Advanced Sleep Phase Disorder (ASPD) case study
Advanced Sleep Phase Disorder, Case Study Nov 21, 2023

Background:

Claudia is a vibrant 65-year-old lady. She has spent most of her life embracing an active and engaging lifestyle. She enjoyed a fulfilling career, relished social activities, and cherished her time spent outdoors. But, since her retirement and recent adjustments in her daily routine, Claudia has found herself navigating the challenges of sleep disruption.

Presenting Issue:

Claudia is worried because she’s having a hard time falling asleep. The easy and calm transition to peaceful nights has become a struggle. She talks about feeling sleepy early in the evening, even as early as 6 pm. This change in her energy levels at night has messed up her usual sleep routine, making her wake up way earlier than she wants to. It’s not about having trouble falling asleep; the bigger problem is waking up too early, taking away the good and refreshing sleep she used to get. Claudia’s nights, which were once calm and trouble-free, have turned into a series of difficulties. Now, she’s looking for ways to understand what’s going on and find solutions to get back the peaceful sleep she used to enjoy without any worries. Clocking Out Early: A Deep Dive into Advanced Sleep Phase Disorder

Symptoms:

  1. Early Evening Fatigue. Claudia experiences profound fatigue and drowsiness in the early evening hours when she should engage in leisure or social activities.
  2. Early Bedtime Tendencies. She finds herself contemplating bedtime well before what society considers a regular sleep schedule, sometimes even before 8 pm.
  3. Insomnia and Early Awakening. Despite retiring early, Claudia faces difficulty staying asleep throughout the night. Her internal clock rouses her much earlier than her desired wake-up time, leaving her feeling unrested.

Lifestyle Changes:

  1. Retirement Transition. Claudia recently retired, a significant lifestyle shift that has altered the structure of her daily routine. The absence of a structured work schedule may have triggered changes in her circadian rhythm.
  2. Reduced Outdoor Activities. Claudia’s daily outdoor activities and social engagements have diminished with retirement. Less exposure to natural light, a crucial element in regulating circadian rhythm, may contribute to her sleep disturbances.
  3. Altered Social Schedule. Claudia’s social interactions have evolved, with fewer evening engagements and more daytime activities. This shift may influence her body’s perception of when to be awake or asleep.

Potential Diagnosis:

Given Claudia’s symptoms and lifestyle changes, Advanced Sleep Phase Disorder (ASPD) becomes a plausible diagnosis. The premature onset of sleep signals and early awakening align with the key characteristics of ASPD, especially in the context of her recent retirement and alterations in daily activities.

Recommendations and Next Steps:

  1. Consultation with Healthcare Professionals. Claudia should seek consultation with a healthcare professional—a sleep specialist, to conduct a comprehensive evaluation and confirm the diagnosis of ASPD.
  2. Sleep Diary: Maintaining a sleep diary documenting her sleep patterns, daily activities, and energy levels can provide valuable insights for the healthcare provider.
  3. Lifestyle Adjustments. Implementing strategies such as exposure to bright light in the evening and maintaining a consistent sleep schedule may help Claudia realign her circadian rhythm.
  4. Behavioral Interventions. Exploring behavioral interventions, including cognitive-behavioral therapy for insomnia (CBT-I), can assist Claudia in developing healthy sleep habits.

In conclusion, Claudia’s case exemplifies the intricate relationship between lifestyle changes, circadian rhythm, and sleep disturbances. A tailored approach involving professional guidance and lifestyle adjustments can pave the way for Claudia to regain restful nights and maintain her well-deserved retirement vitality.

"While the moonlight weaves tales of sleep, my story unfolds with the first light. Advanced Sleep Phase Disorder, where the night is short, and dreams bloom at sunrise."
About author

Karuna Kaul is psycho socio clinical psychologist, who works with all age group people. Her profession motivates her to serve people who are facing behavioral issues. She has over 8 years of experience and has successfully established credibility in the areas of counselling and wellness. Assessment and behavioral analysis and training and coaching. She has been an active advocate of mental health awareness. And all her endeavors in the field are primarily focused on educating more and more people about Mental Health concerns and promoting Holistic Wellbeing. She has done master in clinical psychology PG Diploma in counselling and guidance and certified in drug addiction counselling Also she has done neuro medicine psychology from London University, Kent College of United Kingdom. With an experience of six years, she had worked with various organization which provides mental health services.