsible for 1 in 4 Cases

From prevention.com

A surprisingly common trigger might be behind it 

Key points 

• Circadian depression is an emerging subtype of the mental health disorder.
• Up to 25% of people with depression may have circadian depression, according to a new study.
• More research on this type is warranted, since treatment may be slightly different from that of traditional depression.

There are a lot of different factors that can fuel depression, from genetics to trauma. But new research suggests that there’s a lesser-known element that may play a role, too: changes in your circadian rhythm, or your body’s 24-hour internal clock.

In fact, so-called “circadian depression” may actually account for nearly one in four cases of depression, according to the findings, which were published in the British Journal of Psychiatry.

For the study, researchers analysed clinical and genetic data from more than 10,000 Australians with depression who participated in the Australian Genetics of Depression Study, a large-scale scientific research project that looks at the factors that impact depression. These included self-reported data on the following:

• social jetlag, or a mismatch between someone’s internal clock and their social schedule
• seasonality, or how much someone’s mood varies among seasons
• delayed sleep midpoint, or when the halfway point of sleep is later than expected
• whether people were night owls
• how tired they felt in the morning
• whether they experienced excessive daytime sleepiness

After analysing the data, the researchers found that 23% of the participants had a circadian subtype of depression. The findings support the “validity and potential clinical utility of a circadian subtype of depression as a clinical profile,” the researchers wrote in the study. The possible benefit? Defining this “may support more personalized care options,” they wrote.

Circadian depression is an emerging subtype of depression, so it’s not yet in the DSM-5, the handbook used by mental health professionals to diagnose psychiatric conditions. Much of our understanding is still preliminary until more research can be done. But here’s what we know about circadian depression so far, plus the factors that influence it—and how to get relief.

What is circadian depression?

Circadian depression is an emerging subtype of depression that researchers believe is distinct from the traditional kind. It’s marked by circadian disruption, which is when your body’s internal 24-hour clock is out of sync with your external environment.

People with circadian depression have disrupted sleep-wake cycles, reduced daytime activity, low energy, and weight gain during episodes, according to the researchers. They also tend to become depressed at an earlier age and are more likely to experience “bipolar-like features,” including mania.

Why might circadian disruptions raise the risk of depression?

Your internal clock helps to coordinate sleep, alertness, hormone release, and your metabolism, says Thea Gallagher, Psy.D., clinical associate professor at NYU Langone Health and cohost of the Mind in View podcast. “When that timing falls out of sync with our daily lives, it can disrupt sleep and the biological processes that support mood,” she says.

That can become a “reinforcing cycle”: Disrupted sleep makes it harder to regulate your emotions and stay engaged in daily life, while depression can make sleep and routines more irregular, Gallagher says.

This is commonly seen in sleep medicine, and has gotten a lot of attention recently with the daylight saving time debate, according to W. Christopher Winter, M.D., a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine. “While some may prefer more evening light, research overwhelmingly supports the adoption of permanent standard time because of its improvement of daylight in the morning,” he says. “This has a massive impact on psychological health and depression.”

What’s more, circadian disruption doesn’t just seem to be a risk factor for depression—it also may affect attention disorders and other medical issues, Dr. Winter says.

Dr. Winter stresses that circadian disruption is not the same thing as simply not getting enough sleep—the repercussions of it are likely more pronounced. “I think it is safe to say that consistent sleep timing that is a bit inadequate in amount is less harmful than the situation of getting a perfect seven to eight hours, but the timing is all over the place,” he says.

Symptoms of circadian depression

Because it’s not yet a formal diagnosis, there aren’t yet any established symptoms of circadian depression. Still, the study uncovered a few things that may signal someone is dealing with circadian depression over another form of the condition.

Justin Paget//Getty Images

Patients with circadian depression were more likely to be night owls and deal with insomnia. They were mostly female (80%) and were more likely to have more severe symptoms of depression like mania, suicidal thoughts, psychological distress, and physical symptoms such as pain or fatigue. They were also more likely to have weight gain during depressive episodes and didn’t respond as well to antidepressant medications.

People who fell into the category of circadian depression were also more likely than those with different forms of depression to have these conditions, too:

• ADHD
• Anxiety
• Bipolar disorder
• Obesity or overweight
• Insulin resistance

How is circadian depression diagnosed and treated?

If you think you may have depression, Gallagher says it’s important to see a mental healthcare provider for an evaluation instead of trying to diagnose yourself based on your sleep patterns. “Being a night owl or waking up tired does not, by itself, mean you have depression,” she says. “A brief diary of sleep timing, mood, energy, and seasonal changes can help a clinician see patterns and assess other explanations, including a sleep disorder.”

There is no set treatment for circadian depression, given that it’s technically not yet a diagnosis. “‘Circadian depression’ is still a proposed profile,” Gallagher says. “This study doesn’t establish that people fitting that profile should receive a different medication or stop their current treatment. It suggests we should pay closer attention to sleep and circadian timing alongside established depression treatments.”

However, the study’s researchers noted in their university’s press release that standard antidepressants like SSRIs or SNRIs tend to be less effective in people who have circadian depression and come with more side effects.

As a result, it’s possible that treatments that affect the body’s internal clock, like light therapy and melatonin, may be more helpful, though more research is needed. In fact, the researchers wrote in the study that folks with circadian depression may benefit from “chronotherapies,” or approaches that seek to reset or align the body’s internal clock.

“This is precisely where melatonin shines,” Dr. Winter says. “I use and recommend the use and timing of melatonin to help reinforce proper sleep timing.”

That doesn’t mean you should pop a melatonin nightly if you feel that your mood is off. Instead, Dr. Winter suggests viewing melatonin as an “anchoring beacon when everything else is off,” like you’re constantly traveling across time zones or struggling with changing schedules.

If you have insomnia, cognitive behavioural therapy for insomnia (CBT-I) may also be helpful, Gallagher says.

“Light timing and exercise scheduling are also essentials,” Dr. Winter says. “Finally, when you have the choice, choose sleep. Not the red-eye. Not the next episode. Not the nightcap. Choose sleep.”

https://www.prevention.com/health/mental-health/a74220816/circadian-depression-study/