In a world of working nine to five, it’s easy to take sleeping through the night and waking up early in the day for granted. It can be a hard world for those that don’t fit the mold: people like night owls, new parents and Netflix binge-watchers. And for some other individuals, the inability to sleep through at night and be awake for most of the day is due to a medical issue called Delayed Sleep Phase Disorder (DSPD).
For these people, their sleep cycle is completely shifted from the standard sleep pattern. Without treatment, people suffering from Delayed Sleep Phase Disorder can have significantly decreased the quality of life.
This article will take a look at Delayed Sleep Phase Disorder, providing an understanding of what it is, how to treat it and how to adapt as someone who suffers from the condition.
WHAT IS DELAYED SLEEP PHASE DISORDER?
Before jumping into an understanding of Delayed Sleep Phase Disorder (also known as Delayed Sleep Phase Syndrome), let’s begin with understanding how normal sleep works.
Our drive to sleep is regulated by a complex neurological system known as the circadian rhythm. The circadian rhythm has various triggers, and the predominant one is the type and intensity of light exposure. Light with a shorter wavelength, like that coming out of the sun and computer screen, is interpreted by the brain as daylight, which makes people feel more awake.
Delayed Sleep Phase Disorder is like persistent jetlag, in that your body doesn’t respond in the same way to light. And instead of your body adjusting after a few days, the condition persists indefinitely.
Those with DSPD find themselves unable to sleep until hours after midnight and sleep well into the morning or afternoon. Unlike other sleep disorders, patients’ quality of sleep is fine: They get good sleep and sleep the same amount of hours as other people.
DSPD is a medical condition thought to be caused by genetic mutations or injury. The circadian rhythm is permanently shifted and out-of-sync with the rest of the population. Some researchers believe that the circadian clock in these patients is simply longer than 24 hours.
The percent of the American population experiencing Delayed Sleep Phase Disorder varies widely based on age. An estimated seven to 16 percent of the adolescent population experiences symptoms, compared to 0.17 percent of the general adult population. It is often a condition that a person will grow out of once they pass high school.
Many sleep disorders express similar symptoms, such as persistent fatigue or difficulty sleeping at normal hours. DSPD distinguishes itself with these primary symptoms:
- A delayed phase of sleep relative to the rest of the population and socially accepted norms
- Excessive daytime sleepiness
- No issues falling asleep and staying asleep when within the hours of the patient’s sleep-wake cycle
- Great difficulty or inability to self-correct one’s sleep schedule
Sometimes people with DSPD naturally adapt, selecting lines of work that offer night shifts or flexible hours so the person can continuously “sleep in” and work during their prime hours. But when forced to assume a normal lifestyle with an early wake time, the debilitating effects of DSPD become apparent. Many patients are forced to simply learn to live with the fatigue and sleep deprivation during weekdays and sleep in during weekends to compensate.
HOW IS DELAYED SLEEP PHASE DISORDER DIAGNOSED?
Thanks to increased awareness and a standard testing methodology, diagnosing Delayed Sleep Phase Disorder has become vastly easier. Someone suspecting that they may have a sleep disorder will usually be referred to a sleep therapist, who will perform the following set of tests on the patient:
A sleep diary is where a patient will record the times they fall asleep and wake up and describe how they feel upon waking up. The specialist will look for marked shifts in the patient’s sleep-wake patterns relative to the norm, and attempt to measure the average shift. For example, she may find that your sleep cycle is shifted by three hours relative to the general population. Seeing a consistent delay over the course of two weeks is an important marker for DSPD, and helps rule out other issues.
This in-hospital test is used when there is an uncertainty as to what sleep disorder the patient is suffering from. The test involves hooking the patient up to a variety of tools to measure breath, blood pressure, heart rate and more. It measures:
- Activity during the night
- Blood oxygen levels
- Eye movements
- Heart rate
- Sleep-wake rhythm
It is one of the most effective tests available for screening out issues like narcolepsy or sleep apnea.
This test can be conducted from home. It involves having the patient go through their daily routine wearing a small sensor. This sensor will automatically record reduced levels of activity and records them as wakefulness or sleep. The test reveals the patient’s sleeping pattern without having to depend on them manually recording it themselves in a diary. It also enables the medical practitioners to rule out other sleep disorders.
DSPD can trigger other conditions connected to the body’s sleep-wake cycle. Seasonal Affective Disorder (SAD) is a type of depression caused by the advent of shorter days and less sunlight. Those with DSPD are 3.3 times more likely to report SAD episodes.
Generalized depression is also linked to DSPD. The decreased quality of life and general exhaustion brought on by someone with DSPD often causes severe depression. Sufferers of DSPD often to turn to medications, both legal and illegal, in attempts to fall asleep earlier, increasing the likelihood of secondary symptoms or overdose.
TREATMENTS for DSPD
There is no cure for DSPD, and an individual who develops DSPD should expect the condition to re-occur persistently throughout his or her life. There are some treatments to help lessen the ill effects of the syndrome. Some of the most common treatments prescribed by sleep specialists include:
Melatonin is naturally secreted by the pineal gland located near the brain and serves as the body’s principal stimulator and regulator of sleep. It is often used as a first treatment before stronger sleep medications are prescribed. Melatonin is cheap and widely available without a prescription.
BRIGHT LIGHT THERAPY
There are two forms of light therapy which can be used either in conjunction or on their own.
The first is light deprivation. This is the intentional blocking of short wavelengths of light. These short light wavelengths, also known as blue light, are known to suppress melatonin production. Preventing these wavelengths from reaching patients at times when one would like to go to bed can help enhance sleepiness.
The second therapy involves exposing the patient to shortwave light at the times that they would like to wake up or be awake. This can involve exposing someone to a specialized bright light lamp which produces light which mimics the wavelengths produced by the sun.
CREATING A PEACEFUL ENVIRONMENT
A mind cannot rest in an active environment. By removing obstacles to sleep like electronic devices, it is possible to help the DSPD patient relax and fall asleep. Strenuous activities should be avoided near bedtime due to the increase in heart rate. The general rule of thumb is to avoid anything that will make a patient feel more energetic before bed.
It can be helpful to incorporate stress relief and relaxation into your daily routine with the help of Spire. Spire tracks your breathing rhythms to detect when your body is falling into a state of stress and sends you a notification through your phone or computer to let you know it’s time to take a break and relax. People using Spire report feeling calm and centered all through the day and into the night, making it easier to fall asleep.
Patients are advised to avoid substances that increase energy or stimulate the brain throughout the day, especially in the evening. Substances such as caffeine and alcohol should be reduced or eliminated from a person’s diet.
A variety of sleeping pills are prescribed in order to help patients obtain short-term relief. Due negative side effects, like the risk of addiction and the development of a resistance to the medication, most doctors avoid these prescriptions unless there is no alternative.
A GOOD NIGHT’S SLEEP
DSPD is a lifelong condition that requires lifestyle changes. It is possible, with treatment, to live a full and complete life with this disorder. All it takes is a willingness to work with medical professionals to determine which treatments and lifestyle adjustments maximize relief and promote long-term health.