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Delayed Sleep Phase Syndrome
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Delayed Sleep Phase Syndrome ( DSPS) is a disorder in which the major sleep episode is delayed by 2 or more hours of the desired bedtime. This causes difficulty awakening at the desired time. DSPS causes sleep-onset insomnia, here, sufferers report that they cannot sleep until early morning. Unlike most other insomniacs, however, they fall asleep at about the same time every night, no matter what time they go to bed.

Unless they have another untreated sleep disorder (such as sleep apnea) in addition to DSPS, patients can sleep well, and have a normal need for sleep. Therefore, they find it very difficult to wake up in the morning if they have only slept for a few hours. However, they do sleep soundly, wake up spontaneously, and do not feel sleepy again until their next "night," if they are allowed to follow their own late sleeping schedule.

Symptoms have been present for at least a month, and usually much longer.

Predominantly by the inability to fall asleep before early morning (i.e., 12 midnight to 3 a.m.). The inability to fall asleep at the desired time.

Great difficulty waking in the morning, leading to the principal social complication.

Complaint of insomnia or excessive sleepiness.

Depression may be present.

This sleep pattern has been present for 3 months.

Associated Features:

The person may be described by family as a night owls.

Say they function best, and are most creative in the evening and at night.

Usually have tried many times to change their sleeping schedule.

Frequently request family members to help wake them in the morning.

Symptoms often begin in adolescence, childhood, or infancy.

Sleepy during the day, especially in the morning, if they have had to get up early.

May sleep in on weekends (often past noon and for more than 10 hours) to make up for not getting enough sleep during the rest of the week.

Need at least 30 minutes to fall asleep, even when they go to bed at a time that is realistic for them.

Differential Diagnosis:

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

A Life Style preference for this sleeping pattern.
Obstructive Sleep Apnea.
Insomnia.
Periodic Limb Movement Disorder ( Restless Leg Syndrome).
Jet Lag.

Cause:

The cause of DSPS is unknown, it is believed to be a disorder of the body's timing system. These persons have difficulty falling asleep and difficulty waking because their biological clocks are out of phase with the sleeping and waking times they try to carry out. DSPS is therefore very similar to jet lag, but much longer-lasting. It can develop suddenly or gradually.

Treatment:

The have been a wide range of treatments techniques used most with varying degrees of success. These include Bright Light Therapy, Chronotherapy and the controversial use of Melatonin or other natural sleep inducers.

Counseling and Psychotherapy [ See Therapy Section ]:

Initial treatment revolves around the Improvement in sleep hygiene habits and therefore Cognitive Behavioral Therapy techniques may be particularly helpfully. Persons with DSPS who have been sufferers for many years, starting to sleep at earlier times would demand a major psychological adjustment and therefore CBT is the therapy of choice.

Pharmacotherapy [ See Psychopharmacology Section ] :

Vitamin B12 from sleep disorders to depression has shown to be helpful.

Melatonin, has been synthesized for medicinal and therapeutic use, and is usually taken 30 minutes before bedtime. Some studies have shown melatonin to advance sleep phase but results are not conclusive.
  

 


DSM Code

None

G47.2 Delayed Sleep Phase Syndrome

Disorder Sheets

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Recommended Book

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Delayed Sleep Phase Syndrome

Misc Information

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