The Centers for Disease Control and Prevention (CDC) estimates that 

 suffer from chronic sleep problems.1 Although quetiapine is not approved by the Food and Drug Administration (FDA) for insomnia, doctors have been increasingly prescribing this drug to help with sleeping problems in recent years.

Quetiapine is an antipsychotic medication approved to treat schizophrenia and bipolar disorder.

 Drowsiness is a very common side effect of the drug, leading many to try it as a sleep aid.

Similar to first-generation antihistamines, like 

 (Benadryl, ZZZQuil), quetiapine blocks histamine (H1) receptors in the brain which blocks histamine’s effect on wakefulness, triggering your brain to transition into sleep mode. This may explain why it makes you sleepy.

More than 10% of people taking quetiapine experience drowsiness as a side effect.

 This side effect makes quetiapine an attractive medication to try as a sleep aid.

Your doctor will likely prescribe a low dose of quetiapine to start with, around 25 mg, but may increase the dose from there.

 This is much lower than the recommended dose for schizophrenia or bipolar disorder, which is between 150 mg to 800 mg per day.

You should not drink while taking quetiapine. Quetiapine can increase the effect alcohol has on you and alcohol can worsen the side effects of quetiapine.

 Additionally, alcohol can worsen your quality of sleep.

 If you plan to continue drinking while taking quetiapine, talk to your doctor.

Quetiapine may cause side effects.2 The most common include:

Some of quetiapine's side effects may be more serious. Talk to your doctor if you experience thoughts of suicide, new or worsening depression, anxiety, irritation, or other unusual changes in your mood.

It is very common for people taking quetiapine to gain weight. Many studies show that people taking quetiapine at any dose, even the low doses used for sleep problems, 

 The weight gain usually takes place in the 

 Even if you only use quetiapine for a short time, you may still experience weight gain.

Weight gain is probably due to the fact that quetiapine increases the amount of sugar in your blood, even if you do not have diabetes. Quetiapine can also increase the fat levels in your blood (cholesterol and triglycerides).

 You should monitor your weight and talk to your doctor about ways to control weight gain like exercise and eating healthy.

, a disorder that causes your breathing to stop or get very shallow during sleep, is strongly associated with obesity.10 Because quetiapine can cause weight gain even at low doses for a short time, research shows that quetiapine could 

Quetiapine Lacks Evidence for Use as a Sleep Aid

Quetiapine is not currently approved as a sleep aid and the 

 does not recommend Seroquel for insomnia.

 Even though some clinical trials have shown 

 in people with bipolar disorder, the effect on sleep alone has only been shown in a 

 Experts also don’t yet fully understand the 

Why CBT-I Might Be a Better Alternative Than Taking Quetiapine

Quetiapine is widely prescribed off-label as a sleep aid, but it is often only used as a short-term solution. Over time, your body may build up a tolerance to the drowsy effect of quetiapine and you may need a higher dose to get the same effect. Additionally, many of the side effects get worse with higher doses.

 is a clinically proven and evidence-based method for treating sleep disorders.

 It can help you reframe your thoughts, feelings, and behaviors to improve sleep. CBT-I may have a better balance of potential benefits to risks than medications like quetiapine. Because of this, the American Academy of Sleep Medicine recommends CBT-I as the first-line treatment for insomnia. This means that it is the first treatment that should be tried for people with sleeping problems.

Interested in learning more about CBT-I? Dawn Health provides a comprehensive CBT-I program that can be accessed through an easy-to-use smartphone app. Get started with a 

 to help us better understand where you’re at on your journey to better sleep.

Centers for Disease Control and Prevention. (2017, June). Sleep and Sleep Disorders. 

