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Whether one is naturally inclined to be a night owl or chooses to be one, the repercussions of sleeping or waking up late in the morning are greater than we imagine. This can manifest as a phenomenon called Delayed Sleep Phase Syndrome or DSPS. It is commonly described as a condition that disrupts the healthy sleeping pattern of an individual.

To understand delayed sleep phase syndrome better, it is necessary to know what it is, and all the other related information about it. This article aims to discuss DSPS, its causes, impacts, treatment, and further insights.

What is Delayed Sleep Phase Syndrome?

The more closely we tend to follow the internal clock of our body, the healthier we can be. This internal clock notes down the behavioral pattern of the human body and helps it to align with the social norm. Eating and sleeping are two of the fundamental pillars of human body strength. However, there is a significant population who face serious issues in maintaining the schedule, due to which they exhaust themselves quickly and fall ill now and then.

Delayed Sleep Phase Syndrome (DSPS) is a circadian rhythm sleep-wake disorder characterized by continuous difficulty in falling asleep and waking up often at night. The common symptoms of DSPS are:

• Difficulty in falling asleep
• Excessive sleepiness during daytime
• Often feeling nauseated or exhausted
• Increase in blood pressure
• Depression
• Impaired judgment
• Headaches
• Frequent mood instability.

These may sound familiar to many. But there is nothing to worry about since the diagnosis of this is also very common.

Diagnostic Criteria

The Diagnostic Criteria of Delayed Sleep Phase Syndrome (DSPS) identifies and addresses a few conditions to check if they are sleep disorders. Here's a breakdown of the key indicators:

• Trouble sleeping every night: Having trouble sleeping regularly can be frustrating. People who struggle every night with encompassing sleep can be considered for diagnosis of Delayed Sleep Phase Syndrome.
  
  
• Duration of sleep: Individuals who have no sleeping schedule are more inclined to have DSPS. This involves waking up in the middle of the night or sleeping for less than 6 hours in a 24-hour time frame.
  
  
• Sleeping pattern of last 3 months: To be diagnosed with DSPS, the patient needs to have a disturbing sleep cycle for 3 months or more.

DSPS vs. Insomnia and Night Owl Tendencies

Since sleeping schedule is such an important criterion to keep one healthy, any disturbances in it can cause many distresses in life. Hence understanding the different terms associated with it is very crucial.

“Insomnia”, and “Night Owl” are phrases that have become common in our lexicon. Let us know them in detail, and how they are different from DSPS.

People suffering from insomnia have a typical short sleeping cycle, and face challenges to sleep back once they are up. It can interrupt daily activities. The common symptoms of insomnia are:

• Difficulty in sleeping through the night
• Not feeling refreshed after waking up in the morning
• Feeling sleepy in the daytime
• Constantly fretting about getting enough sleep

Night owl is someone who likes to stay up at night and do their chores, whereas Early Birds are more of early risers and prefer the day to work. Night Owls are characterized by the following points.

• Feeling more active during the night
• Productivity reaches its peak at night
• Feeling best in the later half of the day
• Struggles to stay alert in the morning

Night owls do not have trouble continuing their everyday activities, once their sleeping schedule at day time is sorted. Whereas the insomniacs and individuals with DSPS grapple to sit awake throughout the day and neither can they sleep well at night.

While both people with insomnia and DSPS have difficulty initiating sleep, individuals with DSPS can sleep for longer durations once they do fall asleep, whereas individuals with insomnia would not be able to stay asleep for an extended period.

DSPS stems from the misalignment of the internal clock of the body rather than the inability to sleep, and insomnia is about not being able to get restorative sleep regardless of timing.

Causes of DSPS

The primary reason for DSPS is a disruption in the internal biological clock. This is why the people who maintain timing for their major activities like eating, sleeping, and exercising are more likely to enjoy a healthy life. The causes of DSPS often involve factors that we tend to overlook in our health routines. Here are some of them -

1. Hormonal Imbalance: Melatonin is the hormone responsible for helping the body react to darkness. Cortisol, also known as the stress hormone, regulates the cardiac rhythm that helps in waking up fresh and early. If our schedule involves sleeping late at night, hormones like melatonin and cortisol are produced unevenly, and the results cause Delayed Sleep Phase Syndrome.
   
