X

Delayed Sleep Phase Syndrome

A regular circadian rhythm is shifted with DSPS & DSPD

Delayed Sleep Phase Syndrome

What is Delayed Sleep Phase Syndrome (DSPS)?

Delayed Sleep Phase Syndrome (DSPS) is a sleep disorder where a person’s circadian ryhthm (sleep/wake cycle) is delayed from the typical day/night cycle. People with delayed sleep phase have a natural inclination to go to bed later and wake up later than what is typically considered normal.

How Do Circadian Rhythm Sleeping Disorders Work?

Delayed sleep phase syndrome (DSPS) is one of many circadian rhythm sleeping disorders, and in fact it is the most prevalent of all such disorders. It is the opposite of advanced sleep phase syndrome, in which people go to bed and wake up earlier than normal. People with delayed sleep phase generally go to bed in the early morning hours, from 1 am to 4 am, and wake up later in the morning, from 8 am to 11 am. Socially active people, and those considered ‘night owls’, who feel more awake or sharper during the evenings, are at a high rate of having or getting this disorder.

When delayed sleep phase is not the result of another sleeping disorder, people who have it will achieve sleep quality and duration equivalent to those with normal sleeping schedules. If the delayed sleep phase is not interfering with daily routines, or is in fact complimentary of the subject’s routine, it may be advised to maintain the routine, as the circadian rhythm disorder might not be harmful.

What is Delayed Sleep Phase Disorder (DSPD)?

When Delayed Sleep Phase Syndrome starts to interfere with ‘life’, by conflicting with daily routines such as work or school then it is called Delayed Sleep Phase Disorder (DSPD). When the disorder comes into conflict with daily routines, such as school or work, that requires waking up earlier than would otherwise be natural, the disorder could lead to sleep deprivation and other issues. Delayed sleep phase is responsible for 10% of all chronic insomnia cases.

Common Symptoms of Circadian Rhythm Disorders like DSPS & DSPD

Circadian Rhythm Disorders can become problematic when they interfere with your work or school schedule

People who have a delayed sleep phase which interferes with their routine often compensate by napping during the day, or sleeping excessively on weekends to counterbalance the deprived sleep during the week. This can lead to temporary relief, but perpetuates the delayed phase cycle.

Circadian rhythm disorders are caused by the body’s internal clock not resetting and adapting to changes in sleeping patterns, or doing so slowly. In most individuals, going to bed at a time different than what is normal for them will result in the circadian rhythm adjusting and allowing them to fall asleep and wake up as desired. In those with delayed sleep phase, even when suffering through lack of sleep, the body maintains its inclination to go to bed at the usual time, making it difficult to fall asleep even when feeling physically tired. Likewise the body will tend to wake up at the same time, regardless of the amount of sleep, be it too little or too much.

In contrast to advanced sleep phase, which has minimal effects on work or school obligations, people with delayed sleep phase are more likely to have their sleeping disorder interfere with their necessary daily schedule, leading to chronic sleep deprivation.  This can negatively affect school or work performance and social standing. People with Delayed Sleep Phase Syndrome (DSPS) and Delayed Sleep Phase Disorder (DSPD) may be labelled as lazy, unmotivated or undisciplined.

Who Is Most Likely To Be Affected By DSPS?

Delayed sleep phase affects as many as 15% of teens and adults, a much higher rate than advanced sleep phase, and those with delayed sleep phase are generally younger than those with ASP. It often develops in adolescence and continues into early adulthood, though it may also begin in adulthood. It affects both genders equally. Like ASP, DSP also has a genetic link, and people with a family history of DSP are 3 times more likely to have it as those with no family history of the disorder.

Environmental conditions can lead to the development of Delayed Sleep Phase Syndrome (DSPS) and Delayed Sleep Phase Disorder (DSPD). A lack of morning sunlight exposure, and an overexposure to bright evening sunlight are likely to lead to a shift in the circadian rhythm towards a delayed sleep phase.

What is the Treatment for Delayed Sleep Phase Syndrome?

If delayed sleep phase is interfering with your daily schedule, it is important to take steps to minimize its effects. Nearly 50% of all reported subjects with DSP also suffer with depression. While there is no easy cure for DSP, and although DSP has shown high levels of resistance to many treatment methods, consulting a doctor should still be a priority.

