Other Sleep Disorders

Circadian rhythm sleep disorders (CRSDs) occur when your internal body clock is not in sync with the 24‑hour day and the natural light–dark cycle. Your body wants to sleep and wake at different times than your work, school, or family schedule requires, which can cause insomnia, excessive daytime sleepiness, and serious daytime problems.

At our sleep clinic, we diagnose and treat many types of circadian rhythm sleep disorders for patients from across the Greater Detroit area.

Delayed Sleep Phase Disorder

People with delayed sleep phase disorder naturally fall asleep too late and wake up too late. They often:

• Cannot fall asleep until very late at night
• Struggle to wake up on time for school, work, or morning activities
• Complaint of “insomnia” at bedtime and severe sleepiness in the morning

This condition is especially common in teenagers and college students, but it can persist into adulthood and seriously interfere with school or job performance.

Advanced Sleep Phase Disorder

Advanced sleep phase disorder is more common in older adults. People with this condition:

• Feel sleepy and fall asleep very early in the evening (for example, 6–8 p.m.)
• Wake up very early in the morning (2–4 a.m.) and cannot fall back asleep
• Feel sleepy in the early evening and may be wide awake before dawn

This sleep pattern can disrupt social and family life and may be mistaken for insomnia or depression.

Shift Work Sleep Disorder

Shift work sleep disorder occurs when work schedules (such as night shifts or rotating shifts) conflict with the normal sleep–wake cycle. People with this disorder:

• Feel very sleepy at work, especially during night or early‑morning shifts
• Have trouble sleeping during the day when they are off
• Struggle with both insomnia and daytime sleepiness

Shift work sleep disorder can reduce job performance and significantly increase the risk of workplace and driving accidents.

Jet Lag Disorder

Jet lag disorder affects people who travel across multiple time zones. Symptoms can include difficulty falling asleep at the new local bedtime, waking at odd hours, daytime sleepiness, and poor concentration. A common rule of thumb is that it may take about a day per time zone crossed for your body clock to adjust, although this varies by person and direction of travel.

Non‑24‑Hour Sleep–Wake Disorder

In non‑24‑hour sleep–wake disorder, the internal body clock is longer than 24 hours. People fall asleep a little later each night and wake up a little later each day, so their sleep schedule keeps drifting around the clock.

This is most common in people who are totally blind and do not receive light cues to reset their internal clocks, but it can also occur in sighted individuals. Non‑24 can cause severe insomnia, daytime fatigue, and social and occupational impairment.

If you or someone you love has difficulty sleeping and waking at desired times, we can evaluate for circadian rhythm sleep disorders and recommend treatment options such as light therapy, melatonin‑based approaches, and carefully timed behavioral changes.

Sleep‑related movement disorders involve unusual or repetitive movements when you are resting, falling asleep, or already asleep. These conditions can be uncomfortable, disruptive, and exhausting for both you and your bed partner, and they often require expert evaluation at a sleep clinic. At the Sleep & Attention Disorders Institute, we diagnose and treat a wide range of sleep‑related movement disorders in adults and children.

Restless Legs Syndrome (RLS)

Restless legs syndrome is an uncomfortable sensation in the legs with an irresistible urge to move them. It typically:

• Occurs at rest or near bedtime
• Gets better temporarily when you move your legs
• Is not the same as feeling “hyper” or nervously jiggling your legs

RLS is diagnosed based on symptoms; routine sleep testing is not needed to make the diagnosis. Low iron stores (low ferritin) can cause or worsen restless legs syndrome, so we often order blood tests. Medicines that increase dopamine activity in the brain often help, and other medications are available as well; sleeping pills are not recommended for RLS.

Periodic Limb Movement Disorder (PLMD)

Periodic limb movement disorder involves repeated, jerking movements of the legs during sleep. You may not be aware of the jerks, but your bed partner might notice them or be awakened by them. PLMD can:

• Fragmenting your sleep leaves you tired and sleepy during the day
• Disrupt your bed partner’s sleep as well

A sleep study (polysomnography) is used to diagnose periodic limb movements. Medicines that increase dopamine activity often help reduce leg movements, and other medications may also be used; as with RLS, sleeping pills should not be used as primary treatment.

Sleep‑Related Leg Cramps

Sleep‑related leg cramps are painful muscle contractions that occur when you are trying to fall asleep or during sleep. Stretching the affected muscle in the opposite direction often helps stop the cramp—for example, for calf cramps, straightening the leg and pulling the toes toward you.

Unfortunately, there is no consistently effective medication for sleep‑related leg cramps, but stretching, hydration, and addressing underlying medical issues may help.

Sleep‑Related Bruxism (Teeth Grinding)

Sleep‑related bruxism is the grinding or clenching of the teeth during sleep due to jaw movements. This can:

• Create loud grinding noises that disturb a bed partner
• Causes significant wear and damage to the teeth over time

Bruxism may be detected during sleep testing or by your dentist. Dentists can make a custom mouthguard or oral device to keep the upper and lower teeth separated during sleep, reducing noise and preventing tooth damage.

Sleep‑Related Rhythmic Movement Disorder

Sleep‑related rhythmic movement disorder involves repetitive movements, such as head‑banging or body rocking, while falling asleep or during brief awakenings. It is more common in young children and usually improves with age.

These movements are often harmless, but seizures and other neurologic conditions can sometimes look similar. Treatment is not always needed; when required, certain medications may help, although no medicine works reliably in every case.