A reader asks:

 I would like to know what to do about my severely advanced circadian rhythm!


Here are some strategies: (1) Keep your room lights bright all evening before you go to sleep. (2) Use bright light therapy an hour before you go to sleep, and edge it later as you start sleeping later. (3) Keep your shades drawn to avoid dawn and early daylight exposure. (4) Try the lowest possible dose of immediate-release melatonin (0.1 mg) as soon as you wake up, but be sure not to go into bright light, including outdoor light, for at least two hours. (5) Wear dark sunglasses whenever outdoors in the morning. An alternative, for better visibility, would be glasses that filter out the activating portion of the visible spectrum, as described on CET’s website. Readers may notice that these strategies are generally opposite to those used to counteract the more common delayed sleep phase disorder. They are also opposite to the general strategy for treating depression. Any of these strategies may work on their own, but in all likelihood you’ll need to find an effective combination.