U.S. Food and Drug Administration. (2009, November). Seroquel (quetiapine fumarate) Tablets: Highlights of Prescribing Information. 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020639s045s046lbl.pdf

MedlinePlus. (2022, June 15). Doxylamine. 

https://medlineplus.gov/druginfo/meds/a682537.html

MedlinePlus. (2022, June 15). Diphenhydramine. 

https://medlineplus.gov/druginfo/meds/a682539.html

Reiner, P., Kamondi, A. (1994). Mechanisms of antihistamine-induced sedation in the human brain: H1 receptor activation reduces a background leakages potassium current. Neuroscience. 59(3):579-88. doi: 10.1016/0306-4522(94)90178-3

Coe, H., Hong, I. (2012). Safety of low doses of quetiapine when used for insomnia. Annals of Pharmacotherapy, 46(5):718-22. doi: 10.1345/aph.1Q697

Roehrs, T., & Roth, T. Sleep, Sleepiness, and Alcohol Use. National Institute on Alcohol Abuse and Alcoholism. 

https://pubs.niaaa.nih.gov/publications/arh25-2/101-109.htm

Cates, M., Jackson, C., Feldman, J., Stimmel, A., Wooley, T. (2009). Metabolic consequences of using low-dose quetiapine for insomnia in psychiatric patients. Community Mental Health Journal, 45(4):251-4. doi: 10.1007/s10597-009-9200-0

Brecher, M., Leong, R., Stening, G., Osterling-Koskinen, L., Jones, A. (2007). Quetiapine and long-term weight change: a comprehensive data review of patients with schizophrenia. Journal of Clincial Psychiatry, 68(4):597-603. doi: 10.4088/jcp.v68n0416

MedlinePlus. (2022, June 15). Sleep Apnea. 

Freudenmann, R., Sussmuth, S., Wolf, R., Stiller, P., Schonfelt-Lecuona, C. (2008). Respiratory dysfunction in sleep apnea associated with quetiapine. Pharmacopsychiatry, ;41(3):119-21. doi: 10.1055/s-2008-1058111

Sateia, M., Buysse, D., Krystal, A., Neubauer, D., Heald, J. (2017). Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, 

Calabrese, A., Keck, P., Macfadden, W., Minkwitz, M., Ketter, T., Weisler, R., Cutler, A., McCoy, R., Wilson, E., Mullen, J. (2005). A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. American Journal of Psychiatry, 

https://doi.org/10.1176/appi.ajp.162.7.1351

Tassniyom, K., Paholpak, S., Tassniyom, S., Kiewyoo, J. Quetiapine for primary insomnia: a double blind, randomized controlled trial. J Med Assoc Thai; 2010;936:729-734, 

Anderson, S., Vande Gried, J. Quetiapine for insomnia: a review of the literature. (2014). American Journal of Health-system Pharmacy, 71, (5), 394–402 

Thompson, W., Quay, T., Rojas-Fernandez, C., Farrell, B., Bjerre, l. (2016). Atypical antipsychotics for insomnia: a review. Sleep Medicine, 22,13-17.

Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of clinical sleep medicine, 17(2), 255–262. 

Quetiapine (Seroquel) is an antipsychotic medication. Drowsiness is a common side effect of the drug, leading many to try it as a sleep aid.

Quetiapine (Seroquel) as a Sleep Aid | Dawn Health

Quetiapine (Seroquel) as a Sleep Aid

Many people who suffer from insomnia are interested in trying medications to help them sleep better. Although antidepressants aren’t officially approved as a sleep aid, they are often prescribed for this purpose. Trazodone is the 

Trazodone, also available under the brand names Desyrel, Desyrel Dividose, Oleptro, and Trittico, is approved by the Food and Drug Administration (FDA) to treat major depressive disorder. Doctors sometimes also recommend this drug as a treatment for other conditions such as anxiety, substance abuse, schizophrenia, or fibromyalgia.

 Because tiredness/sedation is a side effect of trazodone, it is also used as an insomnia treatment.

Why Is Trazodone Prescribed as a Sleep Medication?

Trazodone is a popular sleep aid because it may work better and be less addictive compared to other sleep-inducing drugs.

Benzodiazepines have been used since the 1960s to help treat insomnia. However, these medications may not be a good long-term choice because they can cause dependence and tolerance. Tolerance occurs when a drug doesn’t work as well over time, requiring you to take more for the same effect. Dependence occurs when you feel like they have to keep taking the drugs to feel “normal”  and may experience withdrawal symptoms if you try to stop using them.

