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Delayed sleep phase disorder
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Delayed sleep phase disorder
Delayed sleep phase disorder (DSPD), more often known as delayed sleep phase syndrome and also as delayed sleep–wake phase disorder, is the delaying of a person's circadian rhythm (biological clock) compared to those of social norms. The disorder affects the timing of biological rhythms including sleep, peak period of alertness, core body temperature, and hormonal cycles. People with this disorder are often called "night owls". It is considered to be a category of Circadian rhythm sleep disorder.
The diagnosis of this disorder is currently a point of contention among specialists of sleep disorders. Many insomnia-related disorders can present significantly differently between patients, and circadian rhythm disorders and melatonin-related disorders are not well understood by modern medical science. The orexin system was only identified in 1998, yet it appears intimately implicated in human sleep-wake systems.
Evidence for the plasticity of human circadian rhythm cycles has been provided by multiple studies. In one example, 15 volunteers spent 40 days and nights underground in a French cave while researchers monitored their periods of waking and sleeping. Their results found significant divergence between individuals, with most participants settling upon a rhythm of 30 ± 4 hours.[citation needed] Researchers have speculated that the lack of exposure to natural sunrise/sunset cycles relates many of the symptoms of these circadian disorders to modern habits of humans spending extended periods indoors, without sunlight exposure and with artificial light.
Symptom management may be possible with therapeutic drugs such as orexin antagonists or melatonin receptor agonists, as well as regular outdoor exercise. There may be a genetic component to the syndrome.
DSPD is responsible for 7–13% of patient complaints of chronic insomnia. However, since many doctors are unfamiliar with the condition, it often goes untreated or is treated inappropriately; DSPD is often misdiagnosed as primary insomnia or as a psychiatric condition.
People with DSPD generally fall asleep some hours after midnight and have difficulty waking up in the morning.
Affected people often report that while they do not get to sleep until the early morning, they do fall asleep around the same time every day. Unless they have another sleep disorder such as sleep apnea in addition to DSPD, patients can sleep well and have a normal need for sleep. However, they find it very difficult to wake up in time for a typical school or work day. If they are allowed to follow their own schedules, e.g. sleeping from 4:00 am to 1:00 pm, their sleep is improved and they may not experience excessive daytime sleepiness. Attempting to force oneself onto daytime society's schedule with DSPD has been compared to constantly living with jet lag; DSPD has been called "social jet lag".
In the DSPD cases reported in the literature, about half of the patients have had clinical depression or other psychological problems, about the same proportion as among patients with chronic insomnia. According to the ICSD:
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Delayed sleep phase disorder
Delayed sleep phase disorder (DSPD), more often known as delayed sleep phase syndrome and also as delayed sleep–wake phase disorder, is the delaying of a person's circadian rhythm (biological clock) compared to those of social norms. The disorder affects the timing of biological rhythms including sleep, peak period of alertness, core body temperature, and hormonal cycles. People with this disorder are often called "night owls". It is considered to be a category of Circadian rhythm sleep disorder.
The diagnosis of this disorder is currently a point of contention among specialists of sleep disorders. Many insomnia-related disorders can present significantly differently between patients, and circadian rhythm disorders and melatonin-related disorders are not well understood by modern medical science. The orexin system was only identified in 1998, yet it appears intimately implicated in human sleep-wake systems.
Evidence for the plasticity of human circadian rhythm cycles has been provided by multiple studies. In one example, 15 volunteers spent 40 days and nights underground in a French cave while researchers monitored their periods of waking and sleeping. Their results found significant divergence between individuals, with most participants settling upon a rhythm of 30 ± 4 hours.[citation needed] Researchers have speculated that the lack of exposure to natural sunrise/sunset cycles relates many of the symptoms of these circadian disorders to modern habits of humans spending extended periods indoors, without sunlight exposure and with artificial light.
Symptom management may be possible with therapeutic drugs such as orexin antagonists or melatonin receptor agonists, as well as regular outdoor exercise. There may be a genetic component to the syndrome.
DSPD is responsible for 7–13% of patient complaints of chronic insomnia. However, since many doctors are unfamiliar with the condition, it often goes untreated or is treated inappropriately; DSPD is often misdiagnosed as primary insomnia or as a psychiatric condition.
People with DSPD generally fall asleep some hours after midnight and have difficulty waking up in the morning.
Affected people often report that while they do not get to sleep until the early morning, they do fall asleep around the same time every day. Unless they have another sleep disorder such as sleep apnea in addition to DSPD, patients can sleep well and have a normal need for sleep. However, they find it very difficult to wake up in time for a typical school or work day. If they are allowed to follow their own schedules, e.g. sleeping from 4:00 am to 1:00 pm, their sleep is improved and they may not experience excessive daytime sleepiness. Attempting to force oneself onto daytime society's schedule with DSPD has been compared to constantly living with jet lag; DSPD has been called "social jet lag".
In the DSPD cases reported in the literature, about half of the patients have had clinical depression or other psychological problems, about the same proportion as among patients with chronic insomnia. According to the ICSD:
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