The most common method of treatment is the gradual scaling back of sleeping times, until they achieve the desired timeframe. The schedule would then be rigidly implemented. While this can be effective, maintaining the new routine is imperative, as it often resets completely if the individual diverts from the new habit even once with a late night.

How Does Bright Light Therapy Work?

Bright light therapy is also an accepted treatment that has shown some positive results with Delayed Sleep Phase Syndrome (DSPS) and Delayed Sleep Phase Disorder (DSPD). It involves exposure to bright light at early morning hours shortly after waking up, and avoidance of bright outdoor light during the evening hours. This has been demonstrated to readjust the circadian rhythms of individuals to more normal schedules.

Does Melatonin Work To Treat DSPS or DSPD?

At least one sleep study in 2010 concluded that “Melatonin is effective in advancing sleep-wake rhythm and endogenous melatonin rhythm in delayed sleep phase disorder.” If you believe you’re experiencing DSPS or DSPD consulting a doctor should still be a priority to determine proper treatment.

Circadian Rhythm Image Attribution

(Visited 10,312 times, 65 visits today)
Share This:

View Comments (60)

  • Thanks for telling your story John G. Please let me know how it turns out when you remove the electronics. I am trying this with my 12-year-old son who definitely has DSPD and is distracted by electronics at night.
    CK

    • Another option, which I use, is glasses that block the blue light. You put them on in the evening and they block the blue light from tv, phone, tablet, etc. They help me a little. I got mine at Low Blue Lights website, but there may be other sources.

  • I’ve been trying to have a “normal” life having to deal with this since I was a child. I had a sleep study done that showed I never reached phases 3 or 4 being restful sleep and only an occasional jump into rem. I personally think that the study was flawed because they removed the electrodes just before I would normally fall asleep and in fact the Dr’s assistant said I was unrousable but I was having a crazy lucid dream during this period. Also unlike most with the disorder my natural sleep/wake cycle is between 24-36 hours awake followed by 12-15 hours asleep which often causes a bit of initial confusion when I fall asleep at dawn and wake at dusk and don’t know what time it is. I’ve tried all the options prescribed by my neurologist but nothing worked so I basically have to drug myself to sleep and I still wake up between 1 and 3 in the afternoon. Obviously if I have something important to do the next day I just stay up. I would love to find some kind of work that can accommodate my wacky sleep schedule as well as the genetic issues that leave me in constant pain although who knows... they may be related!

