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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 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!

  • Not only does this explain my entire life, it also explains my children! 2 am is exactly when my body wants to go to sleep. For a variety of reasons I now take a prescription sleep aid- but it I take it while I still feel awake it won’t kick in at all. I have to be at least starting to feel ready.

    Sun has no effect. I frequently sleep with my shade up and curtains open, and I can’t ever remember daylight waking me up.

    My children were like this in infancy! Had a joke with my 1st, in 1982, that he simply couldn’t sleep until he’d seen Johhny’s monologue. And he’d sleep until 10 am. Not one of them ever fell asleep when we’d get together with friends for New Years- they always rang in the New Year with bright eyes. All the other children were always sound asleep already, even right in the room with everyone else.

  • My son has just turned 12 - i honestly cannot remember him taking less than 1-2 hours to fall asleep at night tried all the usual things less sugar, black out blinds, calm before bed (no gadgets in bedroom - (ever), making room cooler, reading before bed, chats before bed, keeping him up later, I am stating to think its DSPS, doctors not very helpful keep telling me if he can't sleep to repeat bedtime routine one and over each night or to go to bed later - he's at high school now and its affecting his school work as he's tired in the morning and its getting harder and harder to get him up for school. He says he's not worried about anything (and its not like its a new thing thats just started), He struggles to unwind at bedtime - once asleep thats him until the morning when I wake him up. Would Melatonin help to reset his sleep patterns? Feel we have tried everything suggested - the later he stays up doesn't make any difference he still takes ages to get to sleep we have been putting him to bed later on the doctors advice (10pm) but he's still awake 1-2 hours later and then can't get up in the morning - any advice much appreciated thanks.

    • Jackie, you have just described my 13 year old son. I have now got the school involved because my son refuses to go to school because he is so exhausted.

  • I have this, have had it most of my adult life, I am 51 now. I NEVER fall asleep before 3:00 if allowed to sleep on my own, but working 8:00a-4:30p does not allow that. Because of work, I started taking Ambien 20 years ago and still take it (Meletonin did nothing for me). I have tried to ween off of it but have severe restless leg syndrome without it. We tried ropinerole for the RLS but it made me violently ill. Now the Ambien no longer works, but it does help. I do want to get off the Ambien, but I can't figure out how to balance work/sleep. Without it I am awake until 3:00-4:30 am and sleep until about 11:00a. I should realistically be up at 6:00a to allow enough time to get ready for and be at work by 8:00a but it never happens. Now, I am in bed and take my Ambien at 8:00p, I am asleep by 1:00a, I struggle to get up by 7:00s and race to get ready and get to work before 9:00a. After 20 years I have a new boss and he wants me to work at 8:00a... it is literally impossible. Now, I stress knowing I HAVE to be at work at 8:00a so even on the Ambien I stress having to get up and don't fall asleep till 3:00a. It's catch 22 and a no win situation. On Weekends, I go to bed at 10:00p and take my Ambien. I am usually asleep by 1:00a, and I am awake at 9:30a. I think not having the stress of knowing I HAVE to get makes it easier for me on the weekends. I am probably going to get fired because this new boss won't work with me. My previous bosses didn't stress it because I do my job and I am liked and have 20 years experience. Funny thing, I can sleep all day while the sun is out. Just not at night. I'm seriously at my wits end.

  • Interesting reading all these comments, feel like i among kindred spirits. I have always had trouble with my sleep since childhood but i can remember it was around the age of 8/9 that i religiously read until 2/3am every night and was exhausted for school the next day. Throughout school i got by but was relatively miserable keeping with this pattern. Maybe i went through phases of sleeping around 1am but I cant remember ever falling asleep before 11pm no matter how tired i have been. although it has impacted negatively on my life at times i see it as a blessing because i spent all the time reading while all the other kids were sleeping and now i have a degree in english with creative writing and a masters in writing! if you spend the time before bed when you cant sleep being creative or reading or doing something you love then it stops being a negative just because it doesn't fit in with the 9-5 routine of things. In addition to this, think of being alive two or three hundred years ago. Our peers would have been thankful of someone who was alert every night to keep watch over the camp!

    What helps me sleep is no caffeine at all after 3pm, lots of exercise during the day swimming is the best or hiking and reading before bed.

    In answer to all of you that have mentioned people calling you lazy... go wake them up at 3am and tell them they are lazy then, for we are all wide awake then when they are sleeping away!!

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