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While Chronotherapy has been successful for some, it is necessary to rigidly maintain the desired sleep/wake cycle thenceforth. Any deviation in schedule tends to allow the body clock to shift later again.
Here's an example of how Chronotherapy could work over a week's course of treatment, with the patient going to sleep three hours later every day until the desired sleep and waketime is reached. This technique assumes that an individual can perform effectively with 8 hours of sleep per night. Shifting the sleep phase by 3 hours per day may not always be possible. Shorter increments of 1-2 hours are needed in such cases.
* Day 1: sleep 4 a.m. to noon * Day 2: sleep 7 a.m. to 3 p.m. * Day 3: sleep 10 a.m. to 6 p.m. * Day 4: sleep 1 p.m. to 9 p.m. * Day 5: sleep 4 p.m. to midnight * Day 6: sleep 7 p.m. to 3 a.m. * Day 7 to 13: sleep 10 p.m. to 6 a.m. * Day 14 and thereafter: sleep 11 p.m. to 7 a.m.
Whilst this technique can provide temporary respite from sleep deprivation, patients often find the desired sleep and waketimes soon slip, returning them to a state of delayed sleep onset within a few weeks or even days. The desired pattern can be maintained - to a degree - by following a strictly disciplined timetable for sleeping and rising, but all too often this cannot be maintained, as the body returns to its previous pattern of late sleep onset, regardless of when the patient rises.
A modified chronotherapy (Thorpy et al in J Adolesc Health Care, 1988;9) is called controlled sleep deprivation with phase advance, SDPA. One stays awake one whole night and day, then goes to bed 90 minutes earlier than usual and maintains the new bedtime for a week. This process is repeated weekly until the desired bedtime is reached.
Sometimes, although extremely infrequently, "reverse" chronotherapy - i.e., gradual movements of bedtime and rising time earlier each day - has been used in treatment of patients with abnormally short circadian rhythms, in an attempt to move their bedtimes to later times of the day. Because circadian rhythms substantially shorter than 24 hours are extremely rare, this type of chronotherapy has remained largely experimental, with very little large-scale study.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Chronotherapy". A list of authors is available in Wikipedia.|