It typically emerges during adolescence and affects between 7% and 16% of teens and young adults.
The DSPS symptoms of falling asleep and waking up late can be termed as “night owl” patterns.
They can, however, also be similar to othersleep disorderswith significant health impacts, such assleep apnea.
Illustration by Brianna Gilmartin for Verywell Health
This article presents information about DSPS causes, symptoms, and diagnosis.
It explains delayed sleep phase syndrome treatment options available from asleep specialistor other providers.
Illustration by Brianna Gilmartin for Verywell Health
What Is Delayed Sleep Phase Syndrome?
The circadian rhythm is the internal clock that regulates your sleep.
It can be disrupted when you travel, experience illness, or for other causes.
In extreme cases, the sleep delay means going to sleep closer to sunrise.
Trying to force an earlier time can result in hours of lying awake, tossing and turning.
This can provoke anxiety, frustration, and angerfeelings that make insomnia worse.
When sleep occurs, aside from being delayed, it can be normal and uninterrupted.
What Is Sleep Anxiety?
Sleep anxiety occurs in people who become stressed about falling or staying asleep.
Morning Sleepiness
It can be difficult to wake a night owl in the morning.
It is extremely difficult to wake and function for those with delayed sleep phase syndrome.
For night owls, their sleepiness decreases by mid-day.
When the late evening rolls around, a night owl feels very awake, repeating the cycle again.
Without accommodation, chronic tardiness and absenteeism can lead to educational and professional dysfunction.
This is likely due to the chronic effects it produces.
Some of this science is understood.
Beyond genetic programming, there are environmental factors that may unmask the condition.
Most importantly, light has powerful effects on the timing of the circadian system.
It may provoke the delay in sleep timing.
However, it may also be used to correct the condition.
The Circadian System and Sleep
Sleep is dependent on two processes: sleep drive and thecircadianalerting system.
If isolated in a constant environment, like a cave, the genetically determined circadian timing will become evident.
Every cell and organ in the body follows a circadian pattern.
Exposure to natural light in the early morning hours is a signal to the brain for wakefulness.
It makes it easier to wake up.
It also slightly shifts the timing of sleep earlier, making it easier to fall asleep.
This helps to align the desire for sleep to the natural period of darkness overnight.
Without it, significant problems can develop with sleep and health.
This natural drift in the circadian timing is reset with morning sunlight.
How Is Delayed Sleep Phase Syndrome Diagnosed?
There are ways to know if you have delayed sleep phase syndrome.
Testing is not required to reach a diagnosis.
A careful history by a board-certified sleep physician can typically identify the condition.
In research configs, the measurement of melatonin levels can help to identify the circadian timing.
Unfortunately, repeated sampling requires a carefully controlled laboratory environment.
This is virtually never done in clinical practice.
Currently, researchers are working on blood tests to allow healthcare providers to determine internal circadian time.
In some cases, sleep logs kept over several weeks may aid the recognition.
Rarely is testing withactigraphy(small monitors) needed.
Delayed Sleep Phase Syndrome Treatment
Delayed sleep phase syndrome can be treated.
There areeffective waysto keep the timing of sleep in a normal phase.
It may require a little extra effort, but consider the following potentially helpful interventions.
Consistency
There is good evidence that night owls can maintain a socially acceptable sleep timing.
This requires consistency, especially in regard to the wake time.
Get up at the same time every day, including weekends.
Do not sleep in.
Go to bed feeling sleepy, even if this initially requires a delay in the preferred bedtime.
Morning Sunlight
It is especially important to reset the timing of sleep withmorning sunlight.
This is most effective immediately upon awakening.
attempt to go outside for 15 to 30 minutes upon awakening.
Wake with an alarm, throw on clothes, and immediately get outside.
Read the newspaper in the garden.
Check social media while facing the sunrise.
The light should hit the eyes, but dont stare directly into the sun.
Even on a cloudy or rainy day, attempt to stick to the routine.
In winter months, alight boxmay be necessary for phototherapy.
The effects may take up to one month to become evident.
Light therapies also are used in clinical parameters to treat DSPS.
Avoid Light at Night
Artificialscreen lightshould be minimized at night, especially in the hours preceding bedtime.
It may shift the timing of sleep to occur later, causing insomnia and morning sleepiness.
Devices may be switched to night mode, cutting out the blue light that can shift sleep timing.
Blue blocker sunglasses (with an amber tint) or screen covers may be employed.
Or, simply shut down the electronics in the two hours before bedtime.
Thebuffer zonebefore the goal bedtime should be spent relaxing.
Melatonin
Melatoninis a hormone produced overnight by the pineal gland in the brain.
It can be an external signal to the circadian system, most effective among the blind.
The effects may be somewhat weak, however, and certainly overpowered by the effects of light.
Sleep consolidation, stimulus control, mindfulness, and relaxation techniques may be integrated into a program.
It may be guided with help from a psychologist, class, online course, or book.
Poorly timed light may complicate the efforts, and strict adherence to the final schedule must be observed.
Prescription Medications
Sleeping pillsand stimulant medication to enhance alertness have a limited role in this condition.
Generally, they will be weakly effective.
As a result, they may be overused and even abused.
Instead of masking symptoms with a drug, the underlying timing of the circadian rhythm should be corrected.
The causes aren’t always known, but DSPS is common in people diagnosed with ADHD.
Genetic factors also affect sleep and circadian rhythm.
DSPS can lead to sleep deprivation, which can have serious impacts on health and well-being.
If you are struggling with delayed sleep phase syndrome, consider seeking the guidance of a board-certified sleep specialist.
Stanford Medicine.Delayed Sleep Phase Syndrome.
2023 Dec 2;40(12):1566-1573. doi: 10.1080/07420528.2023.2287058.
An update for 2015: An American Academy of Sleep Medicine Clinical Practice Guideline.J Clin Sleep Med.
2016 Aug;200:74-81. doi: 10.1016/j.jad.2016.04.022.
Knutson KL, von Schantz M.Associations between chronotype, morbidity and mortality in the UK Biobank cohort.Chronobiol Int.
2017;169(2):203-215.e13.
2018;115(39):E9247-E9256.
2016;11(3):389-401. doi:10.1016/j.jsmc.2016.05.004
