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How To Treat Delayed Sleep Phase Disorder

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3 What is delayed sleep phase disorder

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Create A New Work Schedule

While this is generally considered a last option, its possible to create a new work schedule that revolves around your existing sleep schedule. Many self-proclaimed night owls simply choose a career that works for them. If using this method, take your social life into account as well a proper work-life balance is essential for a happier life.

Inability To Fall Asleep At The Necessary Time

If someone is incapable of falling asleep at the required time, this may be a sign of Delayed Sleep Phase Syndrome, especially if they are falling asleep late at night. This is because a persons circadian rhythm is tied to their sleep-wake schedule, and regularly falling asleep well after dark could cause DSPS. Teenagers are especially susceptible, as they may feel higher pressure to stay up to due to their school or social life.

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Practice Proper Sleeping Hygiene

Good sleeping habits are vital for treating Delayed Sleep Phase Syndrome. What are the best sleeping habits? Read below for a comprehensive list of what you can do to get a good nights rest.

Go To Bed the Same Time Every Night

Going to bed and waking up at the same time every day will help you keep a regular sleep schedule, and consistency is extremely helpful for combating Delayed Sleep Phase Syndrome. This is because DSPS is influenced by your circadian rhythm. To regulate that rhythm, maintain a regular bedtime schedule.

Take A Shower Before Bed

If you have Delayed Sleep Phase Syndrome, taking a warm shower each night before bed will help promote drowsiness. Your body will heat up during the shower, then cool quickly as water evaporates. This is a sign to your body that it is time to sleep.

Avoid Blue Light

Avoiding blue light, such as the screens on laptops or phones, will help you to fall asleep at the necessary time. Darkness is a sign to your body that it needs to produce melatonin, and if you are exposed to blue light, this can trick your brain into thinking its still light out, causing a delay in melatonin production.

Eliminate Caffeine

Caffeine is a stimulant that can keep you awake well past bedtime. Since those with Delayed Sleep Phase Syndrome already have trouble falling asleep on time, theyre advised to avoid caffeine entirely. Examples of caffeinated products include coffee, as well as tea or soda that contains caffeine.

Maintain A Cool, Comfortable Room

Delayed Sleep Phase Disorder & Sleep

Delayed Sleep Phase Syndrome

Delayed Sleep Phase Disorder , officially known as Sleep-Wake Phase Disorder, is when the disruption of the circadian rhythm inhibits ones ability to function in day-to-day life properly. This sleep disorder most often presents itself as difficulty waking and preparing for everyday routines such as attending school or getting to work.

People afflicted by DSPD are often falsely diagnosed with insomnia or depression, as the presenting signs can be similar. Additionally, depression and DPSD often present together in some cases, depression can be attributed to DPSD and vice versa. The relationship and comorbidity between these conditions can make them difficult to differentiate and treat.

Those dealing with this disorder often experience decreased academic performance or suffer in their work. Also, these individuals may experience drowsiness during otherwise enjoyable activities. All of these circumstances are common symptoms to depression and insomnia, so, as you can see, identifying DSPD can be challenging.

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How Is Dsps Treated

Sleep physicians treat phase delayed patients by manipulating three factors: light, melatonin, and wake time.

  • Light therapy – This allows the body to distinguish between daytime and nighttime. Exposing yourself to morning light shifts your bedtime earlier. Consider a light box for the morning and, during the evening, over-the-shoulder dim lights as opposed to overhead lights.
  • Melatonin – A small dose of melatonin taken several hours before you want to fall asleep helps to advance bedtime.
  • Sticking to a consistent wake time – Many DSPS patients awaken early during the week and sleep late on weekends, which undermine the benefits of changes in light and melatonin. Try to wake up at the same time every day, including the weekends, to set your internal clock earlier.

The Circadian System And Sleep

Sleep is dependent on two processes: sleep drive and the circadian alerting system. If isolated in a constant environment, like a cave, the genetically determined circadian timing will become evident. It is controlled by the suprachiasmatic nucleus, a region of cells in the hypothalamus of the brain, and highly influenced by light exposure. Every cell and organ in the body follows a circadian pattern.

For most people, this internal clock is programmed to run a little long, perhaps resetting every 24.5 hours. In the cave, without exposure to light variance, an isolated person would naturally fall asleep and wake 30 minutes later, with this timing shifting later each day. In a week, the timing of sleep would move three and a half hours.

In a month, it would shift 14 hours, so that the person would want to sleep during the natural day and be awake in the natural night. This natural drift in the circadian timing is reset with morning sunlight.

