What Is Delayed Sleep Disorder and How Is It Treated?

Delayed sleep phase disorder (DSPD) happens when something causes the body’s internal sleep-wake clock to go out of sync. As a result you may have trouble falling asleep at night or trouble staying asleep. This makes it difficult to stay awake during regular daytime hours, and you may find yourself feeling excessively sleepy and having trouble going about your regular day. 

Here at Neurology Specialists of Albuquerque, board-certified neurologist Timothy Ownbey, DO, specializes in evaluating and treating a full range of neurological conditions, including migraines, movement disorders, and sleep disorders.

DSPD is common, and when it strikes it can make carrying out your daily activities incredibly challenging. 

What is the circadian rhythm?

Circadian rhythms are 24-hour cycles that regulate sleep and other body functions. The suprachiasmatic nucleus (SCN), a brain area, contains an "internal clock" that regulates sleep and wakefulness in part. The SCN, as the body's master clock, sends out signals that cause hormone levels such as melatonin and cortisol and body temperature to fluctuate during a 24-hour period.

Sunlight plays a key role in keeping the internal clock in sync. Every morning, bright light triggers the internal clock to reset and keeps it on a regular daily schedule.

In some cases, the internal clock can malfunction, causing the body to produce hormones at the incorrect time of day. This can lead to sleeplessness at night and excessive sleepiness during the day, which can lead to considerable distress and impaired functioning.

There are five distinct forms of circadian rhythm sleep disorder (CRSD). The sleep schedule of all types deviates from the norm and is frequently a source of concern.

Delayed Sleep Phase Disorder

Delayed sleep phase disorder is the most common sleep problem. Sleeping patterns in people with delayed sleep phase disorder are significantly later than usual. Symptoms include difficulty falling asleep, difficulty waking up in the morning, and excessive morning tiredness.

It can affect anyone at any age, although it is most common in teenagers and young adults, and it commonly interferes with school and work. The natural tendency of people in their teens and 20s to stay up late and sleep late is more common in teens with DSPD.

LED light, particularly electronic screens in computers and cellphones, has introduced late-night bright lights to many people's environments. This strong light decreases melatonin production at nighttime. 

Treatments for delayed sleep phase disorder

The goal of treatment for delayed sleep phase disorder is to bring the body’s internal clock back into sync. Here are some of the treatment approaches. 

Low-dose melatonin

Melatonin taken at specific times has been demonstrated success in treating DSPD in teens, and it may also be useful in adults. Melatonin is available over-the-counter as a supplement. The hormone is produced naturally by your body that plays a crucial role in the sleep-wake cycle. At night, melatonin levels naturally rise in response to darkness, which helps you sleep.

To guarantee the most successful treatment strategy, melatonin dosage and timing should be addressed with our team. 

Light therapy

Bright light treatment is another recognized method for altering internal circadian cycles. Exposure to bright light should, in theory, occur quickly after waking up at the appropriate hour. Then avoid bright light throughout the evening hours. For children and adolescents, light therapy combined with behavioral therapy can be helpful. 

Cognitive behavioral therapy

Cognitive Behavior Therapy (CBT) for delayed sleep phase disorder is an evidence-based, nondrug approach and is regarded as a first-line treatment for chronic insomnia. In the long-term it is more successful than sleep medication.

CBT involves changing certain activities that keep you awake. It helps to establish habits that encourage a healthy sleeping pattern.

CBT techniques for DSPD include sleep restriction, which initially reduces time in bed to match sleep time; stimulus control, which involves strengthening the connection between the bed and sleep; and cognitive therapy, which works to change unhelpful thoughts in relation to sleep. The techniques are tailored to the individual. 

Effective treatment for DSPD requires an individualized treatment plan. The path to sleeping better starts with a comprehensive evaluation. To get started, contact our Albuquerque office or book online to schedule a visit with Dr. Ownbey.