The Truth About Delayed Sleep Phase Disorder

Do you consider yourself a night owl? Do you struggle to fall asleep at a “normal” bedtime, only to feel wide awake late into the night?

Many people feel most alert and energetic in the evening hours. But for some, a tendency to go to bed late and sleep in can start to negatively impact their lives.

If you chronically struggle to fall asleep before 2 or 3am – only to sleep past noon and still feel drowsy – you may have delayed sleep phase disorder (DSPD). Read on to understand what causes this condition, how it’s diagnosed, and what you can do to reset your body’s clock for better health and sleep.

What is Delayed Sleep Phase Disorder (DSPD)?

Delayed sleep phase disorder (DSPD) is a chronic condition in which your circadian rhythm is significantly delayed compared to the average person’s sleep-wake cycle.

With DSPD, you tend to feel alert and energetic much later at night than is typical. You have trouble falling asleep until the early morning hours – sometimes as late as 6am or even later.

No matter how late you stay up, you cannot fall asleep any sooner. And even if you do manage to fall asleep earlier, you’ll likely feel groggy and unrested the next day.

This delayed sleep schedule makes it very difficult to maintain a normal work or school routine. It can severely impact your productivity, health, social life, and overall wellbeing.

What does the term ‘delayed sleep’ mean?

The term “delayed sleep” refers to a circadian rhythm disorder where your internal body clock is shifted much later compared to the general population.

Circadian rhythm is your body’s natural 24-hour clock that regulates when you feel tired or energetic. It's also known as your sleep-wake cycle.

For most people, sleepiness starts to set in around 10 or 11pm. But with DSPD, you don’t start to feel tired until the early morning hours, typically between 2am to 6am.

Along with delayed sleepiness, DSPD causes you to sleep later into the day - 10am, noon, or even later. This is the opposite of typical sleep schedules.

In essence, your body thinks you should be sleeping when you need to be awake and productive. The misalignment between your circadian rhythm and the world around you is what causes issues.

Symptoms and Diagnosis of DSPD

Wondering if your sleep struggles might indicate DSPD? Here are the most common symptoms plus how this disorder is diagnosed.

What are the key symptoms of Delayed Sleep Phase Disorder?

The primary symptom of DSPD is an inability to fall asleep at a conventional bedtime. Specific DSPD symptoms include:

  • Not feeling sleepy until very late at night, typically after midnight or even until dawn
  • Struggling to wake up in the mornings and feeling groggy for hours after getting up
  • Needing to sleep very late into the daytime, until 11am or later
  • Feeling energetic and alert late at night but sluggish in the daytime
  • Taking long naps during the day because you don’t get enough sleep at night
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Other signs of DSPD include:

  • Frequently sleeping through alarms in the morning
  • Strong urge to go to bed later and later over time
  • Inability to fall asleep earlier than your typical sleep time
  • Feeling jet lagged after trying to reset to an earlier sleep schedule

How is Delayed Sleep Phase Disorder diagnosed?

To diagnose DSPD, a sleep doctor will have you keep a detailed sleep diary for 1-2 weeks. This diary documents what times you feel sleepy, what time you actually go to bed, how long it takes you to fall asleep, what time you wake up, and more.

They’ll also ask about your sleep history, habits, bedroom environment, and any other health issues.

In some cases, they may have you undergo an overnight sleep study to precisely measure your sleep stages and circadian rhythm timing.

The key is that you have chronic issues falling asleep at a desired bedtime and feel wide awake late into the night. This severe mismatch with societal norms is what indicates DSPD.

Is there a specific test for DSPD?

There is no single definitive medical test that diagnoses DSPD. It's diagnosed based on your sleep history and inability to fall asleep and wake up at conventional times.

Your doctor may order blood tests or other assessments to rule out other potential causes of sleep disruption, like thyroid disorders, anemia, sleep apnea, or anxiety.

But the disorder itself is identified from your sleep patterns over an extended period of time. Keeping a thorough sleep diary is crucial for an accurate diagnosis.

