Delayed Sleep Phase Syndrome

Delayed sleep phase syndrome (DSPS), also known as delayed sleep-wake phase disorder or delayed sleep phase type, is a circadian rhythm disorder characterized by a persistent difficulty falling asleep and waking up at socially acceptable times. People with DSPS tend to have a natural sleep-wake cycle that is delayed by several hours compared to the typical 24-hour day, making it difficult for them to conform to the schedules of school, work, and other social activities.

DSPS

Risk factors

DSPS affects people of all ages, but it is more common in teenagers and young adults, and is more common in males than in females. The exact cause of DSPS is not fully understood, but it is believed to be linked to genetics, as it often runs in families. Lifestyle factors such as irregular sleep schedules, exposure to bright light at night, and the use of electronic devices before bed may also contribute to the development of DSPS.

Symptoms

Symptoms of DSPS include difficulty falling asleep at night, difficulty waking up in the morning, fatigue, decreased alertness, and difficulty concentrating during the day. People with DSPS may also experience mood changes, such as irritability and depression, as a result of the disruption to their sleep-wake cycle.

Diagnosis

Diagnosis of DSPS typically involves a sleep study that monitors a person's sleep-wake cycle over several days. Other tests, such as blood tests, may be done to rule out other potential causes of the symptoms. A delayed sleep phase syndrome questionnaire may also be used to evaluate an individual's sleep-wake schedule and determine if they may be suffering from DSPS.

Treatment

Delayed Sleep Phase Syndrome

Treatment for DSPS typically involves a combination of behavioral therapy and medication. Behavioral therapy may include implementing a strict sleep schedule, avoiding electronic devices before bed, and exposure to bright light in the morning. Medications such as melatonin or chronotherapy may also be used to help shift the sleep-wake cycle. In some cases, accommodation, such as adjusting a person's work or school schedule to match their sleep-wake cycle, may be helpful.

One of the most effective treatments for DSPS is light therapy. Bright light therapy involves exposure to bright light in the morning to help reset the body's internal clock. This may involve the use of a light therapy box or other light sources that emit bright light in the blue spectrum. Blue light is particularly effective for shifting the sleep-wake cycle because it suppresses the production of melatonin, making it easier to stay awake during the day.

Another treatment option for DSPS is chronotherapy, which involves gradually adjusting the sleep schedule by delaying bedtime and wake time each day until the desired sleep schedule is achieved. This can be a time-consuming process, but it is effective for some people with DSPS.

It is also important for people with DSPS to practice good sleep hygiene. This includes establishing a regular sleep schedule, avoiding caffeine and alcohol, and creating a sleep-conducive environment that is cool, dark, and quiet.

