Delayed Sleep Phase Syndrome: Symptoms, Causes and Treatments

Delayed Sleep Phase Syndrome (DSPS) is a sleep disorder that occurs when a person’s circadian ryhthm (sleep/wake cycle) is delayed from the typical day/night cycle. People with delayed sleep phase have a natural tendency to go to bed later and wake up later than what is typically considered normal.

How Do Circadian Rhythm Sleeping Disorders Work?

Delayed sleep phase syndrome (DSPS) is one of many circadian rhythm sleeping disorders, and  is the most prevalent of all such disorders. It is the opposite of advanced sleep phase syndrome, in which people go to bed and wake up earlier than normal. People with delayed sleep phase generally go to bed in the early morning hours, from 1 am to 4 am, and wake up later in the morning, from 8 am to 11 am. Socially active people, and those considered ‘night owls’, who feel more awake or sharper during the evenings, are at a high rate of having or getting this disorder.

When delayed sleep phase is not the result of another sleeping disorder, people who have it will achieve sleep quality and duration equivalent to those with normal sleeping schedules. If the delayed sleep phase is not interfering with daily routines, or is in fact complimentary of the subject’s routine, it may be advised to maintain the routine, as the circadian rhythm disorder might not be harmful.

What is Delayed Sleep Phase Syndrome (DSPS)?

When Delayed Sleep Phase Syndrome starts to interfere with ‘life’, by conflicting with daily routines such as work or school then it is called Delayed Sleep Phase Disorder (DSPD). When the disorder comes into conflict with daily routines, such as school or work, that requires waking up earlier than would otherwise be natural, the disorder could lead to sleep deprivation and other issues. Delayed sleep phase is responsible for 10% of all chronic insomnia cases.

Common Symptoms of Circadian Rhythm Disorders like DSPS & DSPD

Delayed Sleep Phase Syndrome

People who have a delayed sleep phase which interferes with their routine often compensate by napping during the day, or sleeping excessively on weekends to counterbalance the deprived sleep during the week. This can lead to temporary relief, but perpetuates the delayed phase cycle.

Circadian rhythm disorders are caused by the body’s internal clock not resetting and adapting to changes in sleeping patterns, or doing so slowly. In most individuals, going to bed at a time different than what is normal for them will result in the circadian rhythm adjusting and allowing them to fall asleep and wake up as desired. In those with delayed sleep phase, even when suffering through lack of sleep, the body maintains its inclination to go to bed at the usual time, making it difficult to fall asleep even when feeling physically tired. Likewise the body will tend to wake up at the same time, regardless of the amount of sleep, be it too little or too much.

In contrast to advanced sleep phase, which has minimal effects on work or school obligations, people with delayed sleep phase are more likely to have their sleeping disorder interfere with their necessary daily schedule, leading to chronic sleep deprivation.  This can negatively affect school or work performance and social standing. People with Delayed Sleep Phase Syndrome (DSPS) and Delayed Sleep Phase Disorder (DSPD) may be labelled as lazy, unmotivated or undisciplined.

Who Is Most Likely To Be Affected By Delayed Sleep Phase Syndrome?

Delayed sleep phase affects as many as 15% of teens and adults, a much higher rate than advanced sleep phase syndrome, and those with delayed sleep phase are generally younger than those with ASP. It often develops in adolescence and continues into early adulthood, though it may also begin in adulthood. It affects both genders equally. Like ASP, DSP also has a genetic link, and people with a family history of DSP are 3 times more likely to have it as those with no family history of the disorder.

Environmental conditions can lead to the development of Delayed Sleep Phase Syndrome (DSPS) and Delayed Sleep Phase Disorder (DSPD). A lack of morning sunlight exposure, and an overexposure to bright evening sunlight are likely to lead to a shift in the circadian rhythm towards a delayed sleep phase.

What is the Treatment for Delayed Sleep Phase Syndrome?

If delayed sleep phase is interfering with your daily schedule, it is important to take steps to minimize its effects. Nearly 50% of all reported subjects with DSP also suffer with depression. While there is no easy cure for DSP, and although DSP has shown high levels of resistance to many treatment methods, consulting a sleep doctor should be considered.