After some of the negative effects of benzodiazepines started to become clear, doctors began looking to other drugs to help treat insomnia. Between 1987 and 1996, doctors prescribed 50% fewer benzodiazepine medications and 

Trazodone is not classified by the FDA as a controlled substance — it’s not very likely to lead to abuse or dependence, unlike some other types of sleep medications.

 However, there is a chance that it may cause mild withdrawal symptoms when you stop taking it, including dizziness, nausea, headaches, and sleeping problems.

Despite its increased use, trazodone typically has limited benefits. Research shows that trazodone may slightly increase how much time you spend asleep; however, 

. For example, the original clinical trial studying the effects of trazodone on sleep found that:

The drug helped people fall asleep 10 minutes more quickly at the beginning of the night.

People who took trazodone slept for only 22 minutes longer per night, on average.

Those who took trazodone did not rate their sleep quality as being any better.

These effects are small enough that experts don’t expect trazodone to make much of a difference for people who struggle to get enough rest. For this reason, the American Academy of Sleep Medicine 

Trazodone has also not been approved by the FDA as a sleep aid.

 However, doctors may still prescribe this medication for people with insomnia if they believe that it may help.

Trazodone tablets come in a few different dosages: 50 mg, 100 mg, 150 mg, or 300 mg. For people with depression, doctors usually recommend taking between 75 mg and 150 mg, and gradually increasing the dose over time if needed. Older adults typically use a lower dosage of trazodone.

People with insomnia usually also take a lower trazodone dose — often 

 If you are taking trazodone, make sure to follow the directions that your doctor gives you. Don’t increase your dose or stop taking trazodone without first talking to your healthcare provider.

It is a good idea to avoid drinking alcohol while you are taking trazodone. If you plan to continue drinking while taking trazodone, talk to your doctor first.

It is important to know that if you take trazodone and alcohol together, an overdose can be fatal.8 Additionally, trazodone can boost the effects of alcohol — you may feel more drunk than usual, or experience higher levels of dizziness, confusion, or impaired judgment.

Alcohol also worsens some of the conditions that trazodone is meant to treat. Alcohol use can cause depression and anxiety or make existing mental health problems worse.

 In addition, alcohol can lead to worse quality sleep, especially in the second half of the night.

Like other antidepressants, trazodone may cause side effects. While taking this drug, you may notice:

Low sex drive or decreases in sexual function

Some trazodone side effects may be more serious. Tell your doctor right away if you notice chest pain, irregular heartbeats, fever, breathing problems, fainting, or seizures.

Trazodone may not be a good choice for people with liver or kidney problems. It also shouldn’t be mixed with certain medications, including other antidepressants like monoamine oxidase (MAO) inhibitors or tricyclic antidepressants.

The American Academy of Sleep Medicine (AASM) recommends that all people with insomnia be treated with 

cognitive behavioral therapy for insomnia (CBT-I)

 In their guidelines, AASM says that CBT-I has a better balance of potential benefits and risks compared to sleep medications. This treatment is also proven to be more effective than other common sleep treatments such as 

CBT-I helps you reframe your thinking and behaviors surrounding sleep. While undergoing CBT-I treatment, you may learn more about sleep and your brain, lessen feelings of worry or frustration surrounding sleep and get support in changing your sleep habits.

Dawn Health provides a comprehensive CBT-I program that can be accessed through an easy-to-use smartphone app. To discover whether CBT-I may be a good fit for you, fill out our 

Everitt, H., Baldwin, D. S., Stuart, B., Lipinska, G., Mayers, A., Malizia, A. L., Manson, C. C., & Wilson, S. (2018). Antidepressants for insomnia in adults. The Cochrane database of systematic reviews, 5(5), CD010753. 

https://doi.org/10.1002/14651858.CD010753.pub2

https://www.drugs.com/international/trazodone.html 

Shin, J.J., Saadabadi, A. (2022, May 2). Trazodone. In StatPearls. StatPearls Publishing. 

https://www.ncbi.nlm.nih.gov/books/NBK470560/


MedlinePlus. (2022, January 15). Trazodone.

https://medlineplus.gov/druginfo/meds/a681038.html

Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of clinical sleep medicine, 13(2), 307–349. 