    • OMG! Nicole is it? You're sleep problems and most especially your sleep schedule or "lack there of" sound identical to mine except mine are a bit worse, where there are plenty of days I don't fall asleep til so late into the morning hours (& of course that's even after taking many things just to get myself tired, as since I was a child I've never been able to just fall asleep "on my own") though I was never going to sleep this late, as something back then was able to eventually make me tired, but I was also having to go to school ( on like 4 hours sleep mind you and was a zombie) and then went to college and then was able to work (again on about the same amount of sleep) and etc. back then . But yes since I was a young child I never got tired at the normal time and since a teenager could never have that natural ability to fall asleep on my own. But as I was saying above, probably for the past maybe ten years or so (by the way I'm now turning 38 next month-February of 2018) half the time or maybe most the time I can't get to sleep until about when the sun is coming up and everyone else is going to work, but I say I feel I may be a little worse than you bc on many days, or I should say nights, I don't wake up from anywhere from 6pm-9pm. I never even get to see the daylight. And the other thing is that I've going on is that I used to sleep that entire time-so part of my problem when I was doing sleep studies 5 years ago or so was that I could sleep for sometimes up to 14-18 hours at a time! Well NOW for about the last 2 years I've the opposite problem where when I finally do fall asleep I'm awake every 1-3 hours and it's almost impossible to get back to sleep ugh! And even though I've have dreams and remember them I know for a fact I'm not entering the R.E.M. sleep which is the most important part of our sleep, and I'm sooo exhausted when I wake up and then whatevers left of the day/nite-yet I'm wide awake and can't ever fall asleep to go to bed-even after STAYING UP ALL NITE and trying to go to sleep the next nite! That was other thing I related to you so much on which I've heard anyone else doing except me! I thought I was the only one! I've a lot of Dr appts bc of all my health issues and is any of them are B4 6 or 7pm at nite I have to STAY UP THE WHOLE NITE B4 bc I know by the time I ever get to sleep (if I even get to sleep bc there are many nites I just can't and there have even been plenty of times I've been up at least 3 nites in a row ugh), I'll have to wake up in an hour or two. Or I might not be able to wake up. It's especially amazing how the things I take to try to get me to sleep amazingly sometimes work on those Dr. Appt. days but they don't work til it's too late and then since they just started to kick in and finally work it makes it where it's impossible to wake up in a few hours! But every other nite I try them and use them they never work. Ugh. And I won't even go into my sleep study. Ugh. Waste of time. But then I went to a sleep psychologist which he didn't require one and instead was going to try to start working on "resetting my clock" but I'd to stop going as I'd needed 1 of my many back surgeries (unfortunately I've many health issues but they're unrelated to the sleep). And no one will still give me an en explanation as to why for the past 30+ years I have not been able to just fall asleep naturally on my own! That to me is the most important and the first of my sleep disorders I've ever had. And yes I've tried every dose of melatonin and etc. Nothing works especially after you start taking it for awhile. And even if they help me w/ me DSPD how is that going to help if I still can't fall asleep to begin w/?! All I want is even a semi-normal life. I can't even work part-time bc of this and NO ONE understands it. I live on Long Island,NY and am willing to go anywhere for the best help, actually any help. If you get this I'd love to hear back from you or if anyone else can underworld help that'd be wonderful too. I hope maybe you've had some
      improvements since you wrote and are well. I HOPE TO HEAR BACK FROM YOU & ALSO ANYONE ELSE WHO CAN RELATE &/OR HELP W/ INFO. Here is my EMAIL:xxxxxxxx.
      PS. If they won't show my EMAIL ADDRESS that I wrote above in this I'm going to give the best hint I can below at what it is! It is...
      DANNEIT at aol . com
      I don't think I can make it any easier than that right?

  • Anyone with this issue should get their thyroid checked and checked for autoimmune disease. In addition to late onset sleep I don't get restful sleep and have headaches most days.

  • I have always experienced this phenomenon myself, and it is nice to be vindicated by medical science. However, I do not believe that it is a "syndrome" or a "disorder." Some of us are just born that way, (assuming the absence of any abnormalities in blood work, MRI, hormonal levels and the like, and assuming that we are referring to people who have always had this, it was not sudden onset, and is not environmental). Accepting this instead of letting society tell us when to wake and sleep is probably the first step to feeling better. We all have different roles in life, and I feel like there is a reason that some of us are made this way. There are jobs, roles and professions that not only accommodate this type of sleep-wake cycle, but require it. Rather than trying to cram the square block into a circular hole, we should try to embrace who we are and see how it changes things. God speed to all of you

  • Is so hard. My son is only 15 and he don't sleep I give him Melatonin 10mg and still he fights to go to sleep. He could be 2 or 3 days only sleeping like 2 or 3 hours. The thing is that I get exhausted because I have to stay awake to see what's he is doing . And at school they don't understand . I think teachers need to learn more about their kids situations and conditions. My son has DSPS but he also have ADHD, ODD and AUTISM so is a complete package. Sometimes I don't know what to do.

    • That is my 13 year old son you are writing about, including severe ADHD, Autism, and OCD. I used to get upset that he would not sleep like regular people, even with melatonin. He has been like this since I took him in to adopt him when he was 13 months old. At bedtime, I had to shit him in the room with me to keep him from crawling out of his crib and wandering. Last year, his psychologist sent him in for a sleep study and he was diagnosed. I made sure he went to the one considered to be the best in pediatrics. He told me that the best thing was not to try to force him to adjust to the status quo. It could lead to other things like depression. In addition, it could make symptoms from ADHD worse. I had been homeschooling him since he was in 1st grade, so when the doctor recommended homeschooling, if possible, to work around the "syndrome" I already had everything in place.

