Advanced Sleep Phase Disorder (ASPD), also known as the advanced sleep-phase type (ASPT) of circadian rhythm sleep disorder, is a condition that is characterized by a recurrent pattern of early evening (e.g. 7-9 PM) sleepiness and very early morning awakening (e.g. 2-4 AM). This sleep phase advancement can interfere with daily social and work schedules, and results in shortened sleep duration and excessive daytime sleepiness. The timing of sleep and melatonin levels are regulated by the bodys central circadian clock, which is located in the suprachiasmatic nucleus in the hypothalamus. Symptoms
Individuals with ASPD report being unable to stay awake until conventional bedtime, falling asleep early in the evening, and being unable to stay asleep until their desired waking time, experiencing early morning insomnia. When someone has advanced sleep phase disorder their melatonin levels and core body temperature cycle hours earlier than an average person. These symptoms must be present and stable for a substantial period of time to be correctly diagnosed. Diagnosis
Individuals expressing the above symptoms may be diagnosed with ASPD using a variety of methods and tests. Sleep specialists measure the patients sleep onset and offset, dim light melatonin onset, and evaluate Horne-Ostberg morningness-eveningness questionnaire results. Sleep specialists may also conduct a polysomnography test to rule out other sleep disorders like narcolepsy. Age and family history of the patient is also taken into consideration. Treatment
Once diagnosed, ASPD may be treated with bright light therapy in the evenings, or behaviorally with chronotherapy, in order to delay sleep onset and offset.
Cerebro-costo-mandibular syndrome is a very rare genetic disorder which is characterized by jaw/chin, palate and rib abnormalities. Signs and symptoms
The following list comprises the most common symptoms people with this disorder exhibit:
Severe micrognathia
Thorax in the shape of a bell
Cleft palate
Neonatal respiratory difficulties
Rib gapsCommon (but not the most) symptoms include:

External auditory canal atresia
Hearing loss
Failure to thrive
Glossoptosis
Intellectual disabilities
Fetal growth delays
Kyphosis
Short height
TracheomalaciaNot common but also not rare symptoms include:

Fifth finger clinodactyly
Cerebral calcification
Hydranencephaly
Meningocele
Microcephaly
Polycystic kidney dysplasia
Myelomeningocele
Porencephalic cyst
Short, hard palate
Spina bifida
Ventricular septal defect
Webbed neck

Causes
This disorder is caused by autosomal dominant mutations in the SNRPB gene, in chromosome 20. Epidemiology
Only 110 cases have been described in medical literature. == References ==