Delayed Sleep Phase Disorder

There are various reasons this phenomenon exists but there does seem to be a tendency for many teenagers to naturally have a different sleep cycle than the rest of the population. This is confounded by other variables such as teenagers being so busy during the school day and finally getting some downtime at night, during which they often resort to time with technology (texting/social media/video games/YouTube), which can be activating and counter-sleep. 

What are the common features of Delayed Sleep Phase Disorder? 
-Feeling more alert when others feel it’s time for bed
-Very difficult to get up in the morning in time for school
-May appear lazy and unmotivated with a tendency to be late for morning obligations 

What are the treatments for Delayed Sleep Disorder? 
Depending on the severity of the delayed sleep phase, there are multiple approaches that could be tried. 

  1. Improving sleep hygiene (see below for more information) 
  2. Medications such as Melatonin in the evening or caffeine in the early AM can help with being awake vs tired at the right times.
  3. Bright light therapy (see below for more information)
  4. Chronotherapy (see below for more information) 

The key elements of sleep hygiene are
-Maintaining the same “to bed time” on weekdays and weekends. 
-Engaging in daily exercise but not within 2 hours of your sleep time 
-Avoiding caffeine after lunchtime 
-Avoiding alcohol altogether (alcohol often helps people fall asleep but then greatly disrupts the quality of sleep) 
-Avoiding interactive electronics within 2 hours of bedtime. This means avoiding all video games, social media, phone, YouTube, and working on a computer. TV is a better option as it is less stimulating, but the best option is light reading 1-2 hours prior to bedtime without any use of electronics. 

The key ideas behind bright light therapy are
-Using bright light therapy for 30-120 mins each morning can help shift your circadian rhythm back to normal
-Avoid bright lights and computer screens in the evening 
Here is more on bright light therapy which is very helpful for depression and correcting your sleep-wake cycle: 
https://www.phillyintegrative.com/post/light-therapy

The key elements of chronotherapy are
The idea here is to intentionally delay going to sleep by two to three hours on successive days until you are able to fall asleep at the desired bedtime. This can be difficult to do at home and is sometimes done in a hospital setting.
Another version of this, which is easier to do at home and works faster, is to force yourself to stay up all night and through the next day, only allowing yourself to fall asleep at 10pm the following night. 

“Delayed Sleep Phase Disorder” is when someone has significant difficulty falling asleep on time, and subsequently sleeps in late. It is as if they were on the West coast time zone, 3 hours behind us here on the East coast, and is especially common in teenagers and young adults. 

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