  • My name is Pamela and I've had this. Condition since I was a small child and my son had it add a small child too. I think my dad and brother have it but they deny it. The hardest part is the upstream swimming; your while life trying to please everyone else. Parents, teachers, bosses, etc. Once I got into my executive career in a large company it became harder. I would be the last to leave the building at midnight. I never seemed to start getting good work hours in till everyone started leaving to go home. Eventually I retired early on a long term care disability and then got ss disability.I still have to fight family members saying I'm just lazy. But I take Adderol to wake up when I have a regular world appointment. I don't take it daily or you can either start depending on it out It ŵill stop working. I only take a half a pill to wake up and have a good day. I have to set my alarm 30-60 minutes before I want to wake up and take he medicine. I go back to sleep for the allotted time and my second alarm wakes me up. This works well. Warning don't tell people you take Adderol as there seems to be the public opinion that you are a drug addict if you tell people. Even Department of social services will look at you odd if thou tell them even if it's prescribed. That's because if you take the medicines with our the disorder they become damaging to your body. But a person will this real disorder becomes normal when taking it.people have no idea how horrible. Having this Condition can be. When you are trying to wake up sometimes I see stars or feel half dead. Its like your body is addicted to sleep. And in this half in and half out stage of sleep you can do and say all kinds of crazy things. But it helps to have a son who experiences the same things and you know you aren't crazy. Lol. Yes it's a bad thing to have but there are a while lots worse things in life. Main thing is get a good sleep doctor that can help you through life when others don't understand. My son fell asleep at a stoo light one time and another time pushed his wife when she kept yelling at him half asleep so it's nice to have a doctor who understands the disorder and help you cope in life. Remember if yoh have good records and a sleep study through a doctor you are eligible for SS Disability!! Blessing to all!

  • I'm a 23 years old young student guy. Before, I did well in school and sports and had social life.

    But then my success in life enticed me to work more. I continued working on my studies usually until 4 am. I got depression when I was around 18. I got rid of the worst depression 1 year ago, but sleeping problem remains. I got diagnosed depression only. Some week ago I got re-diagnosed ADD (without hyperactivity). I also suspect this DSPS now.

    It's 14 pm when I wake up. I live in a northern country and in the winter it is faint light outside only 9am-15am. I only get to see one hour of light or none. In the summer it's much better and I don't have most of the symptoms.

    Now I don't make any friends as I manage to get in school once a week or so and I'm so tired all day that I cant get things done without urge. This has become a problem, because I don't like to be alone all the time. My cat has become my best friend.

    I crave for some day-time stimulus. My productive hours usually start at 19 pm and last until 4am. Then I usually go to bed. It also strongly feel that my day is like 26 hours and I always have to fight it to be 24h.

    I hate memories of my happy childhood and the feeling of myself becoming a weak and weird person. Closest people also blaming me all the time and I might get thrown out of university.

    Related treatment tried/trying for ADD/DSPS:
    - Concerta (no help)
    - Strattera (testing)
    - Melatonin (no help)
    - Electrical brain treatment (helps depression)
    - Cortisone (helps, but cannot be used for long)
    - Psychotherapy (helps a little)
    - Met 8 different doctors. I hope current one has a clue
    - Bright light in the morning (helps waking up obviously)
    - No blue light evenings (little help)

    Yet to experiment:
    1. Moving south to some sunny place.
    2. Brighter lights at home
    3. Stimulants. Most of them are amphetamine-related and in EU, there is no DSPS diagnose and real stimulants are off the list without narcolepsy or other verified sleeping disorders diagnose. However, I'm very curious about this stimulant called MODAFINIL or PROVIGIL. It is said to help to these symptoms with very low risk of side effects, addiction and tolerance.

    Any experiences?
    I would be happy to share mine on those mentioned.

    • Tried caffeine too, of course! Big help in big amounts, but I don't know the best way to take it or how much I can use. Somewhat interested in those mushroom teas, ginger powders etc., but also very sceptic. Maybe still looking for some "more medical treatment".

