Hello doctor, I would like to know how to reset my circadian rhythm from being advanced to a more normal schedule. I have been going to bed around 9 pm and waking up at 5 am. I would like to shift my rhythms to waking up at 7 am and going to bed around 11 pm. I get very sleepy at around 8:30 to 9 pm, but if I push through and stay awake until 10 or 11 pm, I still end up waking up at 5 am without an alarm. It is as if my body does not want to sleep in. It is winter where I live, so sunset happens around 5 pm, so staying outside to get bright light is not an option at the moment. It feels similar to jet lag, is this something I could fix with properly timed Melatonin supplements and staying in the bright light of my house in the evening? Any help would be appreciated. I am physically healthy otherwise and I am not taking any medication.
Hello. It is nice to see that you are so aware of your sleep rhythms. Advanced sleep phase syndrome (ASPS) is common in the elderly and not so common in your age. However, your symptoms match ASPS and I will suggest some techniques to delay your circadian rhythm. Ensure that your room has the curtains closed at night. Try wearing a cloth eye mask if you are comfortable wearing it. Avoid going outside the early morning. The idea is to delay your exposure to bright light very early in the morning. If circadian rhythm disturbances are common in your family, or there is a long past history of the same in your case, you can consider investing in a bright light lamp. Our indoor lights are of negligible intensity as compared to sunlight (100 lux vs 10000 lux). So exposure to indoor light will not help much. However, there are bright lights that emit bright light of significant intensity. You can buy them online. Exposure to them in the evening can help in delaying your advanced sleep phase schedule. The whole idea is to minimize your bright light exposure early in the day and increasing it in the evenings. Melatonin supplements could help theoretically, but you need to take it late at around 11.30 pm, so the effect will last till early morning.  Sleep schedule is called so because it is a habit. It cannot be learned or unlearned in a day. You will not see results in a day or even a week. Regularly practicing sleeping late in the day for two to three weeks should help you. I hope this helps.