Delayed Sleep Phase Syndrome

[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.

I find it sort of funny. The only reason this diagnosis exists at all is because society has put a standard on the hours one is supposed to sleep. And if you deviate there must be something wrong with you. So, now I don’t find it that funny anymore, I find it sad. It’s quite typical of closed minds to think that way.

Well, if you think I’m closed-minded, just go ahead and think that way. But I can tell you from experience that this disorder is EXTREMELY annoying. To experience it for yourself, wake up at three in the morning every day for the next month and the go to classes or work. Don’t go to bed until your normal bed time, because for someone like me, it’s impossible. Then you have an idea of what I’ve lived with my entire life.

You may think it’s closed-minded, but I’ve been trying unsuccessfully to change my bed time for about 14 years now. I haven’t accomplished a thing. This condition is real, I promise, whether you choose to accept it or not.

The nature of the condition, after all, is not that I can’t sleep until late, but that I completely lack the ability to reset my internal clock to a different time. If I were a normal person, then staying up all night one night and going to bed at a normal time the next would have helped, but I’m not, and it didn’t. I tried it just three days ago.

So it’s not a condition based on the fact that you deviate from the standard, like you seem to think. The condition is based on the fact that, unlike normal people, you lack the ability to change the time your body is ready for sleep. And let me tell you, it can reap HAVOC on your life, especially when you have early morning classes to go to.

Ok, I’m done ranting now. I do agree that some disorders and diseases out there are indeed the way you just put this one. But, from experience, this is not one of them.

I’m not calling YOU closed minded. You didn’t think it up… and yes, maybe I was a little hasty. I may not understand completely. I know about sleep trouble though. I may even fit the description a little. But I don’t find it impossible to sleep at normal hours so I guess I don’t. My thinking is that normal people may find it very hard to fall asleep at say, 5-6 oclock in the evening. OR very hard to stay UP at 3 oclock at night.
Your second message made it sound much more serious though. That it’s a fixed time to sleep. Wich in ITSELF is unnormal and That I can definately call a CONDITION.
But were it only that ones natural sleepyness sets in later than normal I wouldn’t. That i would call simply being a night person. guess I’m wrong. sorry.

krakatoa means that in nature one is supposed to sleep whenever one wants to, get up whenever one wants to, go pick some apples and hunt some animal for a few hours, socialize all day long, and then fall asleep when their body wants

alarm clocks are so silly… go to bed this time, get up this time, work this time, eat lunch this time, watch tv this time. of course people develop sleeping problems in this world.

that’s what he’s saying more or less.

Have you tried:
brainwave entrainment? (i think 10hz brainwave entrainment is supposed to help reset the circadian rhythmns)

the two combined together can be pretty good, working at a mid-alpha frequency, 8-12 hz probably, 10 as a generally good one. It will take time but the alpha state if really purely accessed is quite good for the brain to chill out, be focused, and reset and revitalize things.

are you following the normal guidelines for healthy sleep, not sleeping too many or too few hours. Exercising every day. Keeping a good diet. Keeping your mind free from stress, things like that?

A hatha yoga class would be worlds of good to help cure a lot of imbalances in all areas of life.

Yes, I’ve tried meditation and brainwaves, and I’ve tried them together. They do nothing. I’m eating a healthy diet, and I get regular exercise. I’m president of the Kendo (Japanese Fencing) Club where I live, and I usually come home after that sweating like a pig, and we always do meditation there at the end of practice to keep our minds calm.

I marched Drum Corps for three years, and, even when I worked so hard I could barely stand up at the end of the day, I still couldn’t get to sleep much earlier than now - instead of 3:00 I managed 1:00, but that’s not much improvement for the amount of work I put into it. Not to mention that, as a result, I have some physical conditions from the stress on my body that prevent me from doing certain things now. We also did yoga daily there, and it didn’t seem to help all that much, if any.

Sorry if I sounded a bit harsh there. I guess you’re right, if we didn’t have schedules like we do, this wouldn’t be a problem. But, if we tried to create a society where everyone did everything on their own schedule, there would be no coordination between people and society would fail. Though, we could probably find some middle ground somewhere that would still work.

Sorry again, I guess I did kind of blow that response out of proportion.