  • I am 13 years old but have been experiencing DSPD for as long as I can remember. The reason why im worried is because i was recently on winter break from school and within about 3 days i would fall asleep between 4-8 am and wake up around 4-5 pm I had become completely nocturnal and I am now realizing maybe i have something thats a little more than just insomnia

  • Here in London there is night-time community out there in the form of the party scene . I know because I spent my eariy to mid twenties working on the bar and club scene and spending nights and mornings alongside the subcultures, the geeks, and "freaks", and party queens. Perhaps not the most esteemable and productive career choice but I was using it to medicate/anaethetise. Also pretty unhealthy as I was consuming class As and alcohol . This was part of it. But i briefly found my clan. It was a temporary fix.. eventually my mental health worsened but this was off the back of a traumatic relationship with someone who had a psychotic drug induced breakdown. I've been a night-owl since I was a teenager but I also believe trauma/stress to be an influencing factor. I've suffered from early onset eating disorders and I have an ongoing battle with depression, anxiety and panic and body dysmorphia disorder. I am 34 now and I have dsps as well as periods of hypersomnia ( meaning I can sleep for 12 hours or more). My mum and sister are both long sleepers ( they require 10 hours sleep per night). At 27, whilst at university I was diagnosed with dyspraxia. Dyspraxia affects coordination as well as the immune system ( who knows the effect it has on sleep) . I also have ptsd and experience flashbacks at night . I have tried taking away my devices, I have tried valerian, melatonin, histamines like Sominex , even Valium ( 10mg and would you believe it did not work- I feel asleep at 2am as I always do), lavender baths, massage, exercise( swim, gym) . I was on ssri's for a decade , but came off them as I felt they were making me manic when I wasn't depressed and wondered if they were causing my jaw tic ( so far this has remained). I fall asleep like clock-work at 2am. I've always taken safe- albeit intellectually unstimulating ( but rewarding in other ways) jobs because my difficulties have meant that I have not been able to inhabit and deal with the stresses of the adult world . I worked as a nanny which required me to be at work for 7am 2 days a week. I'd fall asleep at 2-2:30am still. I was in a relationship with an early riser and I would often get up early with him as his theory my clock would reset, it didn't and I would have to catch up at weekends or when he went away . I am in a catch 22 because if I am sleep deprived I am
    More susceptible to panic attacks. I've mostly given up drinking alcohol and no longer take drugs. I rely on coffee to wake me up. I suffer from neck and jaw pain and can often be tight in my body ( lying down def worse). I find it tricky, I've been signed off work for a year due to depression so I am ( gratefully) living off sick benefits but to get better and into work with more earning potential I could do with spending money, on a new mattress, on physio, chiropractor, acupuncture, Alexander technique and all these recommendations I've had but that all require money. I'm trying to think of careers I can partake in from home but fear this is part of a viscious cycle. It's chicken and egg- did stress/depression cause the sleep disorder or via versa. They probably can't be separated. I know that when I am stressed I get an uncontrollable urge to seek safety in sleep.. almost narcoleptic like. I grind my teeth at night and have to wear a night guard. 9 years ago I had the results from sleep tests and also found to be normal- no sleep apnea. Great to read everyone's stories. As with others here, I've found my partners to view me as lazy... though with a tendency to mania I can actually be quite productive. I am just out of sync with the outside world. Every morning that I wake up late ( between 10-1pm) I feel guilty and replay those messages in my head. I long for early sleep phase syndrome. Interestingly I went through a brief period at 19 of getting back from college and going to bed at 5pm sleeping til 10pm. Eating my evening meal and going back to bed to awaken at 8am ready for college. At school, I would write all my essays at night .I also travelled alot in my early twenties - so shifts in time zone. I guess there are no easy answers. I think the biggest vulnerability of those experiencing DSPS is that they become isolated and cut off from society .

  • I honest to god go into a coma when I sleep, I swear I do - I go into such a deep sleep that I don't even hear the 5 different alarm clocks. My sleep studies showed that I hardly move at all and that my breathing slows so much. They tried an apnea machine but it never worked, besides I didn't have an obstruction that they needed to pressure open. I've often wondered if just a small amount of supplemental oxygen during the night wouldn't help me. I even had my house tested numerous times for CO2, but I think I simply don't breathe enough and that lack of oxygen exchange keeps me asleep. And as you all know, it is nearly impossible for me to even attempt sleep before midnight - 2AM being my norm. I've always said 4 hours is all I need - but that's because that's what I've had to do. I don't know, but I'm relieved to finally know that it's not just me.