   
2. Genetical reasons: The condition can affect one if their family members have it as well. This is because certain genes that are responsible for regulating the internal clock of the body can get carried forward.
   
   
3. Puberty: Reaching adolescence delays the 24-hour clock of your body. During puberty, many changes in the hormones also occur including a fluctuation of melatonin levels in the system, which delays the onset of sleep.

A young teenage girl still awake in the late night

Impact on Daily Life

Physicians always recommend good sleep for an individual to stay fit and perform well during the day. The Delayed Sleep Phase Syndrome adults can be very stressful for them, and affect their performance as they feel dizzy, low, and sleepy. Being unable to keep up with a sleeping schedule can also make a person depressed and have significant behavioral changes. Although DSPS affects children as well.

Delayed Sleep Phase Syndrome children are less commonly discussed but since it can be a genetic condition, many children suffer through this. DSPS plays a pivotal role in their personal and academic progress, as it makes them fatigued in school, social events, and playtime. Parents often complain about behavioral issues with these children who do not get adequate sleep at night.

Effects on Mental Health

Delayed Sleep Phase Syndrome’s effects on mental health and can be very serious, including the risk of bipolar disorder. As mentioned before, food and sleep are the basic requirements of the body. Hence, the discrepancy in sleeping results in higher stress, anxiety, depression, and exhaustion, and can even be as serious as leading to bipolar disorder.

Sleep-deprived people often feel hopeless, and persistent sadness and can develop clinical depression. Not only that, having DSPS can trigger the chances of the individuals diagnosed with bipolar disorder.

Diagnosis and Assessment

DSPS encompasses a range of severity from mild to critical. Sleep clinics and specialists are trained professionals who assist the individuals with DSPS based on some other criteria like medical history, lifestyle, sleeping pattern, and more. Diagnosis involves a few tests and monitoring the pattern of daily schedule, they evaluate if the sleeping trouble is due to DSPS, or if there are any underlying medical reasons.

The tool that is used to assess Delayed Sleep Phase Disorder is called actigraphy. This is a wearable device and needs to be worn for 2 weeks to track the time of their sleep and wake up.

DSPS might also require monitoring the heart rate, oxygen level, heart rate, brain waves, eyes, and leg movements. Sometimes hormonal tests are required to assess hormone levels and their potential impact on sleep patterns.

Treatments for Delayed Sleep Phase Syndrome

How to fix delayed sleep phase syndrome is a common question asked by many people. The DSPS can be treated in more than one way. The professional medical expert decides the best way by knowing a few details about the patient. The first of which is how long they have this problem, and how they feel after waking up.

These are the delayed sleep phase syndrome treatments methods:

• Regulating the internal clock is one way one can fix the duration of sleeping time. It can involve either sleeping 30 minutes early or 1 hour late every day. Chronotherapy is a therapy that modifies the bedtime of the individuals. The process involves 8 days or more to regulate sleep.
  
  
• The Bright Light Therapy is to make the patient sit under sunlight for 30 minutes every morning. The persistent practice of exposing oneself at controlled wavelengths helps to regulate circadian rhythms.
  
  
• The doctors can also prescribe melatonin supplements. Melatonin is a hormone that decides our response to darkness. It regulates the circadian rhythms (24-hour internal clock) and sleep. Being exposed to light at night can stop melatonin production.
  
  
• For further precaution, avoid having caffeine, alcohol, tobacco and do not indulge in a strenuous exercise regime. Further limit your sugar intake, which is known to disrupt your sleep cycle. 
  
  
  

Say NO to alcohol before sleep

Lifestyle Changes and Behavioral Modification

Improve your sleep schedule and feel more refreshed by making some simple lifestyle changes and behavioral modification. This includes setting a consistent sleep schedule. To help with this, you can develop a relaxing bedtime routine with calming tea, a cool environment, limited screen time before bed, and exercise most days of the week. This is also known as sleeping hygiene.