Impact of DSPD on Daily Life

Living with a drastically delayed sleep-wake cycle can significantly disrupt your ability to fulfill work, education, and relationship obligations. Here’s a closer look at how DSPD affects daily living:

How does Delayed Sleep Phase Disorder affect daily life?

DSPD can negatively impact your life in many ways, including:

  • Difficulty waking up on time for school, job, or social commitments
  • Struggling to function in the mornings and fighting sleepiness during the day
  • Poor performance at work or school due to drowsiness and mental fog
  • Less energy for exercise, hobbies, and social activities
  • Strain on relationships from keeping an unusual sleep schedule
  • Increased risk for anxiety, depression, weight gain, and other health issues
  • Frequently feeling out of sync with family, friends, and co-workers

Because your circadian rhythm is mismatched with the typical 9-5 schedule, DSPD makes normal routines very challenging. You may feel like you’re living in a constant state of “jet lag”.

Treatment of DSPD

Resetting your circadian clock is possible with consistent lifestyle changes and targeted therapies. Here are effective treatment options for delayed sleep phase disorder:

What is the best treatment for Delayed Sleep Phase Disorder?

The most effective treatment approach includes both implementing good sleep habits and undergoing circadian rhythm therapy. Key steps include:

  • Maintaining a fixed sleep schedule 7 days a week
  • Avoiding long daytime naps
  • Waking up at the same early time every day
  • Getting regular bright light exposure in the mornings
  • Taking melatonin several hours before your desired bedtime
  • Using blackout curtains to keep your bedroom completely dark
  • Doing vigorous exercise early in the day
  • Avoiding bright lights and screens before bedtime

Combining these lifestyle measures with professional treatments will produce the best results.

In addition to these lifestyle changes, advanced treatments like NightLase® therapy offered by Allure Medical can also help reset your circadian rhythm.

NightLase® uses gentle laser energy to tighten tissues in the throat, reducing snoring and sleep apnea which can worsen circadian issues. Over a series of treatments, NightLase® can help you fall asleep earlier and wake up more refreshed.

What is Sleep Phase Chronotherapy and how is it used in treating DSPD?

Sleep phase chronotherapy is a progressive treatment that systematically shifts your sleep time earlier. It works by resetting your circadian clock in small increments over several weeks.

The process involves:

  1. Sticking to your current late sleep schedule for now
  2. Each week, setting your bedtime 1-2 hours earlier
  3. Waking up at the same early time every morning
  4. And taking small melatonin doses earlier each week

Chronotherapy gradually shifts your circadian rhythm earlier until you reach your desired bed and wake time. It's highly effective but requires discipline and consistency.

Can Delayed Sleep Phase Disorder be cured?

There is no medical “cure” for DSPD since it’s a chronic condition related to your internal clock. But in many cases, the right lifestyle and treatment changes can successfully manage it.

By sticking to healthy sleep habits, undergoing chronotherapy, and taking melatonin, you can get your circadian rhythm aligned with societal norms again.

While DSPD can be challenging, take heart knowing it is possible to reset your body’s clock with the appropriate long-term treatment plan.

In Summary

If you chronically struggle with late-night insomnia yet feel wide awake into the wee hours, DSPD may be the culprit. Don’t despair - with commitment and patience, you can overcome delayed sleep phase disorder.

Through circadian rhythm therapy, improved sleep hygiene, targeted melatonin use, and advanced treatments like NightLase® by Allure Medical, you can get your mind and body back on track.

We at Allure Medical know resetting your sleep cycle is a process. But you have the power to create lasting change for your health and wellbeing.

The future you’ve been dreaming of is on the horizon – let’s start making it a reality!

Authored by

Charles Mok, D.O.

Dr. Charles Mok received his medical degree from Chicago College of Osteopathic Medicine, Chicago, Illinois in 1989. His professionalism and personal attention to detail have contributed to the success of one of the first medical spas in Michigan.

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