U.S. Food and Drug Administration. (2010, January 20). Oleptro: Highlights of Prescribing Information. 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022411lbl.pdf

Rush, C. R., Baker, R. W., & Wright, K. (1999). Acute behavioral effects and abuse potential of trazodone, zolpidem and triazolam in humans. Psychopharmacology, 144(3), 220–233. 

University of Michigan Health. (2020, April 22). Trazodone. 

https://www.uofmhealth.org/health-library/d00395a1

Boden, J. M., & Fergusson, D. M. (2011). Alcohol and depression. Addiction (Abingdon, England), 106(5), 906–914. 

https://doi.org/10.1111/j.1360-0443.2010.03351.x

Anker, J. J., & Kushner, M. G. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol research : current reviews, 40(1), arcr.v40.1.03. 

Trazodone may be prescribed to you for insomnia. Learn about how it works and possible side effects.

Trazodone for Insomnia: How It Works & Side Effects | Dawn Health

Trazodone for Insomnia: How It Works & Side Effects

Are you mono, bi, or poly? No, we’re not talking about your love life. We’re talking about your sleep patterns — how often you wake at night and nap during the day, and whether you are a monophasic, biphasic or a polyphasic sleeper. And, even more importantly, how do you perceive your 

? Are you a merry midnight waker, or do bouts of sleeplessness in the early morning make you feel anxious and tense?

If you are the type of person who puts down your head at ten and wakes up at six with no recollection of waking up in-between, you’re definitely a monophasic sleeper — the scientific term for people who get eight hours of solid shut-eye every night without major awakenings.

However, if you are someone who gets up in the middle of the night for a midnight snack, a cup of tea, or even a quiet (or not-so-quiet) early-hours chat with your roommates before settling in for the second stretch, you’re a biphasic sleeper. You probably sleep in two long stretches, broken by a period of wakefulness every night. You’re also biphasic if you like taking an afternoon nap or siesta and spend shorter intervals in your bed at night. In countries like Spain, for example, it is tradition to siesta for one to one and a half hours and then sleep again for five to six hours at night.

Polyphasic sleepers, on the other hand, take segmentation to the next level. They sleep more than twice a day. They may put in a pre-midnight snooze, walk around the house between twelve and two, settle in for another stretch and take short siestas to rest their brains and bodies during the day. Interestingly, we all start out as polyphasic sleepers when we’re born.

Both biphasic and polyphasic sleep are what experts called segmented sleep. Segmented sleep is any type of sleep pattern that involves sleeping in chunks or segments.

Segmented sleep is not necessarily a problem but it becomes one if you believe it to be so. The mantra that a solid, unbroken, eight-hour stretch of sleep is the gold standard is one of the most common and erroneous sleep perceptions that troubles people who experience sleep problems.Thousands of people who wake up in the middle of the night experience great anxiety because they believe their wakefulness is unnatural and unhealthy. This anxiety, more than the awakening itself, can interfere with healthy sleep patterns;worrying puts your brain in a state of hyperarousal, which interferes with your natural sleep drive .

However, research indicates that waking up during the night is often perfectly normal – a throwback to our pre-industrial past. Sleep researcher Roger Ehkirch points out that people in the pre-industrial era habitually slept in segments.

 His research, based on diaries, documents, books and medical literature, deduces that biphasic sleep occurred across the globe in Europe, North America, the Middle East, Africa, South Asia, Southeast Asia, Australia, and Latin America.

In other words, in the pre-industrialized world our ancestors slept in shifts and thought nothing of it. Biphasic sleep – historically dubbed the “first” and the “second” sleep – were perfectly normal. It is likely that artificial illumination, along with work and school schedules, started extending active hours and shifting when, and how, sleep cycles occurred.

