Delayed Sleep Phase Syndrome
(DSPS) Explained

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Our culture seems to be growing accustomed to abnormal sleep habits to compete in our jobs, schooling, extracurriculars, and social standings. However, we could be significantly impairing our body clocks and developing circadian rhythm sleep disorders as a result. Unknowingly, many of us may be suffering from Delayed Sleep Phase Syndrome (DSPS) or Disorder (DSPD).

 

A recent study found that, within a sample of 5000 people, 40% of sleep-related disorders were attributed to DSPS. So we know sleep is a common problem, but what exactly is DSPS, and how can it be detrimental to your wellbeing? To determine if your nighttime behavior is perfectly healthy or potentially harmful, read on.

Section 1

What is Delayed Sleep Phase Syndrome?

Section 2

Delayed Sleep Phase Disorder (DSPD) & Sleep-Wake Phase Disorder Defined

Section 3

Who is at Risk for Delayed Sleep Phase Disorder?

Section 4

Causes of Delayed Sleep-Wake Phase Syndrome

Section 5

How to Diagnose Delayed Sleep Phase Syndrome

Section 6

Treating DSPD

What is Delayed Sleep Phase Syndrome?

Sleep disorders like DSPS are becoming increasingly widespread, and experts estimate that approximately seven to sixteen percent of today’s youth have DSPS.

 

DSPS is defined as a disorder that causes an individual to delay their sleeping and waking by roughly two hours. This regular sleep/wake cycle disturbance is referred to as a disruption of the circadian rhythm. Typically, someone with this disorder will find themselves staying up until between 1 AM and 4 AM. However, congruently, this same person will regularly find themselves sleeping until between 8:00 AM and 11:00 AM.

Illustration of a Woman Who Can't Fall Asleep and Then Sleeps Long

The commonly used term “night owl” is often applied to those tackling this suspected disorder. For these individuals, life may seem relatively normal. This routine might not sound unappealing to those whose sleep schedule is unaffected. However, it can wreak havoc on the lifestyles of those who struggle with the disorder.

Delayed Sleep Phase Disorder (DSPD) & Sleep-Wake Phase Disorder Defined

Delayed Sleep Phase Disorder (DSPD), officially known as Sleep-Wake Phase Disorder, is when the disruption of the circadian rhythm inhibits one’s 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.

Illustration of a Frustrated Woman Who Can't Fall Asleep

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.[1] 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.

Who is at Risk for Delayed Sleep Phase Disorder?

With the growing prevalence of DSPS in modern culture, it’s helpful to identify early signs before it develops into a more serious clinical condition.

Adolescence and Early Adulthood

Students who are regularly absent from school without good reason and individuals who often stay away from work are both at risk for delayed sleep phase disorder.[2] According to one study, DSPD affects about 7-16% of adolescents.
Illustration of a Teenager Sitting on Her Bed

Depression

Depression and delayed sleep-wake phase disorder often appear comorbidly. Some research indicates that about 64% of individuals with DSPD also suffer from depression, and according to John Hopkins Medicine, people with depression have a significantly higher risk of developing sleep issues.[3]

 

Read More: How Depression Affects Your Sleep

ADHD

Delayed sleep phase syndrome (DSPS) could also be linked to attention deficit hyperactivity disorder in both children and adults. Recent studies point to a correlation between the two conditions, with as many as 75% of adults managing ADHD or diagnosed in childhood also have delayed circadian rhythms.[4]

Kids Playing on a Loft Bed

Causes of Delayed Sleep-Wake Phase Syndrome

Researchers are still searching for the exact reason the condition arises. However, experts agree there seem to be some connections between DSPS and the following:

Illustration of a Guests Resting on a Bed

The condition could also be due to a more extended circadian period than the average person, meaning that these people will not have the same rhythm as others. Having an irregular circadian period means that those afflicted won’t feel the need to sleep when the rest of the world is or be motivated to go to work at the same time as their colleagues. 

 

Further, some experts hypothesize that those with DSPS are ultra-sensitive to light at night.

How to Diagnose Delayed Sleep Phase Syndrome

Before seeking out medical attention, examine your nightly sleep routine. Those who take an unusually long time to fall asleep may want to consider making adjustments to their sleep routine. Everyone is different; however, most people usually take between 5 to 20 minutes to fall asleep, so if it takes you considerably longer, it’s wise to start taking action before your behavior evolves into a clinical delayed sleep phase disorder.

