Delayed Sleep Phase Syndrome (DSPS): Reclaim Your Sleep

Are you aware of the circadian rhythm? Imagine you have a gardener. He wakes up every morning and makes sure that all plants requiring sunlight, water, nutrients, and shade are given the same so that they live healthier, longer, happier, and more productive lives. As the sun starts to set, the gardener begins to wind things down, dimming the lights and slowing the watering. At night, the gardener takes one last look at his plants, goes home, and sleeps. This gardener is you, and the plants are your body. This is what circadian rhythm is. It helps you fix a daily, standard routine, keeping your body on a regular schedule, helping you wake up, stay active and productive, providing the body with all necessary nutrients, and sleep well on a daily basis. But what happens when this rhythm is disrupted and your schedule becomes unconventional and beyond what is considered normal? It’s called the Delayed Sleep Phase Syndrome (DSPS).

Imagine a person named Divya. She used to have a perfect schedule and attended college every day. But when she stayed up for one night due to a college submission, she was unable to fall asleep on time after that incident, for months. Where she used to sleep and wake up from 10 PM to 5 AM, she now sleeps and wakes up from 3 AM to 11 AM. This pattern continued for 3-6 months and persists. She has trouble falling asleep, waking up, focusing on her college classes, and losing her grades. This is what an ideal case of DSPS looks like. Sleep time is delayed, persists for at least three months, and causes problems in day-to-day routines. It can affect anyone at any age, and the exact cause is unknown (but environmental cues—like light, food, and physical activity—might play a role). 

Some myths about this

• It is similar to sleep apnea/insomnia: No, it is not. In DSPS, the duration and quality of sleep are not affected.
• Everything is because of the use of phones: Maybe, but there could be other contributors as well. DSPS is affected by environmental cues, one of which is the light projected by your phone. 
• Only adolescents and young adults get this: Although adolescents and young adults are more prone to getting this due to environmental factors, any age group can get this. It occurs in 0.17% of the general population.
• It’s the same as the “night owl” complex: No, when you are a night owl, you choose to stay up late and wake up late. But in DSPS, you are awake because your circadian rhythm is set that way and you cannot naturally fall asleep at the time you want.

What to do about it?

There are multiple treatment models developed to help with DSPS. Let us understand each with the help of examples:

1. Chronotherapy: Let us take Divya as a classic example. She wants to start sleeping at 11 pm and wake up at 7 am. She will gradually try to shift her sleep schedule by delaying two hours when she goes to sleep and wakes up.

• Days 1-3: Sarah goes to bed at 5 AM and wakes up at 1 PM.
• Days 4-6: Sarah goes to bed at 7 AM and wakes up at 3 PM.
• Days 7-9: Sarah goes to bed at 9 AM and wakes up at 5 PM.
• Days 10-12: Sarah goes to bed at 11 AM and wakes up at 7 PM.
• Days 13-15: Sarah goes to bed at 1 PM and wakes up at 9 PM.
• Days 16-18: Sarah goes to bed at 3 PM and wakes up at 11 PM.
• Days 19-21: Sarah goes to bed at 5 PM and wakes up at 1 AM.
• Days 22-24: Sarah goes to bed at 7 PM and wakes up at 3 AM.
• Days 25-27: Sarah goes to bed at 9 PM and wakes up at 5 AM.
• Days 28-30: Sarah goes to bed at 11 PM and wakes up at 7 AM.

Sarah eventually aligns her sleep period with a conventional 11 PM to 7 AM schedule.

2. Bright light therapy: As the name says, Divya starts by exposing herself to bright light every time she wakes up at 11 am. She spends between thirty and sixty minutes a day in front of a special light box that simulates natural sunlight. This helps signal to his brain that it’s morning and time to be awake. Then she gradually started exposing that special light box 15-30 minutes earlier each day. For example:

• Day 1-3: Wakes up at 10:45 AM and uses the light box.
• Day 4-6: Wakes up at 10:30 AM and uses the light box.
• Day 7-9: Wakes up at 10:15 AM and uses the light box.

Once she achieves the target, she will continue using the special light box to get well-adjusted to the schedule and ensure she avoids bright light in the evening to fall asleep early.

• Melatonin supplements (prescribed low doses)

To be used in combination with the special light box, research has shown it has been very effective in helping with DSPS and preventing relapse. 

• Monitoring and maintaining sleep hygiene, and stimulus control strategy

Fun Facts

• It is quite common among individuals who have ADHD.
• No, not all these late risers are irresponsible party animals!
• It is suggested to avoid caffeinated food, but it might/ might not be a contributing factor.
• Individuals who have social jet lag and must rise early for work or school are known as “late chronotypes.” They also constantly feel worn out.

By comprehending the characteristics of DSPS and putting these treatment methods into practice, people can reclaim control over their sleep cycles, better everyday functioning, and improve their general well-being. It’s critical to practice proper sleep hygiene and consult a specialist for individualized treatment recommendations