Delayed sleep phase syndrome (DSPS) is a condition characterized by a change in sleeping patterns that delays a person’s habitual sleeping sessions by two or more hours a night. The condition forms one specific subtype of a group of officially recognized mental health disorders called circadian rhythm sleep disorders. Teenagers develop DSPS more often than any other population group in the U.S. Unless its effects are corrected through appropriate treatment, the syndrome can significantly increase a teenager’s chances of developing diagnosable depression, exhibiting disruptive behaviors or getting involved in drug or alcohol use.
Delayed Sleep Phase Syndrome Basics
People with delayed sleep phase syndrome feel sleepy much later at night than their unaffected peers, and therefore go to bed at a later hour. In the morning, at a time when most people arise from sleep and start their days, individuals with DSPS typically still need a couple of hours of sleep to restore their energy reserves and feel sufficiently refreshed. Since their schedules rarely allow them to continue sleeping, affected individuals often develop chronic sleep deficiencies. Common symptoms of delayed sleep phase syndrome include difficulty falling asleep at appointed times (often mistakenly interpreted as a sign of insomnia), difficulty waking up at appointed times and an excessive sleepiness that impairs daytime function. People with the syndrome commonly lack other sleep-related problems and would get enough sleep if their schedules could accommodate their habitual sleeping patterns.
DSPS occurs because of specific problems with the body’s natural circadian rhythms. Essentially, these rhythms are biological signals inside of the body’s cells that keep a person’s sleeping patterns aligned with the day/night cycle in the outside world. A group of nerve cells inside the brain senses changes in environmental light levels and acts as a master clock for all of the rhythms found in various body areas. No one really knows why some people have circadian rhythms that don’t align properly with daytime and nighttime. However, one potential contributor to DSPS is unusually low levels of a circadian rhythm-related hormone called melatonin.
Specific Risks in Teenagers
Roughly 7 percent to 16 percent of U.S. teenagers have delayed sleep phase syndrome. This rate is substantially higher than the rate found in adults or younger children. According to the authors of a report published in 2013 by the Cleveland Clinic, teen susceptibility to the syndrome may stem from natural changes in sleeping patterns that occur during the transition from early childhood to adolescence. In addition to the primary symptoms of DSPS, affected teenagers commonly display symptoms such as declines in their grades, increased rates of tardiness or truancy, increased rates of disruptive or dysfunctional behavior, and increased chances of developing symptoms of major depression or some other mental health condition classified as a form of depressive illness. Adolescents with DSPS also sometimes try to alter their habitual sleeping patterns by relying on potentially harmful doses of caffeine or by initiating the use/abuse of alcohol or medications called sedative-hypnotics (or tranquilizers).
Doctors can treat DSPS-affected teenagers in a number of ways. Typically, the first option is elimination of any lifestyle habits that can impede a regular sleeping pattern, especially on weekdays when teens need to prepare themselves for participation in school. Examples of likely lifestyle adjustments include avoidance of all caffeine-containing substances and any other substance with the potential to disrupt sleep, and early evening discontinuation of activities—such as video gaming or computer use—that tend to increase wakefulness.
Doctors may also treat delayed sleep phase syndrome by gradually shifting the body’s circadian rhythms. In order to shift the rhythms forward, a doctor will ask his or her patient to go to sleep at slightly earlier times each night until a target sleeping time is reached. In order to shift the circadian rhythms backward (a technique known as chronotherapy), a doctor will ask his or her patient to go to sleep at slightly later times each night until the patient reaches the target sleeping time. This approach takes much more time, since it requires the patient to shift his or her sleeping pattern backward gradually through both nighttime and daytime before finally reaching an appropriate nighttime sleeping hour. For this reason, sleep specialists typically only recommend chronotherapy during summer vacation or other long breaks in the school year.
Additional potential options for the treatment of DSPS include melatonin supplements, a form of high-intensity light exposure called bright light therapy and strict avoidance of light sources during the hours leading up to a target sleeping time. Sleep specialists commonly combine treatment methods to suit the specific needs of each individual patient.