Delayed Sleep Phase Syndrome

It is difficult to estimate the prevalence of delayed sleep phase syndrome. Many people never seek treatment. Those that do are often misdiagnosed. So, while some surveys say that it is a rare circadian rhythm disorder, it might not actually be rare.

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It is classified as a disability under the “Americans with Disabilities Act of 1990”. As such, employers are required to make accommodations for the condition, which in most cases means a later work schedule than the popular 9-5 shift. In public schools and at the college level, it may be necessary to request specific accommodations, such as a later class schedule or later exam times.

Delayed sleep phase syndrome usually begins in childhood or adolescence. Children may argue about going to bed at a specific time or be difficult to wake up in the morning. If left to their inner schedules, the children may stay awake until 2am or later and stay in bed until noon.

Because of this, children are often viewed as lazy and parents are lectured about enforcing a stricter schedule. The children are often sleepy during the day, which is not tolerated by the public school system.

Since most people can adapt their sleeping/waking patterns to what is "acceptable" to society, people with delayed sleep phase disorder are often misunderstood. Obtaining an official diagnosis is helpful, if only from a psychological perspective. Being labeled as lazy can cause self-esteem issues and depression.

Lady sleeping wearing sleep maskIt is up to the individual to decide if delayed sleep phase syndrome should be treated or simply accepted.
Lady sleeping wearing sleep maskIt is up to the individual to decide if delayed sleep phase syndrome should be treated or simply accepted.

It should be noted that this is not a psychological condition, it is a physical abnormality. Normally, the body produces melatonin, which causes drowsiness in response to the setting sun and decreases production in response to the morning sunlight.

The use of artificial lighting may contribute to delayed sleep phase syndrome. Light therapy is sometimes beneficial. For example, keeping the lights very dim in the evening hours and turning on bright lights in the morning is sometimes, but not always, helpful.

Low doses of melatonin, which is available over the counter in the US and Canada, is sometimes recommended, but high doses can worsen the condition. Sleeping pills are rarely suggested as a course of treatment.

Some authorities suggest vitamin B12 supplementation. This is a safe course of action for mild cases.

Doctors classify delayed sleep phase disorder as mild, moderate or severe. The normal circadian clock has people sleeping from around midnight to about 7:30, when melatonin production stops. Melatonin secretion normally starts at around 11pm. The deepest sleep occurs around 2am.

In mild cases there is a two hour delay in all of these things. Melatonin production does not begin until 1am, deep sleep at 4am and melatonin secretion continues until 930am. Obviously, a person with a mild case may have difficulty waking up and experience daytime fatigue, but they are usually able to function in a 9-5 world.

In moderate cases there is a three hour delay, resulting in more functional difficulties. In severe cases, there is a four hour delay, which is accompanied by even more difficulty with society’s normal schedule.

People with delayed sleep phase disorder may seek out careers that suit their natural internal schedule. Working night shifts, becoming entertainers, working at home or starting their own businesses are some of the things they might do. Usually, it is children and teenagers that have the greatest difficulty, particularly if their parents do not suffer from the condition.

The condition is sometimes referred to as "social jet lag". People that have it can sleep. They just sleep on a different schedule than everyone else. It is up to the individual to decide if delayed sleep phase syndrome should be treated or simply accepted.

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