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referred to as familial advanced sleep phase disorder. However, according to
American Academy of Sleep Medicine's classification of sleep disorders,
advanced and delayed sleep phase (DSP) is only a disorder when it is prob-
phenotypes will not be called disorders. FASP is originally identified as a
highly penetrant autosomal dominant trait in three families in which affected
naire was performed on family members, and FASP subjects scored signif-
icantly higher than unaffected relatives. FASP is early onset: the youngest
affected individual was 8 years old, and most FASP subjects knew they were
obligate “morning larks” by 30 years of age, which is distinctly different
family demonstrate a 4-h phase advance of the time of sleep onset, sleep off-
set, first slow-wave sleep, and REM sleep compared to that of the controls,
although sleep quality and quantity are not significantly different between
the two groups. Narcolepsy, obstructive sleep apnea, “restless legs” syn-
drome, and depression were ruled out as possible causes of early sleep onset
in these FASP subjects. Consistent with the sleep-wake cycle, dim-light
melatonin onset, a reliable marker of circadian phase, and core body tem-
perature rhythms are also advanced by approximately 4 h in FASP subjects
Figure 3.1 Free-running period of sleep/wake and body temperature cycles in a FASP
subject. Sleep/wake (A) and body temperature (B) rhythms of a 69-year-old female mon-
itored in time isolation for 18 days. The data are double plotted. (A) Filled bars indicate
periods of sleep derived from polygraphically-recorded sleep scored using “standard”
criteria. (B) Filled bars indicate periods when body temperature is below the daily mean.
The free-running period of both variables are 23.3 h based on chi-squared periodogram.
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