Exposure to natural light in the early morning hours is a signal to the brain for wakefulness. It makes it easier to wake. 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.

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Cognitive Behavioral Therapy For Insomnia

CBT-I is a 6- to 8-week treatment plan to help you learn how to fall asleep faster and stay asleep longer. This is usually recommended as the first treatment option for long-term insomnia and can be very effective. CBT-I can be done by a healthcare provider, nurse, or therapist you can do it in person, by telephone, or online. It involves the following parts:

  • Cognitive therapyhelps you feel less nervous about not being able to sleep.
  • Relaxation or meditation therapyteaches you how to relax and fall asleep faster.
  • Sleep educationhelps you learn good sleep habits.
  • Sleep restriction therapy gives you a specific amount of time to spend in bed, even if you are not able to sleep during this time. With time, this helps you sleep better when you go to bed. Your sleep time can be increased when you start to sleep better.
  • Stimulus control therapyhelps you have a regular sleep-wake cycle so you can linkbeing in bed with being asleep. This involves going to bed only when you are sleepy, getting out of bed if you cannot sleep, and using your bed only for sleep and sexual activity.

What Is The Treatment For Delayed Sleep Phase Syndrome

Insomnia – Delayed Sleep Phase Disorder

If delayed sleep phase is interfering with your daily schedule, it is important to take steps to minimize its effects. Nearly 50% of all reported subjects with DSP also suffer with depression. While there is no easy cure for DSP, and although DSP has shown high levels of resistance to many treatment methods, consulting a sleep doctor should be considered.

The most common method of treatment is the gradual scaling back of sleeping times, until they achieve the desired time frame. The schedule would then be rigidly implemented. While this can be effective, maintaining the new routine is imperative, as it often resets completely if the individual diverts from the new habit even once with a late night.

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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.

Delayed Sleep Phase Syndrome Treatment

But there is help and a solution to this. I have helped many people who struggle with delayed sleep phase disorder. After about 3 weeks of treatment with a sleep diary, daily follow-up, stimulus control, cognitive therapy, sleep hygiene, and light treatment, they are back in rhythm and can function in normal life again. The treatment time varies from person to person as this requires motivation but my impression is that most people are very motivated to get back into a good circadian rhythm.

The main focus in the treatment of delayed sleep phase syndrome is a combination of light therapy that is used to advance the biological circadian rhythm, along with the gradual shift of time one wakes up in the morning. The treatment continues until the resetting is achieved. It`s also very important to avoid blue light exposure in the evening and during the night. Your body clock gets confused as the blue light triggers your daytime hormones. This is why you should wear blue light blockers if you watch screens at night.

The goal of the treatment is to increase the strength of the circadian rhythm, going to bed earlier, waking up earlier, with better sleep at night and more wakefulness during the day.

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Risk Groups For Delayed Sleep

Delayed sleep-wake phase syndrome is more prevalent in young men and middle-aged women. Overall, however, there is no significant difference in DSPD among genders. The disorder is also quite prevalent among adolescents and teenagers. The circadian rhythm changes during the teenage years, causing delays in the sleep-wake phase. The onset of melatonin, the sleep hormone, begins about an hour later in teens than adults. As a result, DSPD affects anywhere between 7% and 16% of adolescents. One study found that 90% of adults with DSPD experience onset of symptoms in childhood or adolescence.

Depression is common in people diagnosed with DSPD. Up to 64% of people with DSPD also have depression. New research also suggests a link between delayed sleep phase syndrome and ADHD. As many as 75% of adults diagnosed with ADHD in childhood also have circadian rhythm delays.

Struggles With Delayed Sleep Phase Syndrome

What Is Delayed Sleep Phase Syndrome?

For most people, the problems start in puberty, where hormones and disturbed development of melatonin production can be one of the biological causes. In addition to biological vulnerability, social factors and habits can also be a major cause.

Unfortunately, many people are having these sleep problems for a long time without being aware that there is a treatment for this. Many young people struggle with both work and studies because they dont manage to get up in the morning. They are seen as lazy, disobedient, and unmotivated. Some have struggled with this since childhood and they havent received the help they are entitled to. The tragedy is that this can result in them dropping out of school or work life and also developing personal problems.