Frequently asked questions

Q: What causes delayed sleep phase syndrome? Our body contains an internal clock that regulates many physiologic functions including when we sleep, wake up, hormonal production patterns, eating habits and many other functions that have a diurnal pattern. If you have delayed sleep phase syndrome or DSPS, this clock is not running properly.
Q: Can a disturbance in production of Melatonin lead to DSPS? Yes. Changes in the production of Melatonin might be involved which in turn might be affected by improper exposure to light such as watching stuff on bright screens late, excessive SUN exposure in the evening, habitual staying up late type behaviors etc.
Q: What is melatonin? This is a hormone that your body makes to help control your body clock. Having the wrong amount of Melatonin at the wrong time can cause problems with your sleep. Melatonin levels increase at night and makes you feel sleepy.
Can the blue light from computer screens affect your circadian rhythm? Yes. The blue light from computer screens can suppress your natural melatonin levels and stop you feeling as sleepy at night.
Q: How common is DSPS? DSPS is very common in teenagers. About 7% of teenagers are believed to have it. It can occur at other ages, but it is less likely.
Q: How does DSPS affect people, especially teenagers? If you have DSPS, you have a higher chance of getting mood disorders such as depression and also insomnia. Also, many people have to get up early in the morning for work or study. This can cause problems if DSPS is present.
Q: What helps to cope with DSPS? Some people find it very hard to overcome their DSPS. Some changes to your lifestyle may help you cope. These changes won't stop DSPS, but will make your life easier. You can try to work in the evening, or do night shifts. If your work hours are flexible, then DSPS will be less of a problem. Some people with DSPS find that naps are helpful but they need to be kept short. If you are feeling sleepy during the day, then try to avoid driving. The same goes for using dangerous machinery.
Q: What symptoms does DSPS cause? Some people with DSPS think they have Insomnia. This is because they can’t fall asleep at the expected time. If you have a good night’s sleep when you are allowed to chose your own sleeping and waking times then DSPS is a more likely diagnosis.
Q: Do I need a sleep study to diagnose DSPS? DSPS is usually a clinical diagnosis although sleep studies might be considered when there are other comorbid conditions or to rule out other sleep disorders.
Q: How do you treat delayed sleep phase syndrome? DSPS is One treatment strategy is light therapy (phototherapy), with either a bright white lamp providing 10,000 lux at a specified distance from the eyes or a wearable LED device providing 350–550 lux at a shorter distance. Sunlight can also be used. The light is typically timed for 30–90 minutes at the patient's usual time of spontaneous awakening, or shortly before. Melatonin is also used to adjust the circadian rhythm. A very small dose of melatonin can also, or instead, be taken some hours earlier as an aid to resetting the body clock; it must then be small enough not to induce excessive sleepiness as the purpose of Melatonin is to help regulate circadian rhythm taken several (2-5 hours) prior to sleep onset.
Q: Who can help properly diagnose and treat DSPS? A sleep specialist can help in diagnosing and treating DSPS properly as many with this dosorder are often misdiagnosed as insomnia, depression or other psychiatric or sleep diagnosis. Some questions to ask the sleep doctor when you think you may have DSPS
Q: What are the risk factors for delayed sleep phase syndrome? The risk factors for delayed sleep phase syndrome (DSPS) include genetics, age, gender, and lifestyle factors such as irregular sleep schedules, exposure to bright light at night, and the use of electronic devices before bed.
Q: Who gets delayed sleep phase syndrome? Delayed sleep phase syndrome can affect people of all ages, but it is more common in teenagers and young adults. It is also more common in males than in females.
Q: What are the symptoms of DSPS? The main symptom of DSPS is a persistent difficulty falling asleep and waking up at socially acceptable times. People with DSPS may also experience fatigue, decreased alertness, and difficulty concentrating during the day.
Q: How do you diagnose DSPS? A diagnosis of DSPS is typically made by conducting a sleep study that involves monitoring a person's sleep-wake cycle over several days. Other tests, such as blood tests, may be done to rule out other potential causes of the symptoms.
Q: How do you treat delayed sleep phase syndrome? Treatment for DSPS typically involves a combination of behavioral therapy and medication. Behavioral therapy may include implementing a strict sleep schedule, avoiding electronic devices before bed, and exposure to bright light in the morning. Medications such as melatonin or chronotherapy may also be used.
Q: How do you fix circadian rhythm disorder? Treatment for circadian rhythm disorder involves resetting the body's internal clock through a combination of behavioral and environmental changes, such as maintaining a regular sleep schedule, avoiding bright light exposure in the evening, and implementing a light therapy routine.
Q: What is advanced sleep phase syndrome? Advanced sleep phase syndrome is a circadian rhythm disorder characterized by a tendency to fall asleep and wake up earlier than is socially acceptable. This can lead to difficulty staying awake in the evening and early morning hours.
Q: What is non-24 hour sleep-wake syndrome? Non-24 hour sleep-wake syndrome is a circadian rhythm disorder in which a person's internal clock is not synchronized with the 24-hour day. This can lead to difficulty falling asleep and waking up at socially acceptable times.
Q: What is a delayed sleep phase syndrome questionnaire? A delayed sleep phase syndrome questionnaire is a set of questions used to evaluate an individual's sleep-wake schedule and determine if they may be suffering from DSPS.
Q: What is the approach of NHS towards delayed sleep phase syndrome? The NHS typically recommends a combination of behavioral therapy, light therapy, and medication to treat delayed sleep phase syndrome.
Q: What is the role of accommodation in delayed sleep phase syndrome? Accommodation, such as adjusting a person's work or school schedule to match their sleep-wake cycle, can help manage the symptoms of delayed sleep phase syndrome.
Q: How can we treat delayed sleep phase syndrome? Treatment for delayed sleep phase syndrome typically involves a combination of behavioral therapy, such as implementing a strict sleep schedule and avoiding electronic devices before bed, and medication, such as melatonin or chronotherapy.
Q: Is there any quiz to know if I have DSPS? There are online quizzes and questionnaires available that can help individuals determine if they may be suffering from DSPS. However, it is always recommended to consult with a healthcare professional for a proper diagnosis.
Q: How do people discuss delayed sleep phase syndrome on Reddit? Reddit has several forums and subreddits dedicated to discussing sleep-related issues, including delayed sleep phase syndrome. People can share their experiences and seek advice from others who may be going through similar challenges. Advanced sleep phase syndrome is a sleep disorder in which a person tend to fall asleep earlier than is socially acceptable, typically in the early evening, and wake up earlier than desired in the morning. This can lead to difficulty staying awake during the evening and early morning hours, which can disrupt a person's work or social life. Non-24 hour sleep-wake syndrome is a circadian rhythm disorder in which a person's internal clock is not synchronized with the 24-hour day. This can lead to difficulty falling asleep and waking up at socially acceptable times, as well as other symptoms such as fatigue, decreased alertness, and difficulty concentrating during the day.
Q: Can blue light cause delayed sleep phase syndrome? Yes, exposure to blue light, particularly from electronic devices such as smartphones and tablets, can disrupt the body's natural sleep-wake cycle and contribute to delayed sleep phase syndrome. This is because blue light suppresses the production of melatonin, a hormone that regulates sleep, making it more difficult to fall asleep at night.
Q: How can W8MD's sleep program help me with DSPS? Sleep medicine program uses state of the art technology including the convenient home sleep studies or in lab sleep diagnostic studies to diagnose and treat over 80 different sleep disorders including delayed sleep phase syndrome, sleep apnea, narcolepsy, restless leg syndrome, insomnia to name a few.

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