Delayed sleep phase syndrome Guide, Meaning , Facts, Information and Description
Delayed sleep phase syndrome (DSPS) is a sleep disorder in which the patient's internal body clock is not in sync with the morning-rise evening-sleep pattern of the majority of adults. A growing body of evidence suggests that the problem is genetic, and may be inherited.Sufferers – traditionally termed "night owls" – have an identifiable sleep pattern, with the majority falling asleep in the pre-dawn hours and waking in the afternoon. If the sufferer is allowed to follow their in-built sleep pattern, there are generally no problems with either falling asleep or waking naturally.
However, left unacknowledged, DSPS can cause the same problems that would be expected if an adult with a normal sleep pattern forced themselves to wake up in the middle of the night and go to sleep in the early evening.
For most sufferers, the problem is evident from birth. Parents may find themselves chastised for not giving their children acceptable sleep patterns, and schools are generally unco-operative in helping children. This can have severe physical and mental ramifications, as children are treated for insomnia when there is no real problem falling asleep – except it's at an unsocial hour.
Often, sufferers manage on a few hours' sleep a night during the working week, then "catch up" by sleeping excessively at the weekend, with the corresponding effects on social activities.
As many schoolchildren and young adults, particularly students, exhibit DSPS-like symptoms anyway (usually stemming from dislike of school, social activities and the like) initial diagnosis may be difficult.
Some consider a crucial test to be whether the patient is able to choose to wake up at normal times when it suits them – during holidays, for social outings etc. A DSPS sufferer will usually find it as difficult to rise at 8am for a day out with friends as they will on a Monday morning. However, this is far from foolproof as many DSPS sufferers will on occasion be able to rise early for short periods of time anyway and may well be able to rise early for a social event that matters to them. They just would not be able to keep this up on a consistent basis over a lengthy period of time successfully.
Behaviours established in childhood often last well into adulthood, with many sufferers either denying the existence of a problem or refusing to accept that they may not be suited for a 9–5 lifestyle. This denial often is caused or exacerbated by friends and relatives claiming there is no such problem as DSPS and claiming the sufferer is "just lazy". Attempting to force oneself through 9–5 life with DSPS has been likened to "constantly living with 6 hours of jetlag".
Treatments include light therapy with a full spectrum lamp set on a timer, and chronotherapy. These can have marked success with some patients. For other patients, acupuncture may be a solution. Several treatments may be necessary before results are seen, and the treatment is not a cure, only a way to manage the condition. Others are less fortunate – for many there is no cure and social and work patterns must either be adjusted to accommodate or the physical and mental penalties outlined above must be paid. Treatment with melatonin taken 30 minutes to an hour before bedtime may be helpful in establishing a pattern "gone awry", but has limited effect on a pattern that is healthy, albeit out-of-sync. Too high a dose of melatonin may have the unintended effect of disturbing the sleep or even causing nightmares, and uncontrollable yawning the next day.
Research into DSPS, and its opposite, ASPS, is relatively new and by no means conclusive. Many doctors reject its status as "uncurable", while others see it as "shifted phase", i.e. that a normal pattern exists but has been suppressed. These beliefs are highly contentious, especially among sufferers.
There has been some confusion between DSPS and Non-24 hour sleep phase syndrome, in which the circadian rhythm has been extended, often to more than 27 hours. People with this syndrome will also typically sleep later than society deems normal. And in some people both syndromes may be present.
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