Delayed sleep phase syndrome is a condition that results in a delayed pattern of sleep, wherein the affected person sleeps later than two hours or more as compared to traditional, accepted standards of bedtime. Such delays in falling asleep lead to many problems in getting up at preferred times. For example, an individual affected by delayed sleep phase syndrome, who needs to sleep by 11 pm and get up by 7 am will generally end up falling asleep by 1 am or 2 am and then face many problems while trying to awake for work or school.
Children and adolescents are mostly affected by delayed sleep phase syndrome. Such affected individuals tend to perceive themselves as ‘night owls’ and report to be most alert and at their best functionality during the late evening hours or at night. The sleep pattern of individuals with delayed sleep phase syndrome will usually indicate short periods of sleep during the weekdays with very few or no interruptions in the night, and long periods of sleep lasting to very late mornings or early afternoons, during weekends.
Delayed Sleep Phase Syndrome Symptoms
Some of the signs and symptoms of delayed sleep phase syndrome are discussed below:
- Unable to fall asleep at the preferred time: This symptom can be considered as a part of insomnia. This inability may be increased due to many social pressures such as use of internet or cell phone and homework, etc., faced by the adolescents, which prompt them to stay up late
- Absence of other sleep disorders: The absence of other types of sleep disorders in individuals with delayed sleep phase syndrome generally leads to a peaceful and uncomplicated sleep through the short period of sleep during the night. The only defect is that the circadian rhythm of the body is pushed by two or more hours. The patients may not experience any problems in falling asleep or maintaining it.
- Unable to wake up at preferred time and increased sleepiness during the day: This is generally the common cause of complaint by patients of delayed sleep phase syndrome, rather than insomnia during night. Since the patients are unable to fall asleep at desired times, they have problems in waking on time for school/work. Also, decreased sleep durations lead to excessive drowsiness during the day, particularly on weekdays.
- Depression and behavioral abnormalities: Teenagers and children with delayed sleep phase syndrome may experience behavioral disorders, depression and other psychiatric difficulties due to sleepiness during the day as well as missing school. Drowsiness in the daytime can lead to affected children missing school, diminished concentration levels and tardiness which the result in lowered performance in academics. One may also observe increased dependency on sedatives, caffeine, alcohol, etc. in the patients.
Causes of delayed sleep phase syndrome
The cause of delayed sleep phase syndrome is still a subject of research. However, it can be considered as a common problem as 7 to 16 percent of the teenagers experience the disorder. It is popularly believed that delayed sleep phase syndrome is a type of heightened reaction of the body to the normal change in the internal clocks, experienced by adolescents post puberty
It is essential to note that the disturbed sleep behavior is not a premeditated effort. Most cases of delayed sleep phase syndrome have been reported only with teenagers. A few cases have been observed in children, and in very rare cases, the condition may commence post early adulthood.
Treatment of delayed sleep phase syndrome
The methods to treat delayed sleep phase syndrome are as follows:
- Developing good sleep habits is one of the best ways to overcome the effects of delayed sleep phase syndrome. The habits may include avoidance of caffeinated products like cola, tea, coffee, chocolates, etc.; avoidance of stimulating activities like playing or watching television just before going to sleep; avoidance of stimulants intake; going to bed and getting up at the same time every day, and keeping a quiet, cool and relaxed environment in the bedroom.
- Advancement of the internal clock: It refers to successively advancing the bedtime by some minutes every night, till one is able to sleep at the preferred time. For example, one may start by going to bed at 12 am on the first night and then successively advance it by 15 minutes the following nights to 11:45 PM, 11:30 PM, and so on till the desired bed time is achieved.
- Delaying the internal clock refers to delaying the sleep by a few hours or more every night till one is able to sleep at the preferred time. This treatment method requires many days off from school or work and hence should be tried during the holidays. It is thought that delaying the sleep is easier on the body than advancing the internal clock
- Bright light therapy may also be used, wherein the child with delayed sleep phase syndrome is exposed to about 30 minutes of bright light in the morning via a special light box, which will lead to adjustment of the internal clock
- On rare occasions, doctors may prescribe medications to induce sleep.