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Delayed Sleep Phase Disorder And Advanced Sleep Phase Disorder

DSPD and ASPD are disorders where sleep is misaligned with the social day or the desired sleep time. In DSPD, sleep occurs later than desired and in ASPD, sleep occurs earlier than desired ). According to the current clinical criteria, any misalignment between a patient’s sleep pattern and one’s desired time for sleep may qualify for a diagnosis in extremis, this could mean that someone who wanted to go to sleep at 7 p.m. but could not fall asleep until 11 p.m. would qualify for DSPD, even though the sleep pattern might be considered normal. Similarly, someone who wanted to go to sleep at 5 a.m., but fell asleep naturally at midnight could be diagnosed with ASPD, despite perfectly normal physiology. Of course, the clinical criteria were not developed to identify such cases and are meant to target those patients who want to go to sleep at a normal social time but find that they fall asleep very early or cannot go to sleep until very late . Clarification of what is considered clinically abnormal, however, would be helpful in order to differentiate disorders resulting from a natural physiological response or intrinsic disorders of sleep timing.

Continuous Positive Airway Pressure

CPAP is a device that uses mild air pressure to keep your airways open while you sleep. A CPAP machine includes a mask that fits over your nose or your nose and mouth with straps that position the mask. It also includes a tube that connects the mask to the machines motor and a motor that blows air into the tube.

For the treatment to work, you should use your CPAP machine every time you sleep, including during naps. You should also take your CPAP machine with you when you travel. It will take some time and patience to get used to your CPAP machine.

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Signs Of Delayed Sleep Phase Syndrome

The list below contains possible signs of Delayed Sleep Phase Syndrome. These symptoms can fit the description of a number of other conditions, and can also sometimes happen in healthy people as well. Because of that, we recommend that you use this list in tandem with other signs of any disorder you feel you may have and talk with your doctor if you have any concerns.

How Is Delayed Sleep Phase Syndrome Treated

RE: Delayed Sleep Phase Syndrome
  • 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:

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    Common Symptoms Of Circadian Rhythm Disorders Like Dsps & Dspd

    People who have a delayed sleep phase which interferes with their routine often compensate by napping during the day, or sleeping excessively on weekends to counterbalance the deprived sleep during the week. This can lead to temporary relief, but perpetuates the delayed phase cycle.

    Circadian rhythm disorders are caused by the bodys internal clock not resetting and adapting to changes in sleeping patterns, or doing so slowly. In most individuals, going to bed at a time different than what is normal for them will result in the circadian rhythm adjusting and allowing them to fall asleep and wake up as desired. In those with delayed sleep phase, even when suffering through lack of sleep, the body maintains its inclination to go to bed at the usual time, making it difficult to fall asleep even when feeling physically tired. Likewise the body will tend to wake up at the same time, regardless of the amount of sleep, be it too little or too much.

    In contrast to advanced sleep phase, which has minimal effects on work or school obligations, people with delayed sleep phase are more likely to have their sleeping disorder interfere with their necessary daily schedule, leading to chronic sleep deprivation. This can negatively affect school or work performance and social standing. People with Delayed Sleep Phase Syndrome and Delayed Sleep Phase Disorder may be labelled as lazy, unmotivated or undisciplined.

    Depression And Behavior Problems

    If you cant keep a normal sleep schedule, you may develop depression due to stress.

    Daytime sleepiness can also interfere with work or school. You might show up late, miss days, or have a hard time paying attention. Children and teenagers with DSPS may experience poor academic performance.

    DSPS can also lead to a dependency on caffeine, alcohol, or sedatives.

    While the exact cause of DSPS isnt known, its often associated with several factors.

    These include:

    • Genetics. If you have a close relative with DSPS, you have a higher chance of developing the condition. Forty percent of people with DSPS have a family history of the disorder.
    • Changes after puberty. During adolescence, the bodys 24-hour sleep cycle becomes longer, which requires later sleep and wake times. Adolescents also tend to become more social and take on more responsibilities.
    • Psychological and neurological disorders. DSPS is linked to conditions like:
    • depression
  • Chronic insomnia. DSPS affects 10 percent of people with chronic insomnia.
  • Poor sleeping habits. DSPS symptoms can get worse if you dont get enough light exposure in the morning. Symptoms might also increase if youre exposed to too much light at night.
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    When Does Delayed Sleep Phase Syndrome Normally Start

    Delayed Sleep Phase Syndrome often begins early in life. In a study, approximately 90% of patients with DSPS reported the onset of the syndrome in early childhood or adolescence.

    It is possible for DSPS to begin at any time, but it rarely starts after early adulthood. It is important to recognize DSPS symptoms early since this sleep disorder can greatly affect a childs or teenagers school and social life if not treated.

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