Ehkirch says the consolidated sleep to which the industrialized world aspires is for Western societies “a remarkably youthful form of sleep, a product not of the primeval past but of forces grounded in technology (artificial illumination) and shifting cultural attitudes toward sleep over the course of the Industrial Revolution.”

Sleep patterns are not a one-size-fits all affair. Sleep is not a passive state. You sleep in stages , which range from very light sleep to deep sleep. And different people have different sleep cycles, depending on factors such as their circadian rhythm .

Segmented sleep can be unhealthy if all your sleep segments in a 24-hour period do not add up to the total number of hours of sleep you need to function properly. But for different people this figure is different. There is no hard-and fast rule. Some people are genetically inclined to need less sleep.

A 2021 survey done in India even found that medical students performed better academically if they slept segmentally rather than monophasically and that segmental sleepers did not suffer from daytime sleepiness as much as monophasic sleepers did.

When Is Polyphasic Sleep Unhealthy for Me?

Polyphasic sleep is sometimes associated with neurodegenerative illnesses like Alzheimer’s and dementia. And it can become a problem if you’re sleeping polyphasically because you’re stressed or depressed. Or if your job causes multiple interruptions of your natural circadian rhythms over a 24-hour period. Doctors, nurses and night-shift workers, for example, may experience fatigue as a result of such forced polyphasic sleeping patterns.

The Journal Sleep Health warns that polyphasic sleep schedules, and the sleep deficiency inherent in those schedules, are associated with a variety of adverse physical health, mental health, and performance outcomes.

 However, if a polyphasic rhythm works for you and allows you to function optimally, there is no reason why you shouldn’t follow this rhythm.

If you are worried about waking up at night, 

 and talk to our experts to discover if your biphasic or polyphasic sleep patterns are optimal for you.

Sudhansu Chokroverty, Sudhansu. (1994). Sleep disorders in Sleep Disorders Medicine, 7-16. Butterworth-Heinemann. 

https://doi.org/10.1016/B978-0-7506-9002-7.50007-0.

Ekirch A. R. (2016). Segmented Sleep in Preindustrial Societies. Sleep, 39(3), 715–716. https://doi.org/10.5665/sleep.5558

Ekirch, A. (2015) The modernization of Western sleep: or, does insomnia have a history? Past & Present, 149–92.

Hirano, A et al. (2018) DEC2 modulates orexin expression and regulates sleep. PNAS, 115 (13), 2434 – 3439. https://doi.org/10.1073/pnas.1801693115.

Shalini S.P. et al. (2021) Effect of Segmented Sleeping on the Academic Performance of Medical Students. A Questionnaire Survey. Medico-legal Update, January-March 2021, Vol. 21, No. 1.

Weaver, MD et al. (2021) Adverse impact of polyphasic sleep patterns in humans: Report of the National Sleep Foundation sleep timing and variability consensus panel. Sleep Health, 7 (3), 293-302. https://doi.org/10.1016/j.sleh.2021.02.009.

Learn about segmented sleep and the difference between biphasic, polyphasic & monophasic sleep

Segmented Sleep: Monophasic, Polyphasic & Biphasic Sleep | Dawn Health

What is Segmented Sleep? The Difference between Biphasic, Polyphasic & Monophasic Sleep

Sleep is controlled by two different processes in your body: your circadian rhythm and your sleep drive. These two processes help determine your ability to fall asleep and stay asleep and affect how awake or tired you feel during the day.

 Experts collectively refer to your circadian rhythm and your sleep drive as the two-process model of sleep.

 is your “biological clock” that responds to external cues in your environment, such as light, to influence what times you fall asleep and wake up.

Your homeostatic sleep drive, also called sleep pressure or sleep load, is a process that increases your desire to sleep throughout the day. Your sleep drive can be thought of as a balloon that gradually fills up during your waking hours and then slowly deflates during sleep. The longer you are awake, the more the “pressure” builds, making you feel increasingly tired. While you are asleep, the pressure decreases, eventually making you feel less tired and causing you to wake up.

