Delayed sleep-wake phase syndrome (DSWPS) is a condition that affects the circadian rhythm of a person’s body. This means that a person will have a different sleep pattern from that of a normal person. Some people will have a sleep pattern that is delayed by as much as two hours, while others have a sleep pattern that is advanced by as much as four hours. The most common symptom of DSWPS is difficulty falling asleep or staying asleep at night. Let’s get deeper into the delayed sleep-wake phase syndrome.
What is Delayed Sleep-wake Phase Syndrome?
Delayed sleep-wake phase disorder (DSWPD) is when people stay up past socially acceptable or conventional bedtime, staying up later and getting up earlier than expected. It is difficult to wake up at the desired time because of the delay in falling asleep. For someone with DSWPD, getting adequate sleep is not easy, but a teenager with this condition should stay up till well after midnight, and it is extremely hard to get up for school in the morning.
Children and adolescents with DSWPD report themselves as “morning larks” and say they function best or are most alert during the morning or daytime hours. Students who consistently go to bed late and get up early will have a log that shows many wake-ups and sleep-ins throughout the week and long sleep periods during the weekend.
Causes, and Symptoms of Delayed Sleep-wake Phase Syndrome
Causes
The exact cause of DSPS isn’t known, but it’s often associated with several factors.
- Poor sleeping habits. DSPS is a medical condition that can get worse if you don’t get enough light exposure in the morning. It could also be related to not getting enough sleep, which in turn will increase the symptoms.
- Chronic insomnia. 10 percent of people with chronic insomnia are affected by DSPS.
- Genetics. You have a higher chance of developing the condition if you have a close relative with it. A large number of people with the disorder have a family history.
- Psychological and neurological disorders. Depression, anxiety attention deficit disorder, and obsessive-compulsive disorder are some of the conditions that are linked to DSWPS.
- Changes after puberty. The body requires later sleep and wake times when it becomes longer in its sleep cycle. Adolescents tend to take on more responsibilities as they become more social.
Symptoms
- Inability to fall asleep at the desired time. It usually presents as insomnia complaints. Teenagers may feel pressured to stay up late because of social pressures.
- Inability to wake up at the desired time and excessive daytime sleepiness. This is a very common complaint because it is more easily observed than nighttime insomnia. With DSWPD, most people need at least 8 hours of sleep per night. This is because they have difficulty falling asleep, wake up during the night and don’t usually fall back asleep until the next morning. This leads to sleep-onset insomnia.
- Generally, no sleep problems if allowed to maintain their desired sleep/wake schedule. Many children and adolescents with DSWPD don’t need to be treated for their sleep problems; however, if uncomplicated by other sleep disorders, these children and adolescents tend to sleep well. The shift in their internal clock or sleep-wake cycle is what causes them to suffer. When there is no pressure to wake up at a certain time, children and adolescents with DSWPD are able to sleep well. It’s not an issue with sleep maintenance.
Depression and behavior problems. Kids with Down syndrome experience problems related to daytime sleepiness and missing school. As a result, they may experience depression, behavioral issues, and other problems. Reduced academic performance from missed school days, tardiness, and inattention can be caused by daytime drowsiness. It is possible that dependency on alcohol, caffeine, and sedatives is also seen.
Diagnosis
DSPS is often misdiagnosed. A lot of people with DSPS force themselves to follow a normal routine. If you are constantly tired, you may be misdiagnosed with depression. It is possible to be misdiagnosed with insomnia if you report problems falling asleep. Talk to a sleep specialist if you or your child are having sleep issues. If you have trouble sleeping for at least seven days, you should see a doctor. Different tests can be done by a sleep specialist to determine if you have the disorder.
This might include the following:
- Actigraphy. You’ll wear a sleep tracking wrist device so you can know when you’re awake, sleeping, or in between. There are times when you will be off from work or school, so this is a good time to do this test.
- Request a sleep log. When you fall asleep and wake up, your doctor might want you to write something down. If you want, you should bring a sleep log for your first appointment.
- Gathering medical history. This will help your doctor understand your family history and symptoms.
- Polysomnogram. Your doctor will probably want an overnight sleep test, called a polysomnogram. Your doctor will put a device over your head that monitors your brain waves and heart rate while you sleep.
Treatment Options
The treatment of DSWPS involves more than one method. Treatment includes adjusting your body clock, which will normalize your sleep schedule.
Your doctor will help you decide which treatments are best for you.
- Bright light therapy. You will sit near a light box for a while after waking up. Light exposure during the morning can help you sleep earlier.
- Delaying your internal clock. If you want to use this method, you have to delay your sleep by at least 1 to 2.5 hours every six days. Until you can follow a normal sleep schedule, this is repeated multiple times.
- Advancing your internal clock. You will go to sleep 15 minutes earlier each night. You will wake up a bit earlier each day.
- Improving sleep hygiene. Good sleep habits include following a regular sleep schedule and avoiding electronic devices.
- Melatonin supplements. Sleep and wake are controlled by hormones, and you can help your body better regulate them using melatonin. It is important to follow your doctor’s exact instructions because the best amount and timing are different for each person.
FAQ
Orthopnea is a condition where you feel like you’re not getting enough air while sleeping.
Orthopnea can be dangerous because it can lead to other health problems. For example, if you have orthopnea, you may not be able to get enough air while sleeping. This could lead to sleep apnea.
Orthopnea can be caused by several things, including obesity, smoking, and heart disease.
There are ways to prevent orthopnea. For example, you can lose weight and quit smoking.
If you’re having trouble sleeping, try using a pillow that’s too soft. You can also try sleeping on your side instead of your back.
If you have orthopnea, you can try using a neck pillow. Also, you can use a machine that blows air into your nose or mouth.
Conclusion
This condition is caused by a misalignment between the circadian rhythm of the body and the timing of external events. The result is that your internal clock becomes confused with your external environment, causing you to feel tired in the morning and alert at night. It’s not a life-threatening condition but can cause significant problems if left untreated.
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