I have been suffering from this for quite some time and went to see my PCP today about it. I currently also have Sleep Apnea and use a CPAP. I thought that when I was diagnosed with Sleep Apnea and put on the CPAP it would solve my sleep problems. I was quite disappointed when I realized this wasn’t solving the whole issue. I have tried to talk to my neurologist about my sleep pattern and he didn’t say anything about this syndrome to me or offer any real feedback. My problem is that no matter what time I go to bed…I do not fall asleep until about 2am and if left to wake up naturally, I tend to wake at about 9am. The problem is I work a 8-5 job and have to be up at 6am. By the time its time to wake up I am in deep sleep. I tend to sleep through alarms and have to set up at least two different methods of alarms with multiple settings to ensure I hear at least one of them. I have tried Melatonin, Sonata, going to bed earlier, later, booted the husband to another room…nothing has helped. I began researching this morning and found the Delayed Sleep Phase Syndrome which sounds verbatim to my problem. I even sleep in on weekends to make up for lost sleep during the week as described in an article I found. I do not feel like I am suffering from depression but if I am, its depression that I CAN’T SLEEP!!!
My doctor today prescribed Rozarem every night, if not asleep within 30-60 mins, take Trazodone, and if still groggy in the morning take Provigil. I am also looking into the Light Therapy option. Any feedback to offer?

Well, last night, I tried Melatonin, and it worked like a charm for me. Lately, mine had actually advanced to 5:30 AM. I took the melatonin last night and was out by about 11:30, which was amazing for me today. However, you’ve already stated that that doesn’t work for you, so I guess that’s not very sound advice.

Have you tried Chronotherapy? I know it’s kind of hard on a work schedule to do that one, but if you get a week or so off at some point it sounds like it’d be worth a try. At least in my case, when I stayed up later several nights in a row, it seemed to make the symptoms worse and I couldn’t sleep 'till that time each night, so, at least in my case, that one sounded most promising. Though I personally would want at least three days in a row on each step before advancing it more.

Other than that, I don’t know what else you can do that you haven’t done or aren’t already doing. I hope you get it taken care of; I know from experience how horrible this thing can be. If you have any success with this new stuff, let me know.

My sleep patterns for the past year fall into the patterns described by this quite perfectly. I haven’t fallen asleep before midnight, or even before 2am for as far back as I remember. I don’t get tired late at night (i mean, it’s 3:15am and I took melatonin 30 minutes ago and I’m not remotely tired). I have to force myself into bed because I want to get up at a reasonable time (for me… being any time before noon), but I never sleep until 3-5am, and then don’t get out of bed until 12-1pm. And at that point I still have to force myself out of bed because I know that I’m wasting away my day and the time I have before class/work. Some of the smaller symptoms also apply to me, such as increased creativity late at night.

While it seems like already a lot of people on here have responded saying that this disorder seems to apply to them, despite its lack of prevalence, it’s largely due to the fact that this forum is made up mostly of people who already have a large focus on their sleep and dreams.

Nevertheless, I’ve had to make serious adaptions in my life in order to balance life itself with sleep. I had to quit a job because of the hours and my inability to get up in time and focus and get my job done (hard to work in a photography lab around acidic chemicals when you’re half asleep). I had to drop classes this past semester because I missed class too often because of sleep issues. And lastly, my entire schedule this semester is made up of mid-afternoon to late-evening classes because I know that I would mess up another semester if I was subjected to even remotely early wake-up times. And of course, now I work only evenings/nights.

It’s a pain in the ass. Could make life tough when I have to make a true career after I finish college…

I suppose if your bodyclock is so set that nothing will alter your waking/sleeping periods … then the only true solution would be to emigrate to a country that keeps to the same time zone as you do :eek:

Luckily, I’m going to Japan for graduate school :razz:

No, seriously, Melatonin seems to be working for me. And it’s helping me remember my dreams, though I’ve been to busy to officially start a dream journal here lately. Downside is, the dreams I’m having, at least the last two or three, were edging on the nightmare side. Hopefully that’s not from the melatonin and won’t develop into an all-the-time thing, cause I like sleeping at night.

(But I’m going to Japan anyway :happy: 日本は最高な国です!)

I recall having nightmares when I used Melatonin as well. One was so real and involved my death and it bothered me for days.
The Rozarem has helped me fall asleep faster, however I can’t stay asleep. I go to bed at 10pm, awake at 1am, and then again at 3:30am wide wake. Unfortunately, my day starts at 6am and so I go back to sleep. When I awake at 6am, I am drowsy and can’t wake up. The doctor says it will take about 2 weeks to see a difference.

