# PWR-051 — Circadian phase alignment: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 10 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Common household or practice equipment — A 14-day sleep, light, activity and symptom diary.; The target sleep and wake schedule tied to work, school or care needs.; A provider-approved light source, outdoor-light plan or light-avoidance aid.; A clock and alarms accessible to the learner. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Circadian timing can shift, but direction and benefit depend on when, for whom and toward what schedule. Circadian alignment requires a target schedule and correct timing. The learner first maps sleep, light and activity, then follows a provider-selected phase-advance or phase-delay plan. Light at the wrong biological time can move the clock the wrong way; medication and melatonin remain clinician-controlled. Target outcome: The learner completes a 14-day timing record and follows a provider-set light and wake schedule with adherence, sleep timing and daytime function measured. ### Authority and setup conditions - A qualified provider determines whether the goal is to advance earlier or delay later and screens bipolar disorder, eye disease, photosensitivity, migraine, medications and shift-work constraints. - Do not buy or improvise high-intensity light exposure without a plan for intensity, distance and duration. - Do not start or retime melatonin or sedating/stimulating medicine from this lesson. - Agree stop rules for mood elevation, eye symptoms, severe headache, worsening sleepiness or unsafe function. ### Required or supplied materials - A 14-day sleep, light, activity and symptom diary. - The target sleep and wake schedule tied to work, school or care needs. - A provider-approved light source, outdoor-light plan or light-avoidance aid. - A clock and alarms accessible to the learner. ## 1. Name the target phase Write the required sleep and wake times and whether the current pattern needs to move earlier or later. Why: “Better sleep” is not a timing direction. Success check: The plan shows a clock-time target and direction. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The plan shows a clock-time target and direction.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Map fourteen days Record sleep attempt, estimated sleep, final wake, naps, outdoor/bright light, exercise, meals, work and symptoms. Why: Timing patterns and social constraints must be visible before intervention. Success check: At least fourteen dated days use the same fields. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “At least fourteen dated days use the same fields.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Select the phase cue with the provider The provider chooses the timing, intensity, distance and duration of light or light avoidance, using clinical phase information when needed. Why: The same light can advance or delay the circadian clock depending on timing. Success check: The prescription states when, how bright, how close and how long. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The prescription states when, how bright, how close and how long.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Anchor the wake period Rise within the agreed window and use the provider-selected light, activity and meal anchors in the planned order. Why: A stable cluster of morning or evening cues strengthens the intended schedule. Success check: The diary shows whether each anchor occurred in its window. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The diary shows whether each anchor occurred in its window.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Block the opposite cue Use the agreed dim-light or light-avoidance step at the time that would oppose the intended shift. Why: Unplanned bright light can cancel or reverse the desired movement. Success check: The learner can name which light window is being protected and why. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner can name which light window is being protected and why.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Shift in provider-set increments Move schedule cues only by the amount and frequency in the written plan; keep naps inside the agreed rule. Why: Large jumps can worsen sleep loss and adherence. Success check: No unscheduled jump or all-nighter is used. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “No unscheduled jump or all-nighter is used.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Record response and adverse effects Each day record sleep timing, sleepiness, mood, headache, eye symptoms and real-world function. Why: Clock change is not worthwhile if safety, mood or function worsens. Success check: The response record includes both timing and burden. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The response record includes both timing and burden.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Review and verify After the set interval, the provider compares the diary with the target and decides whether objective phase testing or plan adjustment is needed. Why: Sleep time is an imperfect proxy for internal circadian phase. Success check: The conclusion says aligned, partly shifted, unchanged or unsafe—not “clock reset”. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The conclusion says aligned, partly shifted, unchanged or unsafe—not “clock reset”.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.