Delayed sleep phase disorder is a common sleep disorder that usually affects teenagers. We spoke to Shelby Harris, Psy.D., director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center in Bronx, New York, for one approach to the medical problems you or your loved one may suffer from when trying to sleep.
If you think you might have delayed sleep phase disorder, use this as a reference point before getting personalized medical advice from your doctor or other accredited sleep expert. --Nana-Adwoa Ofari
With delayed sleep phase disorder, the sufferer's sleep pattern is "delayed" at least two hours from a normal sleep pattern. According to Harris, DSPD is sometimes misdiagnosed as insomnia. "The way you can really decipher whether the issue is insomnia (which is a lack of sleep) or DSPD, is to wait until you are on vacation," she says. "When you have a week off, toward the middle and end of the week, you should track your sleep. See what time you are going to bed and waking up. If on your vacation time you can sleep a full six to nine hours... chances are that you have DSPD as opposed to insomnia."
Change Your Zeitgebers
Harris says, "I tend to think of Zeitgeibers as things we do to tell our body 'it is awake time, let's be productive,' as opposed to 'let's get ready for bed.' I think the key here is to stress that patients with [delayed sleep phase disorder] tend to have the signals mixed up. They tend to have more energy at night, and since they're not sleeping, they do more stuff and try to be more productive at night... When the morning comes, and they need to be up to get to school, work, etc., they are so tired from not having slept much that night that they instead tend to stay in bed and sleep."
Practice Good Sleep Hygiene
Some ways to practice good sleep hygiene are to wind down before bed, and limit caffeine, exercise, tobacco, alcohol and TV. Stop drinking caffeinated drinks at least six hours before bedtime, and turn off the TV three hours before bedtime. Harris says, "It is vital not to do anything stimulating." Zeitgebers and sleep hygiene will not cure delayed sleep phase disorder, but it is a part of the process of achieving a desired sleep pattern.
Work With A Sleep Specialist On Chronotherapy
"It is important to work with a sleep specialist to ideally time your sleep," says Harris. "Let's say I have a client who sleeps from 2 a.m. to 10 a.m. During their vacation, I would work with the client to track their sleep. I would then delay their natural bedtime two to three hours every single day until they finally get around to their natural bedtime. The notion here is to work with the client to help them get more and more sleepy until they come around to the bedtime they are supposed to have. Once the client reaches the bedtime they are supposed to have, it is crucial to keep the new bed/wake time every single day."
Practice Light Therapy In The Morning
"Light therapy should really be used with the help of a specialist," says Harris. "If you use it too early in the morning, it could make the problem even worse. If you have light therapy at the time that you naturally wake up (and not too early because of work) it can help to set your bedtime earlier." Light therapy can consist of bright sunlight or (with the help of a sleep specialist) you can get a light-box or sunbox.
Use Regulated Doses Of Melatonin
Melatonin can be used to gradually move your bedtime earlier, says Harris. "Melatonin in low doses (about 1/2 to 1 milligram) if taken five to six hours before bed can help to drift your bedtime earlier. You should consult a sleep specialist beforehand because there are some medications or preexisting medical problems that can interact with the melatonin. The key with the melatonin is to keep the same bed/wake time everyday."
Shelby Harris, Psy.D., C.BSM, is director of the behavioral sleep medicine program at the Sleep-Wake Disorders Center at Montefiore Medical Center and assistant professor of neurology as well as psychiatry at the Albert Einstein College of Medicine. She is board certified in behavioral sleep medicine by the American Academy of Sleep Medicine.
Have you ever suffered from a sleep disorder? What worked for you?