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Delayed Sleep Phase Syndrome

Delayed Sleep Phase Syndrome (DSPS) is a sleep disorder that occurs when a person’s circadian ryhthm (sleep/wake cycle) is delayed from the typical day/night cycle. People with delayed sleep phase have a natural tendency 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  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 Syndrome (DSPS)?

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 Delayed Sleep Phase Syndrome?

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 sleep doctor should be considered.

The most common method of treatment is the gradual scaling back of sleeping times, until they achieve the desired time frame. 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 Delayed Sleep Phase Syndrome 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.

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  • 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.

  • I am 12 I have depression, anxiety and delayed sleep phase syndrome, it really affects my school when I get back my eyes will be closing and then I will snap them open trying not to fall asleep but when I get home from whoever picked me up I won't be sleepy at all anymore and when I try sleeping when I get back I can't fall asleep at all it's the same at night.

  • I am on the verge of tears. I have had this problem with sleep all of my life, and I am now 57. Many people think I am lazy, and it is not true. As I read through the comments above...I have had so many of the experiences described above. I am not alone!

  • Yep. Same.
    I have had this problem all of my life (45 years old, now). I cannot remember EVER waking up before noon (voluntarily) in my life.

    As a child, I would be put to bed at a "normal" hour and lay there for an eternity until sleep would come. Sometimes I would sneak out of bed to find something that would relieve the sheer boredome from doing NOTHING for hours and hours. But inevitably I would get caught, and subsequently yelled at.

    My mother would yell herself hoarse to wake me up for school in the morning, and I would keep falling back to sleep. Even after going downstairs to eat my soggy cereal, I would go back to my room and fall asleep while getting dressed. My mother would check on me, find me asleep with my pants around my ankles, and jolt me awake again by hollering that I was going to miss the bus! Heh.

    I was a zombie at school, and would sometimes sleep right after I got home. Would sleep all the way through until I had to wake up for school again. Wash, rinse, repeat.

    When I tried to keep a day job, I would sleep through my multiple alarms, get written up for being late, or get fired for the inevitable "no call, no show".

    I realised that I just could not keep a day job, so looked into working nights. I knew that I would never be able to make a decent wage with those hours, as NightWalkers are not as valued, or given the same opportunities as their day-shift counterparts.

    Ok, so that's my lot in life. School obviously wasn't working, so I would have to find something that I could do that didn't require much. Luckily I found that Emergency Veterinary medicine was a thing I could do at night. I still don't make much $$, but at least I can feel like my job is important. Tears up my body like crazy, though. So I don't know how long I can keep it up.

    As far as my social life, its tough. I stick with trying to befriend other Night Owls, but even then, they tend to wake up early just fine.

    They would like to call me lazy, but I disproved that theory long ago just by how hard I work. I have told ppl about my disorder, and they kind of "get it", but can't relate. If there's any smack-talking about it, they wouldn't dare do it to my face, lol! They just say, "Ok, well that's just how she is."

    Intimate relationships are fleeting, mostly because I cannot tolerate anyone who cannot understand what I go through. I will never get married or have children (luckily I don't want any). I get intimacy when I want, and don't care too much about having a true "partner". I'm also fortunate in that I actually like being single!

    My bedtime nowadays is around 6am. Wake up naturally between 2-4pm. I work 3 12-hr nights (4pm-4am), and this suits me pretty well. I get 4 days off to do stuff. But it's always nighttime stuff. I can't keep appointments unless there are extended hours. When I try to ask for as late of a time-slot as possible, they say, "Alrighty, how about 11am?" *facepalm* This was especially maddening when I was trying to make an appointment with a sleep specialist! I just don't try anymore. Le sigh..

    I am pretty fortunate, in that I don't have any sort of mental illness on top of it all. I'm not prone to anxiety, no PTSD, no major mood disorders at all, really. Don't get me wrong, I have been depressed. I have cried and cried over this. Some days I just feel so hopeless about it all. But there is a concrete reason for it. Not like an actual mood disorder.