I have this! I had no idea it was “diagnosable” thing but i’ve been this way ever since i can remember. my earliest recollection of this is kindergarten. kids were talking about their bedtimes, and one kid said he stayed up til 11 o’clock(!). a prissy girl in the class said to him “ooooh you’re bad” and i said nothing, embarassed that i had gone to sleep at 12:30 the night before. Not late by adult standards but i was only 4. i remember always staying up late, not sleepy at all, til 2 or 3am even at age 7 or 8. i just wasn’t tired, and i’d stay up and play weird games in my room (my teddy bear went on global adventures, i would sculpt things out of bubble gum, etc.
but i’ve NEVER had a problem sleeping 8 hours or more (usually more!). one of my early memories is of waking up and my mom seeing me as she came up the stairs and she said “well, good afternoon!”. all throughout elementary school, highschool, college, up to the present i’ve had sleep schedule of getting tired between 2am and 5am, with a wake up time between about 12:30 and 4:30. That is, when left to my own devices (weekends, school breaks, vacay, my whole college career…). and i have a lotta lotta memories from elementary school thru highschool being very tired during the day because i couldnt fall asleep until 3am or later. of course, i’ve had to deal with the schedule of the regular world but its led in part to a problem with chronic lateness. I’m a very difficult person to wake up when i’m not ready, i can be so delerious when the alarm clock goes off, that i’ll convince myself (and others) that i don’t need to get up. I was always asking my wife “wake me up at such and such time, it’s important” and then when the time came, i’d literally scream at her to leave me alone, i don’t to be at work early that day (lies). and often i just don’t hear the alarm at all if i get under 4 hours sleep. loud ones too. I have four alarms currently.
things that have helped:
provigil (modafinil) - the prescription drug recommended for work sleep shift disorder and narcolepsy(!)
ambien - a sleep aid you ask? well… yes. if i take it before the time i want to get to bed, i will sleep 6-7 hours and then snap awake rather alertly. that’s just how it affects me personally, it may be different for others.
i have gotten modafinil over the internet from india and places like that. i’m loathe to pop ambiens every single night, but i use it at times when my sleep schedule gets way off, to get me back on track to a “normal” sleep schedule.
my current schedule: i’m generally able to get myself to sleep before 2am. one or two of my alarms go off, at which point i realize that i need to take my morning meds, and along with these i pop two no-doz. i then go back to bed and wait for the caffeine to kick in. in other words, it takes me about an hour to wake up. [also: i’d probably be in trouble if i had to rely solely on my alarm clocks. i can “snooze it” for a long long time. thus, i actually (don’t laugh) have my mom call me each morning. she talks to me about god knows what but because i’m forced to carry on a conversation, thus i “talk myself up” and it brings me much closer to alertness than i would if it were just a bunch of alarms going off].
i crave 8 hrs sleep but getting only about 5 or 6 each night actually helps keep me on schedule… it’s a crappy method because i feel really tired in the evenings due to lack of sleep, but that tiredness helps get me to bed earlier. the downside is that i MUST crash on the weekends. saturday and sunday i sleep 12-14 hours. my house is a mess, i can get no housework done on weekends :meh:
sorry for the novel, it’s just a nice feeling to know that this is something that other people experience and it is recognized as (i wouldn’t call it a “condition” or “disorder” but…) a phenomenon that a certain percentage of people experience in their lives.

I have something that is or is similar to this; I have a tendancy to go to sleep a couple hours later than I should, and sleep later than I should as well. it’s not really a defect I don’t think, so much as my body trying to live in 26-28 hour days (Yesterday I was awake from 2PMish to about 6AM). This might just be because I have a habit of sleeping for 10 to 12 hours, but my hours don’t seem to deviate much when i’m on vacation… I guess I feel like I need to be awake longer than normal when i’m working, even if i’m not working the whole time?

Interesting you’d mention this. I remember when I had to keep a schedule i’d occationally take melatonin to help get to sleep, and I remember having a dream where a good friend of mine was run over right in front of me, and it bugged me for at least a week (although it might’ve been partial guilt). I don’t remember if that dream followed me taking melatonin, although I do know I was taking it quite often (at least 2-3 times a week) around then.

Exactly why I made this topic :happy:

If that’s the case, you may instead have Non-24-hour sleep-wake sydrome. And that’s a lot harder to take care of…

I seem to deviate from teh 24hour circadian rythm. I’ve noted this in my dream journal. I manage to get to sleep at “normal” hours. Hold it for a time. Then gradually getting to bed later and later. That is from the perspective of a Desired bedtime. And ofcourse getting up later. Then It gets all crazy when I try to reset it. I’ve felt for a long time that my days are longer that others’.

provigil (modafinil) - the prescription drug recommended for work sleep shift disorder and narcolepsy(!)

Can you tell me if you experienced any side effects from this drug. My doctor has prescribed it but I haven’t taken it yet. I rarely consume caffiene and if I drink more than one styrofoam cup of coffee, I have the shakes all day. I am worried how I might feel on this drug.

I see where Krakatoa is comming from. I was in a class and we learned about ADD. The ADD that is so prescribed by huge pharmacies could REALLY just be doctors making a condition just to sell their ‘cure’. Its just a theory I mean things in the brain are really hard to explain but when society (america here) is telling you :‘you’re kid cannot focus in class, does your kid fidget etc’ Maybe its something else like depression or withdrawing or boredom and stuff.

Or it may be a sleep disorder. Sleep deprivation causes very ADD and ADHD-like symptoms.

Since we can’t understand processes in the brain directly, diagnosis’s as ADD are temporarily the best we can get.

Perhaps in a 100 years or so a psychiatrist will know whats wrong just by observing your brain activity, for now, our best shot is with Freud.