Understanding how your sleep drive grows and knowing the factors that can weaken it may help you get a better night’s sleep.

The sleep drive is powered by adenosine. Levels of this molecule are controlled by energy metabolism within cells.

Every cell in the body uses adenosine triphosphate (ATP) as its energy source. ATP consists of adenosine attached to three phosphate molecules. As the cell breaks off the phosphate molecules one by one, it gains energy that it can use to complete various tasks. Eventually, once all three phosphate atoms are removed, your body is left with just adenosine.

This remaining adenosine forms the sleep drive. As adenosine builds up, it leads to changes in the brain: it slows the activity of brain networks that makes you feel more awake and turns on brain processes that make you feel tired.

Overall, the longer you stay awake, the more energy your brain uses and the more adenosine accumulates to make you feel sleepy.

Sometimes, other factors can also ramp up your sleep drive. Large amounts of mental or physical effort can sometimes increase sleep pressure, causing you to feel more tired after a busy day. Additionally, when you’re sick, and your immune system is activated to fight off germs, it produces molecules that further increase your sleep drive and make you want to sleep more.

The sleep drive is based on natural processes in the body related to metabolism, energy, and brain activity. You can’t damage your sleep drive or turn it off. However, some things may temporarily weaken the sleep drive and make it harder for you to fall asleep.

 is a process that can occur when you are under a lot of stress. It can also be a symptom of post-traumatic stress disorder (PTSD). During hyperarousal, the brain creates stress hormones that activate brain pathways and make you feel more awake. These hormones can also cancel out the effects of the sleep drive.

Caffeine may also affect your sleep drive. When you drink coffee, tea, or soda, caffeine molecules attach to adenosine receptors — proteins in the brain that are responsible for sensing and responding to adenosine. Caffeine blocks adenosine from interacting with these receptors, preventing it from triggering the sleep drive.

How to Harness Your Sleep Drive for Better Sleep

To reinforce and strengthen your sleep drive, 

 can help. “Sleep hygiene” refers to basic sleeping habits that can help you get longer, higher-quality rest.

Many experts recommend going to sleep and waking up at the same time every day. 

 Sleeping in for several hours on the weekend may make you feel better rested in the short term, but it doesn’t give your sleep drive as much time to build up. You may then have problems sleeping later that night, causing you to feel tired for the next few days.

Waiting until you’re tired to lay down in bed is also a good idea for boosting your sleep drive. If you’re trying to go to sleep before your sleep drive has built up enough pressure, you’ll lay awake. On the other hand, waiting longer to go to bed or even occasionally depriving yourself of a little bit of sleep can make your sleep drive stronger, helping you fall asleep more easily.

 In the same vein, avoiding napping during the day helps increase your sleep drive so you feel more pressure to sleep later in the day.

Trying to sleep with a weak sleep drive is a common cause of insomnia and is something that 

Cognitive Behavioral Therapy for Insomnia (CBT-I)

 can help fix. CBT-I is recommended by sleep experts such as the American Academy of Sleep Medicine as the first treatment option for people having trouble sleeping.

CBT-I can help you better understand how sleep processes work and learn how to change your attitudes and habits to strengthen your sleep drive and get better rest.

To see if CBT-I might be the right fit for you, fill out 

Deboer T. (2018). Sleep homeostasis and the circadian clock: Do the circadian pacemaker and the sleep homeostat influence each other’s functioning?. Neurobiology of sleep and circadian rhythms, 5, 68–77. 

https://doi.org/10.1016/j.nbscr.2018.02.003

National Institute of General Medical Sciences. (2022, March 11). Circadian Rhythms. 

https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx

Centers for Disease Control and Prevention. (2020, March 30). NIOSH Training for Nurses on Shift Work and Long Work Hours. 

https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod2/11.html

Dunn, J., &Grider, M. H. (2022). Physiology, Adenosine Triphosphate. StatPearls. 

https://www.ncbi.nlm.nih.gov/books/NBK553175/

Besedovsky, L., Lange, T., & Haack, M. (2019). The Sleep-Immune Crosstalk in Health and Disease. Physiological reviews, 99(3), 1325–1380. 

https://doi.org/10.1152/physrev.00010.2018

Taillard, J., Gronfier, C., Bioulac, S., Philip, P., & Sagaspe, P. (2021). Sleep in Normal Aging, Homeostatic and Circadian Regulation and Vulnerability to Sleep Deprivation. Brain sciences, 11(8), 1003. 

