Delayed Sleep Phase Syndrome - Effects, Causes, Diagnosis and Treatment

What Is Delayed Sleep Phase Syndrome?

Also called delayed sleep-wake phase sleep disorder, delayed sleep phase syndrome (DSPS) is a disorder of the circadian rhythm. In this, there is a delay in the sleep pattern than usual by a period of two hours or more. As a result, waking up is also delayed, and one might find it challenging to get up in the morning to go to school or work.

How Is Being a Night Owl Different From DSPS?

In DSPS, it is not that you wish to stay late, but you end up staying late because of a change in your internal body clock.

What Is the Effect of Delayed Sleep Phase Syndrome?

Delayed sleep phase syndrome results in periods of sleep which are short during the weekdays. They find it difficult to wake up in the morning during the weekends and sleep till late morning or early afternoons. This, in turn, disrupts their day-to-day activities and affects their performances in school or the workplace.

What Is the Prevalence of Delayed Sleep Phase Syndrome?

DSPS is not a syndrome with an age predisposition and can occur in anyone. However, it is widely prevalent in teenagers and young adults. In adolescents, the incidence of DSPS is around 7 % to 16 %.

What Is the Cause of Delayed Sleep Phase Syndrome?

The cause of delayed sleep phase syndrome is not precisely known, but the following factors have been attributed:

• Pubertal Changes:

The sleep-wake cycle tends to become a bit longer with puberty resulting in delayed sleep and wake-up times. As their age advances, they become more responsible and take up social activities, which further leads to a disturbance in their sleep-wake cycle.

• Insomnia:

People who have chronic insomnia develop delayed sleep phase syndrome. It has been estimated that around one-tenth of people affected with chronic insomnia get DSPS.

• Family History:

Having a close relative or family member who has delayed sleep phase syndrome can put the individual at an increased risk of getting the syndrome. The percentage of risk is around 40 in these cases.

• Sleeping Habits:

Sleeping habits limiting exposure to light in the morning or increasing light exposure at night might bring about delayed sleep phase syndrome.

• Psychological Disorders:

The following psychological disorders have an association with delayed sleep phase syndrome:

• Anxiety.

• Attention deficit hyperactivity disorder.

• Depression.

• Obsessive-compulsive disorder.

How Do I Know if I Have Delayed Sleep Phase Syndrome?

The following signs and symptoms help in identifying sleep phase syndrome:

• Difficulty in Falling Asleep:

Individuals with DSPS exhibit signs of insomnia further aggravated by the social pressures, homework, or usage of cell phones and the internet.

• Difficulty in Waking Up:

It is a supposed sequel to delayed sleep time. Lack of sleep during the night eventually leads to delayed morning waking ups on the weekends and daytime sleepiness on the weekdays when they wake up to work or school.

• Behavioral Problems:

Delayed sleep phase syndrome might bring about depression and problems with behavior in those children and adolescents who experience it. Behavioral issues that occur with DSPS include daytime sleepiness and missing school and work, which might lead to inattention and poor performance in academics or work.

• No Sleep Problems:

If people with DSPS do not have any other associated sleep disorders, they do not have disturbed sleep. These individuals with delayed sleep phase syndrome only have difficulty falling asleep; however, after sleeping, they do not tend to have any disturbances and sleep with no or few awakenings through the night.

How Is Delayed Sleep Phase Syndrome Diagnosed?

1. Symptoms present in the affected individuals help diagnose delayed sleep phase syndrome.

2. Maintaining a sleep log or sleep diary, a day-to-day sleep record, also helps identify this syndrome.

3. In addition, other devices like actigraphy and polysomnography help in diagnosis. An actigraph is a non-invasive device that resembles a wristwatch, and a polysomnogram is a sleep study done overnight to detect the presence of any other associated sleep disorders.

4. Melatonin test and core temperature rhythms are marked when tests are indicated for research purposes.

How Is Delayed Sleep Phase Syndrome Treated?

• Practicing Good Sleep Habits:
  • Avoid caffeine-containing products like chocolates, coffee, tea, medications, and energy drinks before going to bed.
  • Do not take any stimulants that disturb sleep like nicotine, sleeping tablets, tobacco, and alcohol.
  • Keep your bedroom cool and calm.
  • Avoid stimulating devices like computers, television, tablets, and smartphones.
  • Avoid doing strenuous activities before going to bed.
• Chronotherapy:

In this method, bedtime is delayed by one to three hours more than usual to shift the internal clock. It is done in the subsequent days when you are free from social activities. These therapies should be tried during long vacations or school breaks. Chronotherapy is followed until the desired bedtime is reached. The success of this type of strategy lies in the fact that the body quickly adapts to sleeping late rather than trying to sleep early.

• Advancing Internal Clock:

Advance your bedtime in subsequent steps. Each successful night, the bedtime is a bit advanced until the desired sleeping time is reached. For example, if you go to bed by 12.00 AM on the first day, try to sleep the next day by 11.45 PM, and so on till you achieve the desired time.

• Bright Light Therapy:

Increasing the exposure to bright light in the morning and reducing its exposure in the evening helps sleep.

• Medications:

Medications like Melatonin and sedatives can be tried to induce sleep, but these should be taken only on the physician's advice. Melatonin is a hormone responsible for controlling the sleep-wake cycle.

Conclusion:

Delayed sleep phase syndrome might seem like a negotiable problem, but remember, it is only the tip of an iceberg, and there are plenty of things underneath that have to be paid attention to. Therefore, if you seem to experience a disruption in your sleep-wake cycle, try to inculcate measures to overcome it. If not, reach out to your healthcare provider at the earliest.