[I think this topic needs to be out there. Delayed Sleep Phase Syndrome is a big problem for lucid dreamers because they can’t get a full night’s sleep, but the knowledge of its existence seems scarce. I’m going to try and up the awareness of this condition, and hopefully it will help some people find a better sleep life, and, in turn, a better waking life.]
Well, it seems I’ve hit a snag in my ability to lucid dream. I haven’t had an official diagnosis yet, but, when researching my continuing inability to sleep at night, which I’ve struggled with for as long as I can remember, I am pretty sure I have Delayed Sleep Phase Syndrome. It’s often misdiagnosed as chronic insomnia, but is not, in fact, a form of insomnia. (Hence, the reason I didn’t post in the “insomnia” sticky.)
Whether I have it or not, though, I think it is something that needs to be known about. It is not a very well known condition, and so it is often misdiagnosed by doctors. In addition to the chronic insomnia diagnosis, it is also known to be diagnosed as depression, schizophrenia, ADD, ADHD and other psychiatric or sleep disorders. So, I want to get a little bit of information out, because if you think you have one of those above disorders, you may, in fact, be wrong.
To put a long story short, DSPS is characterized by the following:
- Sleep-onset and wake times that are intractably later than desired
- Actual sleep-onset times at nearly the same daily clock hour
- Little or no reported difficulty in maintaining sleep once sleep has begun
- Extreme difficulty awakening at the desired time in the morning
- A relatively severe to absolute inability to advance the sleep phase to earlier hours by enforcing conventional sleep and wake times.
People with DSPS have at least a normal - and often much greater than normal - ability to sleep during the morning, and sometimes in the afternoon as well. In contrast, those with chronic insomnia do not find it much easier to sleep during the morning than at night. They also fall asleep at more or less the same time every night, and sleep comes quite rapidly if the person goes to bed near the time he or she usually falls asleep. Young children with DSPS resist going to bed before they are sleepy, but the bedtime struggles disappear if they are allowed to stay up until the time they usually fall asleep.
What distinguishes this from insomnia is that DSPS patients can sleep well and regularly when they can follow their own sleep schedule, e.g. on weekends and during vacations.
It’s usually treatable, but cannot be cured.
Treatments include:
- Mild cases of DSPS can be controlled by waking up and going to bed 15 minutes earlier every day until the desired sleep schedule is reached. More severe cases are treated by the methods discussed below.
- Light therapy (phototherapy) with a full spectrum lamp or portable visor, usually 10000 lux for 30-90 minutes in the morning. Avoidance of bright light in the evening may also help.
- Chronotherapy, which consists of resetting the circadian clock by going to bed several hours later each day for several days.
- A small (~1mg) melatonin supplement taken an hour or so before bedtime may be helpful in establishing an earlier pattern, especially in conjunction with bright light therapy at the time of spontaneous awakening. Side effects of melatonin may include disturbance of sleep, nightmares, daytime sleepiness and depression. The long-term effects of melatonin administration have not been examined and production is unregulated. In some countries the hormone is available only by prescription or not at all.
- Some claim that large doses of vitamin B12 help normalize the onset of sleepiness, but little is known of the effectiveness of the treatment.
- A treatment option which shows promise is Ramelteon, a recently-approved drug which in some ways acts as a synthetic melatonin. Production of ramelteon is as regulated as any other prescription medicine, so it avoids the problems of variable purity and dosage with melatonin supplements.
- Modafinil is approved in the USA for treatment of Shift-work sleep disorder, which shares some characteristics with DSPS, and a number of clinicians are prescribing it for DSPS patients.
- There has been one documented case in which a person with DSPS was successfully treated with trazodone.
So, hopefully, some of you out there with these chronic insomnia problems will be able to figure this out, as it accounts for 7-10% of chronic insomnia cases. As they say, knowing is half of the battle. If you think you have DSPS, you should probably see a sleep specialist. (I know I will.)
More information at Wikipedia.
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