 

If you constantly find yourself struggling to wake up or go to bed at the desired time, you may have DSPD, and seeking professional testing and treatment is an option.

Illustration of A Tired Man at the Doctors Office

Actigraphy

In an actigraphy test, you’ll wear a small device, also referred to as an actimetry sensor, which is similar to a watch, for a week or more to measure your at-home sleep-wake activity. Actigraphy is a non-invasive technique for monitoring behavior to help determine issues and an effective treatment method.[5]

Sleep Diary

Keeping notes about your sleep cycles could help your doctor identify issues. Your physician may ask you to keep a diary to log your patterns to help them create an effective treatment plan for your individual needs.

Polysomnogram

A polysomnogram is a test in which you stay overnight in a sleep center for observation. A polysomnogram will monitor your brain activity, oxygen levels, heart rate, eye movements, and breathing while you sleep.

Treating DSPD

There are a number of options available for individuals with DSPD, and many involve simple lifestyle changes aimed at aligning one’s sleeping timing to fit their specific lifestyle. For some, the mere avoidance of light in the evening hours is enough to amend the issue. However, more proactive treatments include routine adjustments, chronotherapy, a reduction or elimination of caffeine intake, bright light therapy, or the incorporation of a nightly melatonin tablet.

Sleep Hygiene

For some, treating DSPD can be as simple as sticking to a strict sleep schedule, adhering to your daily routine regardless of how tired you are, until the problem is naturally corrected. Good sleep hygiene involves adhering to a regular sleep routine and avoiding the bedroom for all activities except for sex and sleep. Your doctor may recommend you exercise in the morning (as opposed to at night) and avoid caffeine, tobacco, and/or alcohol to improve your quality of sleep.

A Woman Using Phone Laptop and Watching TV Before Bed

Melatonin Supplements

Melatonin is a naturally occurring hormone in humans that increases as the sun goes down and weans off as the sun comes up.[6] Taking an over-the-counter supplement could help induce drowsiness before bedtime. We recommend starting with a small dose and working your way up to one that feels right for you.

 

Check Out Our Guide: Best Melatonin Supplements

Chronotherapy

Chronotherapy is when your bedtime is slowly adjusted bit by bit until you reach a desirable routine.[7] Your bedtime can be moved as small as 15 minutes each night, or as large as two hours at a time.

 

Controlled sleep phase deprivation with phase advance, or SDPA, is another known method for circadian rhythm adjustment. During SDPA, an individual stays awake a full night and day, then goes to bed 90 minutes earlier than typical. They work to maintain this new bedtime for one week, and the method is repeated weekly until the person settles into the routine.

Light Therapy

Light Therapy is a growing method of addressing several sleep disorders. The therapy is used to gradually shift sleep patterns to what most of us consider normal.

 

Bright Light Therapy treatment consists of placing the patient near a device that emits a bright light mimicking natural sunlight, aiming to affect certain chemicals in the brain connected to mood and sleepiness. For maximum results, the timing of the light exposure is crucial, so the patient must be exposed to the light as soon as possible after waking.

 

Find Out More: Top Rated Light Therapy Lamps

Wake up light by the bed
[1] Delayed Sleep Phase Syndrome Is Related to Seasonal Affective Disorder”, Journal of Affective Disorders, May 2011.
[2] Delayed Sleep Phase Disorder Risk Is Associated with Absenteeism and Impaired Functioning, Sleep Health, U.S. National Library of Medicine
[3] Depression and Sleep: Understanding the Connection, Johns Hopkins Medicine
[4] Editorial Perspective: Delayed Circadian Rhythm Phase: a Cause of Late-Onset Attention-Deficit/Hyperactivity Disorder among Adolescents?, Journal of Child Psychology and Psychiatry, and Allied Disciplines, U.S. National Library of Medicine
[5] Delayed Sleep Phase, Mayo Clinic, Mayo Foundation for Medical Education and Research, November 18, 2017.
[6] Is Melatonin a Helpful Sleep Aid — And What Should I Know About Melatonin Side Effects?, Mayo Clinic, Mayo Foundation for Medical Education and Research, November 13, 2020.
[7] Sleep Deprivation as a Method of Chronotherapy in the Treatment of Depression, Psychiatria Polska, U.S. National Library of Medicine
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