DSPS - Delayed Sleep-Phase Syndrome (DSPS or also known as Circadian Rhythm Disorder)

Delayed Sleep-Phase Syndrome (DSPS) is a circadian rhythm sleep disorder in which the individual's internal body clock is delayed with respect to the typical sleep at night, rise in the morning pattern of most adults. Such people are sometimes called "night owls", though for those with DSPS, their hours are not by choice. 

People with DSPS generally fall asleep late at night, often in the pre-dawn hours, and wake in the late morning or in the afternoon. Furthermore, there is a striking inability to fall asleep at an earlier, more typical bedtime. As a result, many people with DSPS have been labeled as insomniac. But if such a person is allowed to follow his internal sleep pattern, he generally has no problems with either falling asleep or waking naturally. 

However, if its ignored the internal clock and attempts to live on a normal schedule, DSPS can cause difficulty thinking clearly, driving safely, and generally functioning well. Over time, this may significantly reduce a person's productivity and enjoyment of life, and can lead to clinical depression or other stress-related medical problems. 

These are much the same problems that would be expected if an adult with a normal sleep pattern forced himself to go to sleep in the late afternoon and to wake up in the middle of the night. Although some people are able to shift their schedules in this way, others find it difficult or impossible to do so and still function at an acceptable level. 
This suggests that DSPS is a two-pronged issue: one is the body's daily cycle, which is later than normal. The other is the difficulty or even inability to shift one's schedule to a different time. 

Attempting to force oneself through a daily 9-to-5 schedule with DSPS has been likened to constantly living with 6 hours of jetlag. It's a daily struggle which in the long run can lead to depression. 
Further Description

DSPS patients are typically unable to fall asleep before 2 a.m., regardless of how early they got up the previous day or how tired they may be. For some, it is impossible to sleep before 6 or 7 a.m. 
Some people with DSPS manage to function on a few hours' sleep a night during the working week, then "catch up" by sleeping excessively at the weekend. But their ability to think clearly often suffers, and the irregular sleep-wake pattern is likely to have long-term consequences. 

Some DSPS people are on occasion able to rise early for a few days at a time. But typically they are not able to perform well on this schedule, and they would not be able to keep this up on a consistent basis over a longer period of time. Also, such a temporary change can "confuse" the body's circadian clock, resulting in an erratic circadian rhythm and making it difficult to return to the previous regular schedule. 

Many people with this disorder deny the existence of a problem and refuse to accept that they may not be suited for a 9-to-5 lifestyle. This denial often is encouraged by friends and relatives claiming there is no such problem as DSPS and accusing the DSPS individual of "just being lazy" or lacking will power. 

Many others are not even aware that such a syndrome exists, and experience life as a constant struggle to get up on time, to stay awake, and to perform the activities required by their job or their family. Such a person often fails courses in school or loses jobs. This can affect his confidence and self-worth, and can cause social problems and health issues. 

For many DSPS people, the "night owl" pattern is evident from earliest childhood. Parents may find themselves chastised for not insisting strongly enough that their children follow acceptable sleep patterns, and schools are generally uncooperative in helping these children. These children often fail courses in school and lose faith in themselves. 
For many others, the disorder develops during adolescence. 

Related Sleep Disorders
There has been some confusion between DSPS and non-24 hour sleep phase syndrome, in which the circadian period has been extended, often to more than 27 hours. People with this syndrome will also typically sleep later than society deems normal. In some people both syndromes may be present. 

Some people with DSPS also have other sleep disorders which compound their problems. Some have sleep apnea, which interferes with getting good rest even during their natural sleep time. Others report restless leg syndrome or other causes of poor quality sleep. These people generally require more than eight hours of sleep a night to function well, in addition to needing a shifted schedule. 

Body Temperature Cycle
Body temperature varies on a circadian (daily) cycle, rising during the day, generally peaking in the evening, and falling at night. The overall range is generally 1° to 2° F. For most people with DSPS, this temperature pattern is shifted as well, so it can provide a diagnostic insight into one's natural daily rhythm. But monitoring one's temperature to the required accuracy must be done with care. Do not eat, drink, or exercise for half an hour before each measurement. Relax for several minutes before. And use a sufficiently accurate thermometer. Note that most digital thermometers are not any more accurate than about 0.5° F., despite having displays that can be read to greater apparent precision. And ear probes, which provide the quickest readings, are even less accurate. 

Current Research
Research into DSPS, and its opposite, ASPS (Advanced Sleep-Phase Syndrome, distinguished by a need to fall asleep early, and wake up early), is relatively new. A growing body of evidence suggests that these problems may be genetic and run in families. 

Recent research on the eye has found three kinds of receptors, rather than the two kinds (rods and cones) previously known. This third type of receptor is sensitive to light, and helps entrain an organism's circadian rhythm to daylight. Some blind people, without any perceptual vision, nevertheless maintain a regular daily schedule, while others do not. It seems reasonable that the former group has functioning receptors of this third kind, while the latter group does not. Equally reasonable is the possibility that some normally sighted people are deficient in this third kind of receptor, and so do not entrain their schedules well to the usual daylight cycle. 

A recent study by M Uchiyama et al (abstract) concluded: "These findings suggest that poor compensatory function for sleep loss predisposes DSPS patients to failure to reset their sleep phase. Our results provide implications for understanding not only the pathophysiology of DSPS but also the biological basis for why some people can change their sleep schedule easily according to personal or social demands while others cannot." 

There is no permanent cure for Delayed Sleep-Phase Syndrome. The suggested treatments only provide ways to manage the condition. They can be successful, at least partially, with some patients. But for others there is no improvement, and social and work patterns must either be adjusted to accommodate the delayed schedule of the patient, or physical and mental dysfunction as described above will result. Often, several of these treatments are used together. 

Sleep Hygiene:
Light Therapy: 
Experience has shown that it is generally not possible for a DSPS person to shift his sleep time earlier. In chronotherapy, he is asked to shift his sleep time later instead. Typically, sleep time is shifted three hours later each day, all the way around the clock, until the desired schedule is reached. Doing this is generally possible for the patient, but he will be living a very strange schedule for a week or two, requiring time off from work. 

The real difficulty comes with sticking to the new schedule. The patient must rigorously maintain the new schedule, seven days a week, for as long as he wants to be on it. Any delay in getting to bed, even for one night, is likely to allow his body clock to shift later, and make it difficult to impossible to shift earlier again. This then necessitates repeating the whole around-the-clock process again. 

As a result, there are no late nights out with friends, no staying up with a sick child, no late nights trying to meet a school or work deadline. In practice, most people find such an exacting schedule impossible to adhere to in the long run, and so the chronotherapy ultimately fails. 

Additionally, some DSPS people find that the early (for them) schedule feels unnatural and disorienting, and they cannot perform their best work following such a schedule. 

Another approach has also been reported, called "Sleep Deprivation Phase Advance". This involves staying up around the clock and then going to bed 90 minutes earlier than the patient's previous sleep time. Let the new time stabilize, and repeat. This is described in more detail in this Sleep Review article. The same difficulties maintaining the new schedule apply. 

Some have suggested large doses of vitamin B12. Others have mentioned acupuncture. We have no knowledge of whether these work. 

Login form

Private Messages


Click Here to Visit our FaceBook Page

Click Here


Click Here to Visit our Twitter Page

Click Here


Click Here to Visit our Yelp Page

Click Here