    So I go along in life, doing the best that I can within the confines of this beast. I try not to think about it too much, and just accept that this is my "normal".

    One thing that makes me feel better is that I am not alone. I found out about this disorder by doing a google search. I think I was about 30. Imagine going your whole life not knowing what is wrong with you. Thinking that maybe people were right when they said you were lazy. Wondering why you can't wake up for school or work. I know the older generation of folks here can relate. Those people with kids who have this thing are lucky. Their kids are lucky to have understanding parents. I never had that.

    Look at the bright side. Go ahead and cry about it, though. It sucks. Alot. But pick yourself up afterwards, and carry on. There's still much joy to be had in life

  • Could this be seen and qualified as a disability, taking into consideration that in addition to constant sleep deprivation and lack of energy it also causes depression and is linked to insomnia?

  • I have suffered from DSPD all my life. Would be awake in bed while entire family slept & get in trouble for playing or sneaking outside to play at night. In high school I went to private school and had to be there at 6am. Since my average sleep onset is 5:30AM, I did not sleep Mom-Fri and only slept on weekends. Caffeine was the only saving grace in high school, but it's effectivity wore off at 18yrs old in college. At that point, hypersomnia set in & unfortunately began sleeping through days, tests, final exams, work and had to retake courses. By some miracle I graduated college to tart a day job centric career. After 3 years of misdiagnosis of insomnia, I was finally diagnosed with DSPD. That started a 10 year battle with employers trying to maintain a medical accommodation when coworkers, managers, family, & friends labeled me as lazy and a fraud. I was apparently making this up, and why the hell would I want this type of lifestyle? Persistent abuse of my natural sleep cycle for work resulted in massive and scary bouts of hypersomnia (much like during college), and triggered Non-24. I though DSPD was bad. At least I knew when I'd get sleepy. With Non-24, you have no clue what your sleep-wake patterns will be or how long your days will be. After starting g to fall asleep for days at work, trouble and near accidents driving a vehicle, destroyed relationships, and massive struggle with maintaining employment, I finally received a referral to a specialist. My new DR helped me stop the Non-24 and reset to DSPD 6am-2pm sleep cycle. It took over a year of unemployment and a very disciplined routine with light therapy to accomplish this. My new DR identified that, along with massive sleep deprivation, hormone imbalances were triggering the migraines and hypersomnia. I was prescribed a DHT blocker to take prior to menses to balance testosterone-estrogen levels. This so far seems to have decreased (hasn't eliminated) episodes of hypersomnia. I still battle hypersomnia as result of work-Induced sleep deprivation, which triggers non-24. But with new regiment, highlighting take off work & sleep during 6am-2pm, I'm able to pull out of free running & reset back to Fixed cycle within 2-6 week period. I just recently got new job that operates 24/7. After I finish 1 year of training, I can finally for the first time in my 36 years work a midnight shift. Hopefully I can last through training so that I can experiment with my new regiment on a healthy sleep cycle of 6am-2pm. Maybe I can finally hold down a job that isn't toxic to my health & family/few friends won't label me as lazy of mental anymore. I've given up on children & family. It's not a practical goal, since so few folks understand. Next goal: destroy apathy related to having to let go of "normal life hopes/dreams & expectations" by redefining a new purpose and redefined self-expectations. In other words, discover my unicorn version of a healthy lifestyle.

    My advice for those struggling with DSPD/Non-24: quit trying to be society's normal. Quit everything that is preventing you from a healthy sleep every day. Find the lifestyle, goals and e pectatio s that works uniquely for you. The words are easy to speak/type, but a brutally difficult life change to execute. Expect others to not understand you & have unrealistic expectations of you. Don't place those burdens on yourself. Rock being a unicorn, a limited edition social interaction experience. Be the healthiest you, so that you maximize the rare opportunities when you can overlap schedules to invest in other humans. Bring your best self to each of those star-aligning moments. DSPD/Non-24 is a lifelong battle requiring courage and the utmost self discipline. Stay strong!