Reviewed by Laura Angers, LPC
Many of us are forced to wake up early each morning, whether we enjoy it or not. Some of us are getting ready for work, so we’re not late, while others are preparing for school, practice, or any other responsibility you have that day.
It’s not that there’s anything wrong with an early start to the day. In fact, it’s a great way to start your day, so long as you receive the proper amount and quality of sleep the night before.
Unfortunately, many people that are forced to wake up early each morning don’t receive the proper amount or quality of sleep each night. While some of us choose to stay up late (making it difficult to wake up early), others are struggling with a delayed sleep-wake phase disorder.
The difference between the two is crucial to receiving the right help. On one side of the spectrum, you have night owls that need to make better decisions. On the other side of the spectrum, you have someone suffering from a neurological disorder that needs further assistance.
So, what is a delayed sleep phase disorder?
A delayed sleep phase disorder (DSPD) is a subtype of the circadian rhythm disorders. Most patients have difficulty falling asleep at the desired time, which often leads to difficulty waking up at the desired time. Many people with insomnia also suffer from DSPD.
The International Classification of Sleep Disorders (ICSD-3, published in 2014) classifies it as ‘Delayed Sleep-Wake Phase Disorder,’ while the Diagnostic and Statistical Manual of Mental Disorders (5th Edition: DSM-5) classifies it as ‘Circadian Rhythm Sleep-Wake Disorder – Delayed Sleep Phase Type.’
In order to be considered a delayed sleep-wake phase disorder, the individual must be experiencing a delay of two hours or more when trying to fall asleep. Sometimes the problem stops there, especially if the individual receives the proper amount of sleep once they finally fall asleep.
Unfortunately, those that have to wake up early don’t have such a nice morning. Since they weren’t allowed to wake up late, their minds and bodies didn’t receive the proper amount of sleep the night before. This leads to daytime sleepiness and further complications in life.
Those suffering from a delayed sleep-wake phase disorder aren’t considered night owls, largely because they don’t choose to stay up late. Instead, their internal clock (circadian rhythm) is misaligned, which leads to complications of the body’s sleep-wake cycle. Of course, night owls could develop DSPD with enough consistency.
HOW DOES DSPD AFFECT YOUR LIFE?
A delayed sleep-wake phase disorder can impact your life in a variety of ways, none of which are positive or beneficial to your day-to-day life.
For example, someone that starts work at 8 AM might want to wake up by 6 AM. Considering the importance of sleep, they want to go to bed around 10 PM. If you’re a night owl, you’ll stay up until 2 AM watching TV. With DSPD, you might stay up until 2 AM against your will.
Doing this a few times each month is normal. Something might come up that causes you to slip away from your normal sleep schedule, but you’re always right back into the swing of things. With DSPD, this happens almost every night and isn’t caused by ‘something coming up.’
Since people suffering from a delayed sleep-wake phase disorder experience this often, the repetitive damage to the body and mind starts to toll on the individual. If they have to wake up early, they don’t get enough sleep. If they get to wake up late, they have to deal with a late start to the day — which has the potential to throw off your entire day.
Many people with DSPD experience a drop in their work or school performance, suffer from mood disorders such as depression and anxiety, build a dependency on caffeine to keep them active throughout the day, and the physical effects of not receiving enough rest each night.
Since DSPD is considered a neurological disorder, it must be dealt with professionally to see the right progress moving forward. Since everyone’s mind and body are different, it takes a deep understanding of each individual to get to the sleep disorder source.
DIAGNOSING A DELAYED SLEEP PHASE DISORDER
When diagnosing a delayed sleep-wake phase disorder, healthcare professionals often look at the symptoms, sleep logs, and answers to several of their questions. Since it’s a circadian rhythm disorder, DSPD has to result from a misaligned internal clock.
For the most part, DSPD is developed in your teenage to young adult years. A wide range of factors contribute to a shift in the internal clock, but a lot of the research today points towards puberty, the urge to stay up late consistently, and pressure from school.
Over time, those repetitive behaviors develop into something more serious — which could be diagnosed as a delayed sleep-wake phase disorder if the individual meets the criteria.
Some healthcare professionals give their patients a non-invasive wristband that monitors their rest-activity rhythms. The more traditional way of diagnosing a delayed sleep-wake phase disorder is with a study performed at a sleep study clinic. This is where you’re hooked up to several wires that monitor your brain and body activity before, during, and after sleeping.
TREATING A DELAYED SLEEP PHASE DISORDER
Once diagnosed, the main goal behind creating a delayed sleep phase disorder is to normalize the individual’s internal clock. That way, they can return to falling asleep and waking up at the appropriate times each day.
There are several methods healthcare professionals use when retraining the individual’s circadian rhythm (internal clock). For most patients, they’ll need to follow several different methods before finding the relief they need.
Let’s take a look at some of the most common treatments for delayed sleep phase disorder:
- Good Habits –one of the first things healthcare professionals do is replace bad habits with good habits. That means avoiding stimulants and caffeine, maintaining a regular daily routine, and ensuring your sleep environment is adequate.
- Shifting Schedule –shifting the person’s sleep schedule gradually over time could retrain the individual’s internal clock. Instead of setting their bedtime for 10 PM and going to bed at midnight, they’ll set their bedtime for midnight and slowly work their way down until they get to 10 PM consistently.
- Medication –many healthcare professionals consider the use of melatonin, a chemical the body releases when it’s time to go to bed. While it won’t solve the issue, it could help the individual fall asleep regularly and eventually retrain the internal clock.
It’s important to note that the wrong treatment could make the delayed sleep-wake phase disorder worse. That’s why you should always consult with a doctor before trying any treatment. They’ll suggest the right treatment and help monitor your progress over time.
ARE THERE OTHER CIRCADIAN RHYTHM SLEEP DISORDERS?
Your circadian rhythm is an extremely important aspect of your day-to-day life, which is why it’s so important to maintain a healthy one at all times. Unfortunately, there is a wide range of things that can go wrong with your circadian rhythm — including DSPD.
A delayed sleep phase disorder is common, but it’s not the only circadian rhythm people suffer from. Let’s take a look at the other subtypes of this classification of disorders:
- Advanced Sleep Phase Disorder –the opposite of DSPD, when the individual falls asleep too early in the day and wakes up too early in the morning.
- Jet Lag –disturbances to the circadian rhythm due to a sudden change in time zones. This is one of the few circadian rhythm sleep disorders we all experience at least once in our life.
- Shift Work –disturbances to the circadian rhythm due to your work schedule interfering with your normal sleep-wake cycle.
- Irregular Sleep-Wake –individuals with no clear or defined sleep-wake cycle. These people generally take multiple naps throughout the day but never truly sleep.
- Non-24 Sleep-Wake –when your internal clock runs longer than 24 hours, resulting in the sleep-wake cycle changing every day. It’s common in blind people.
Many people suffer from multiple different circadian rhythm disorders. Still, they all have differences that need to be understood before diagnosing someone with a circadian rhythm sleep disorder — otherwise, they might not receive the correct treatment.
DO YOU NEED PROFESSIONAL HELP?
Now that you understand the DSPD meaning, how the disorder affects someone’s life, and what the doctor might try once a delayed sleep phase syndrome is diagnosed, it’s time to live a proactive life when monitoring your sleep habits.
Since many people are under the impression that their irregular sleep habits are normal, it’s important to detect bad habits early and reach out for help immediately. If you need reassurance that your habits aren’t normal, Mind Diagnostics is here to help.
We’ve created a delayed sleep phase syndrome test that can help you determine your risk of developing this disorder. Those at high risk should seek help from a medical professional to learn the next steps moving forward.