Delayed Sleep Phase Syndrome

The disorder is defined as a condition during which an individual’s bedtime is deferred by approximately 2-3 hours further than the typical or socially acceptable sleep time. The DSPS is also defined as a condition where an individual’s circadian rhythm or sleep/wake cycle is wholly disturbed or altered from the typical day/night cycle.

The syndrome leads to waking issues in the morning according to their desired morning or waking time. For example, consider a child or an adolescent who should wake up in the morning at 6:00 am, if he is suffering from DSPS, he or she will find it impossible to get up in the morning as the individual goes to bed after midnight.

Night Owls is the title given to individuals with DSPS. They claim that they function better at night or evening hours. However, if you maintain a sleeping chart, you will notice that you have short sleeping phases on weekdays while lengthy sleeping times during the weekends when you are at work or school.

Delayed Sleep Phase Syndrome

Causes of This Syndrome

The exact reason for this syndrome is still unknown. However, it is common amongst 7-16% of the adolescents. Scientists assume that DSPS is a type of an exaggerated response of the body to the standard shift that occurred within the internal clock primarily seen in children and adolescents after they reach their puberty. Certain habits and lifestyle changes are the leading cause which makes the DSPS worse, rather than the pubertal changes.

Causes of This Syndrome based on sleep phase

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Signs & Symptoms Associated With DSPS

The signs and symptoms include the following:

The patient usually complains of insomnia, i.e., inability to nap according to their desired bedtime. Insomnia might be aggravated due to the social pressure over the teenagers to stay awake at night which includes internet use, cell phones or homework.

The patient sleeps excessively during daytime and is unable to get up in the morning according to the anticipated time. It is seen as one of the standard complaints of the patients suffering from this disorder. There is a delay in bedtime at night and getting up early for school or work, leads to the aggravated daytime drowsiness.

The delayed sleeping rhythm late at night leads to the deferment in the hormonal cycle of melatonin which is a night time hormone, lingering in your body at morning time, making it difficult for an early wake-up timings in the morning.

There are no sleep disorders associated with this syndrome, but if the disorders are associated the sleeping phase then it is complicated. However, if no sleep disorder is linked with DSPS, then the individual sleeps well without awakening at night.

The child or an adolescent suffers merely from the shift of sleep cycle or internal clock, pushing it further to 2 hours later. These individuals do not usually suffer if they are given freedom to sleep for extended periods and wake up according to their desired time.

Adolescents and children having this syndrome, experience psychiatric and depression issues which might also include the behavioral problems due to missing school or work and daytime drowsiness. Daytime drowsiness leads to lowered performance at work or in academics due to tiredness, inattention or due to the absent days from school. You might feel dependent on sedatives, caffeine, and alcohol.

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What Are The Diagnostic Tests Available For DSPs?

  • The diagnosis of this syndrome is solely based on the symptoms along with the sleeping chart or logs.
  • A Polysomnogram or an overnight sleeping chart is also advised to eradicate the incidence of any disorder if the medical history suggests one.
  • Primary temperature rhythms and melatonin tests are considered sophisticated ones and are reserved for the research purposes.
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What Are The Treatment Options For DSPs?

DSPS is highly resistant to the treatment options, so you need to consult your doctor in the first place to identify the issues and help you get rid of the symptoms associated with this syndrome. 50% of the children and adolescents suffering from the DSPS usually undergo depression.

The treatment for DSPS include the following:

  • Good bedtime habits

If you are diagnosed with DSPS, then you need to develop and maintain a steady bedtime schedule with good bedtime habits. The healthy bedtime habits include the previous sleeping and waking up on same timings during weekdays as well as on weekends.

Avoid drinking caffeinated products such as tea, coffee, chocolates, colas, non-cola pops, energy drinks or medications such as Excedrin.

Avoid stimulants which might disturb your nap which includes sleeping pills, alcohol or nicotine.

Maintain a perfect environment in your bedroom, i.e., comfortable, quiet and calm.

Avoid stimulating activities before going to bedtime such as watching television or playing computer games and being social on cell phones.

  • Shift your bedtime schedule

The shifting of your bedtime schedule involves two methods, i.e., advance or delay the internal clock of your body.

the correct schedule for bedding and living and work

  • Advance your internal clock:

In this method, you need to move your bedtime slightly earlier on each successive day until the time you reach the anticipated sleeping time. For example, you can start with sleeping at midnight on the first day, 11:45 on the next day, and 11:30 pm on the other night and so on.

Now you need to facilitate the waking time by moving it successively as well to allow the transition to happen in a controlled manner. You can achieve best results with these methods under the observation of a specialist.

  • Delay the internal clock also termed as chronotherapy

For this method, the bedtime is forwarded by 1-3 hours sequentially or later on the following nights till the favorite sleeping time is achieved. For this purpose, you need to keep yourself away from all the social activities. This technique can be entirely approached during the vacation period or school break.

The idea behind this method is to keep your body at ease and adjust yourself to a later bedtime than the previous one which you were used to while suffering from DSPS. Again, for this method as well you need a sleep specialist.

  •   Stay Motivated And Stick To The Schedule

It is highly essential to keep your goals in mind and does not lose the sight of your goals during weekends or holidays. Adhere strictly to the waking and bedtimes, maintain your body’s clock strictly under control, however, it does not cure the tendency of DSPS in a child or an adolescent.

Once you achieve your desired bedtime, then you need to stick to it and stay motivated on a nightly basis so that you can reset your internal clock. As soon as you adhere to the bedtime for several months, you can make slight flexibility in your sleeping time on special occasions or weekends. However, try to get up within the prescribed period otherwise you will again reach back to zero efforts.

Maintain your night time and waking moments to keep your circadian rhythm under check.

  • Bright Light Therapy

Physicians recommend the use of fluorescent light therapy which requires you to purchase a particular lightbox. Expose the child or adolescent to the bright light for around half an hour during the morning which aids in resetting the internal clock of your body. Reduced exposure to bright light during evening might also help. The specialist can suggest the patients with the commercially available particular light boxes along with the correct method of using the bright light therapy.

  •  Avoid Light During Night Time

Any devices such as computers, handheld devices or watching television should be avoided at bedtime, as they lead to the delaying effect on sleep rhythm and make it harder for you to have a good night sleep. Avoid using such devices few hours before going to bed, especially when you are planning to shift the circadian rhythm.

  • Medications:

The sleep specialist might recommend you with the natural-sleep inducing drugs or melatonin for relieving the DSPS.

According to a study, conducted in 2010, it concluded that Melatonin is useful in advancing the circadian rhythm along with the endogenous melatonin rhythm for curing this syndrome.

The clinicians also advise modafinil or Provigil for curing the DSPS patients. The stimulant was approved in the United States do treating the Shift-work sleep disorder which has similar characteristics to DSPS. The drug aids in improving the functioning ability of the sleep-deprived patients during the social or working hours.

The doctors do not recommend this medicine to be consumed afternoon as it is a long-acting drug with a half-life of 15 hours and if it is taken after evening or noon, then it will be impossible for you to sleep well at night.

Vitamin B12 was also suggested as a curing agent for DSPS during 1990’s and is still considered as a sleeping agent by some clinicians. Several clinical trials and studies were conducted regarding the use of Vitamin B12 for DSPS, but according to a review, it had no benefits in curing DSPS.

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Control your bed timings as well as wakeup timings with the help of your family members or consult a specialist to help you out while curing yourself of DSPS. It takes much time to rest the circadian rhythm, so you need to stay motivated during the entire process. Maintain healthy bedtimes, exercise regularly, consume a healthy diet and avoid using handheld devices for extended periods.

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