Overview
Delayed sleep phase, also known as delayed sleep-wake phase sleep disorder, is an internal sleep clock (circadian rhythm) sleep disorder where an individual's sleep pattern is delayed two hours or more from a conventional sleep pattern. This results in the person going to sleep later and waking up later than usual.
Understanding the disease
Symptoms
Symptoms of delayed sleep phase include falling asleep later than two hours from a conventional sleep pattern and waking up later than others, causing difficulty in maintaining a consistent sleep-wake schedule. Other symptoms include difficulty waking up in the morning, difficulty falling asleep before midnight, excessive daytime sleepiness, and difficulty functioning during the day due to poor quality of sleep.
Development
Delayed sleep phase, also known as delayed sleep-wake phase sleep disorder, develops when a person's internal sleep clock (circadian rhythm) is delayed by two hours or more from a conventional sleep pattern, causing them to go to sleep later and wake up later than usual. This disorder can be caused by a variety of factors, including genetic predisposition, exposure to excessive light or darkness at inappropriate times, and irregular sleep-wake schedules.
Assessment and Diagnosis
Triage
You should consult a medical professional if you have, or if your partner notices, any symptoms of sleep disorders, including delayed sleep phase. If you or your partner observe symptoms such as excessive daytime sleepiness, trouble staying asleep, sudden awakenings with shortness of breath, or pauses in breathing during sleep, you should see a doctor for further evaluation and appropriate treatment.
Diagnosis
To diagnose delayed sleep phase, your doctor may review your family and medical history and conduct a physical examination. They may also order several tests, such as:
- Actigraphy: Wearing a small device that tracks your sleep-wake behavior at home.
- Sleep diary: Keeping a sleep diary in which you log your daily sleep and wake times to help show your sleep pattern. However, there is no specific diagnostic test for delayed sleep phase, and the diagnosis is mainly based on the patient's symptoms and sleep history. If necessary, your doctor may also consider ruling out other sleep disorders that could be causing your sleep pattern issues. Treatment for delayed sleep phase typically involves addressing any underlying medical or psychological issues, as well as making changes to your sleep hygiene and environment. Your doctor may also recommend a sleep specialist for further evaluation and personalized treatment recommendations.
Management and Treatment
Treatment
Treatments for delayed sleep phase typically involve changing the sleep schedule and creating a consistent routine. Some strategies that may be effective include:
- Gradual Shift: Gradually shift your sleep schedule 15 to 30 minutes earlier each day until you reach the desired bedtime.
- Consistent Routine: Establish a consistent pre-sleep routine, such as reading or taking a warm bath, to signal your body that it's time to sleep.
- Light Management: Use bright light in the morning to help regulate your body clock and minimize exposure to bright light in the evening.
- Sleep Hygiene: Follow good sleep hygiene practices, such as maintaining a comfortable sleep environment, avoiding stimulating activities before bedtime, and minimizing caffeine and alcohol intake.
- Relaxation Techniques: Incorporate relaxation techniques, such as deep breathing exercises, meditation, or yoga, to reduce stress and promote sleep.
- Chronotherapy: In some cases, a sleep specialist may recommend chronotherapy, which involves gradually advancing your bedtime and wake-up time over several days to reset your body clock. Remember that it may take time to adjust to a new sleep schedule, so be patient and consistent with the treatment plan. Consult a healthcare professional if you continue to struggle with delayed sleep phase.