Maintaining good sleeping hygiene over years contributes to healthy sleeping habits. Whereas bad sleeping habits reinforced over years can result in distress. A little change in lifestyle and behavior and being persistent with them help immensely in having healthy sleeping hygiene.

The impact of dietary nutrition in sleeping hygiene is undeniable. Having three good meals a day along with the necessary proteins and vitamins will improve sleep quality and keep you refreshed and active throughout the day.

Managing cortisol levels is important, you can take the assistance of your health professionals to develop strategies in managing cortisol. Cortisol is a steroid hormone that helps the body to respond to stress. Nutrition has a profound effect in keeping the hormones in check, and this is why nutritional diets should be taken seriously.

Adults with symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Delayed Sleep Phase Syndrome (DSPS) experience a reciprocal impact on their conditions. Both conditions can have shared symptoms like impulsivity, attention difficulty, and more. ADHD already messes up the circadian rhythm, and DSPS can further exacerbate it. The adults who have Delayed Sleeping Phase Syndrome adhd must have a specially tailored approach to solve this.

The Debate: Is DSPS a Disability?

The legal status of DSPS as a disability can vary. While Section 504 of the Americans with Disabilities Act (ADA) can cover it, the severity of the condition determines its qualification. Incurable DSPS that significantly impairs daily life may be considered a disability under the ADA.

Even if the condition of a few individuals does not align with the legal definition of disability, they might face social implications like issues in sustaining a job, taking advantage of academic opportunities, participating in social activities and more.

Success Stories and Patient Experiences

There are innumerable success stories of people overcoming DSPS. One of them being Peter Mansbach, who quite humbly has shared his story with the world.

He writes, “I'm now retired from paying work, but I work pretty much full time as president of Circadian Sleep Disorders Network. These days I normally go to bed around 3:00 am, give or take, and sleep till noon. I still feel tired for the first hour or two after I wake up, and holding a conversation then is difficult. But that improves as the day goes on. I often feel a spell of tiredness later, and I take a short nap (20 - 30 minutes) during the afternoon.”

Future of DSPS Research and Treatment

Exciting possibilities exist for research on Delayed Sleep Phase Syndrome (DSPS). Future advancements may lead to a deeper understanding of the underlying biological mechanisms and genetic factors that contribute to this condition. This knowledge could pave the way for the development of personalized treatment plans and more precise medical approaches for managing DSPS.

To Sum Up

In conclusion, DSPS presents a significant challenge to individuals striving to maintain a healthy sleep schedule, impacting their daily functioning and overall well-being. Through understanding its causes, symptoms, diagnosis, and treatment options, individuals can take proactive steps towards managing DSPS effectively.

DSPS, while disruptive, is not insurmountable. With interventions such as chronotherapy, bright light therapy, and lifestyle adjustments, individuals can regulate their sleep patterns and mitigate the adverse effects of DSPS on their lives. Moreover, ongoing research offers promising avenues for deeper insights into the condition, potentially leading to more personalized and effective treatments in the future.

By prioritizing healthy sleep habits and seeking professional guidance when needed, individuals can navigate DSPS with resilience and reclaim control over their sleep health. Remember, health is wealth, and investing in quality sleep is essential for overall well-being. Let us endeavor to prioritize our sleep and strive for a healthier, more fulfilling life.

Sources and Further Readings:

1. Delayed Sleep Phase Syndrome: https://www.thoracic.org/patients/patient-resources/resources/delayed-sleep-phase-syndrome.pdf
2. Delayed sleep syndrome: Causes, Symptoms, Diagnosis: https://www.healthline.com/health/sleep-deprivation/delayed-sleep-phase-syndrome
3. Delayed sleep–wake phase disorder and its related sleep behaviors in the young generation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235460/
4. Phase-Dependent Treatment of Delayed Sleep Phase Syndrome: https://academic.oup.com/sleep/article/28/10/1271/2708107

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