DSPS: Delayed Sleep Phase Syndrome

Delayed sleep phase syndrome (DSPS) is a condition in which people have trouble timing their sleep around daily activities. Because their sleep is driven by their own internal clock, those with DSPS go to bed considerably later (generally in the early morning hours) and have an extremely difficult time waking up in the morning.

While nearly everyone skews his sleeping hours occasionally, DSPS prevents a person from being able to synchronize his sleep and waking with the external environment. Although their need for sleep is normal and they can sleep soundly once they fall asleep, DSPS sufferers have difficultly sleeping during traditional sleeping hours.

The causes of DSPS are not related to jet lag, sleep-wake changes from working shifts or any other external factors. DSPS results from an abnormality in body rhythms, causing the internal clock to be out of sync with normal sleep-wake cycles.

Most people with DSPS have trouble going to bed before 2 a.m. and even more difficulty waking up early in the morning. The biggest challenge is getting seven to eight hours of sleep when they fall asleep so late and have schedules to follow the following day.

Symptoms usually appear in childhood, mostly young men, and often disappear in adulthood. DSPS can result in health and social impacts, causing:

Generally, the above symptoms are strong enough to affect performance at school, work or with friends and family. To combat constant tiredness, those with DSPS tend to develop dependencies on alcohol or medications to induce sleep or stay awake.

Sleep logs and sleep monitoring devices that chart sleep and wake patterns are both key to diagnosing. However, because the symptoms of this disorder are so vague, DSPS is often misdiagnosed as insomnia or a mental illness, such as depression, schizophrenia and attention deficit disorder.

Most DSPS treatments are focused on synchronizing the internal body rhythms with the demands of work, school and social activities. The goal of treatment is to get those with DSPS to wake up at normal times feeling rested and ready to go on with their days.

Mild cases of DSPS usually require gradually moving bedtime to earlier hours, advancing the sleep stage to enable more sleep during traditional sleep times. Lifestyle changes, such as trying to maintain regular schedules and avoiding caffeine and other stimulants in the evening, can help alleviate symptoms.

For more severe cases of DSPS, doctors recommend bright light therapy, a treatment that relies on keeping a bright light that timed to turn on in the morning for 30 to 90 minutes at a patient's bedside. In conjunction with bright light in the morning, this treatment calls for limiting bright light in the evening to ease the body into a more restful state.

Chronotherapy, a therapy that attempts to reset the body's natural circadian rhythm, may also be prescribed. In chronotherapy, a DSPS patient goes to sleep later each night for many days in a row until the desired bedtime is reached, gradually adjusting the internal clock.

Doctors generally prescribe Vitamin B-12 and Melatonin to all of their DSPS patients. However, more research is needed to determine the effectiveness and potential side effects of each.

Resources

About.com (2007). Delayed Sleep Phase Syndrome: The Basics. Retrieved January 17, 2007, from the About.com Web site: http://sleepdisorders.about.com/cs/dsps/a/dsps_basics.htm.

 

Sleep Disorder Channel (2007). Delayed Sleep Phase Syndrome. Retrieved January 17, 2007, from the Sleep Disorder Channel Web site: http://www.sleepdisorderchannel.com/dsps/.