Kalmbach, D. A., Cuamatzi-Castelan, A. S., Tonnu, C. V., Tran, K. M., Anderson, J. R., Roth, T., & Drake, C. L. (2018). Hyperarousal and sleep reactivity in insomnia: current insights. Nature and science of sleep, 10, 193–201. 

Lazarus, M., Shen, H. Y., Cherasse, Y., Qu, W. M., Huang, Z. L., Bass, C. E., Winsky-Sommerer, R., Semba, K., Fredholm, B. B., Boison, D., Hayaishi, O., Urade, Y., & Chen, J. F. (2011). Arousal effect of caffeine depends on adenosine A2A receptors in the shell of the nucleus accumbens. The Journal of neuroscience : the official journal of the Society for Neuroscience, 31(27), 10067–10075. 

https://doi.org/10.1523/JNEUROSCI.6730-10.2011

Centers for Disease Control and Prevention. (2016, July 15). Tips for Better Sleep. 

https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

Goel, N., Basner, M., Rao, H., & Dinges, D. F. (2013). Circadian rhythms, sleep deprivation, and human performance. Progress in molecular biology and translational science, 119, 155–190. 

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Feuerstein, S., Hodges, S. E., Keenaghan, B., Bessette, A., Forselius, E., & Morgan, P. T. (2017). Computerized Cognitive Behavioral Therapy for Insomnia in a Community Health Setting. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 13(2), 267–274. 

The homeostatic sleep drive, also known as sleep pressure is a biological process part of the two-process model controlling sleep.

How the Homeostatic Sleep Drive Works | Dawn Health

How the Homeostatic Sleep Drive Works

Advanced sleep phase syndrome (ASPS) and delayed sleep phase syndrome (DSPS) are conditions that cause your sleep schedule to be out of line with what is considered “normal” by society’s standards. ASPS and DSPS don’t necessarily affect 

If you have an unusual sleep schedule due to working a job or going to school outside of typical daytime hours, it doesn’t necessarily mean you have ASPS or DSPS. When people do have these conditions, they often want to follow a different sleep schedule, but their bodies don’t seem to let them.

If you feel like you may have signs of ASPS or DSPS, talk to your doctor. Treatment can help you safely and effectively adjust your sleeping patterns or cope with keeping an unusual schedule.

ASPS, also called advanced sleep-wake phase disorder, causes you to be an extreme early bird. If you have this condition, for example, you may find yourself becoming very sleepy in the late afternoon and needing to get to bed in the early evening, despite wanting to stay awake longer. You may then find yourself naturally waking up extremely early in the morning, lying awake until your alarm eventually goes off.

Get tired and fall asleep earlier in the day than you want to

Wake up early in the morning and can’t get back to sleep

Experience these symptoms nearly every day, including days when you have work or school as well as your free days

Have had these symptoms for at least three months

ASPS typically occurs due to predispositions or development changes in your circadian rhythm (internal body clock) and sleep drive (the process in your body that makes you feel increasingly sleepy the longer you are awake).

 These changes may develop because of genetics — about 

 of people with ASPS have a family member with the condition. Additionally, ASPS is more common among older adults.

On the other end of the spectrum, DSPS turns you into a night owl. If you have DSPS, you may find yourself regularly staying awake until the early hours of the next morning. In the absence of any responsibilities the next day, you might find yourself sleeping in until noon or later. Some experts also refer to DSPS as delayed sleep-wake phase disorder.

You may want to talk to your doctor about DSPS if you:

Advanced sleep phase syndrome (ASPS) and delayed sleep phase syndrome (DSPS) are conditions that cause your sleep schedule to be out of line.