The most common method of treatment is the gradual scaling back of sleeping times, until they achieve the desired time frame. The schedule would then be rigidly implemented. While this can be effective, maintaining the new routine is imperative, as it often resets completely if the individual diverts from the new habit even once with a late night.

How Does Bright Light Therapy Work?

Bright light therapy is also an accepted treatment that has shown some positive results with Delayed Sleep Phase Syndrome (DSPS) and Delayed Sleep Phase Disorder (DSPD). It involves exposure to bright light at early morning hours shortly after waking up, and avoidance of bright outdoor light during the evening hours. This has been demonstrated to readjust the circadian rhythms of individuals to more normal schedules.

Does Melatonin Work To Treat Delayed Sleep Phase Syndrome or DSPD?

At least one sleep study in 2010 concluded that “Melatonin is effective in advancing sleep-wake rhythm and endogenous melatonin rhythm in delayed sleep phase disorder.” If you believe you’re experiencing DSPS or DSPD consulting a doctor should still be a priority to determine proper treatment.

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99 thoughts on “Delayed Sleep Phase Syndrome: Symptoms, Causes and Treatments

  1. Gail Selsmeyer Reply

    Have to agree with Merlin. I don’t fall asleep until 5 – 7:00 a.m. I’ve done the sleep hygiene for decades (I’m 71). I’ve tried forcing the morning light with leaving my east facing bedroom window curtains open until the sun finally got painful hitting my eyes if I happened to be facing that direction. I’ve got a Go-Lite and it helps my SAD only marginally. I can’t fall asleep for a nap. Going to bed earlier only makes me roll around for more hours. I’ve been living on an average of 3 hours of sleep a night for over 10 years. Fortunately I’m retired and can stay in bed in the morning hoping for another 1/2 hour of nodding off. It rarely happens. It’s also not unusual for me to not be able to fall asleep at all so I just end up doing a 48 hour day. Then I might be lucky enough to get a 5 hour night of sleep. Depression is my life it seems.

  2. sarah Reply

    5 years ago, i decided to stop trying to be normal by taking melatonin, advil pm, etc I dont fall asleep before 5am, i am a vampire but it works for my body. I work in restaurants as result. But my health is 100x better and i am so much happier, content and calm when i get 8hrs a night. If i dont sleep, i am miserable, sick, mean and tend to make more mistaks and get into accidents. This is not a good way to life. I am happy to be a night owl as long as I can find work to support this lifestyle which is harder but if i have less money but happier and healthier than that is okay for now:)

  3. Laura Cisco Reply

    I naturally sleep 4am to noon. At 55 y.o., after decades of being forced to function in a 9 to 5 world, I have now slipped into a non-24 pattern. After sleeping all weekend, I will wake Monday and if I am really lucky finally fall asleep Thursday night/Friday morning at 5 or 6 am. Sometimes, I don’t fall asleep until Saturday or Sunday. As I get older, I’m finding it harder & harder to go days without sleep. I recently broke both my ankles because after 4 days of no sleep, I fell asleep while standing. I woke-up as my upper-body was falling to the floor. My feet stayed planted and my ankles just snapped when my upper-body hit the floor. Through the Patient Portal, I read my Primary Care doctors notes- he has diagnosed me with a Personality Disorder. He also discharged me from the practice I had been a patient at for over 20 years. This is a living hell. I’m never sure what day it is (I have to put a post-it on my desk every morning with the day so I don’t mess-up when talking with a customer). There is no, “tomorrow is a new day.” It all one neverending day of constant exhaustion. My coworkers hate me – she is teary, she is moody, she is crabby. There is no explaining, “This is what sleep deprivation looks like you jack-asses.” My ankles are healing & I can walk again. For that I am grateful. But, I dread returning to work

  4. Bogdan pop Reply

    I’m an night owl and i love it..! My father was the same…I sleep like a baby from 2-3 am to 10-11 am …but i’m an independent contractor , and i choose my own hours. If i put the clock to wake me up before 8-9 am , i don’t sleep at all…i just tuss in bed and look at the clock every 30 min……so i choose not to do that anymore…my life is beautiful now ….and i don’t get to drive in rush hour anymore…!!

  5. Natalia Reply

    Ever since I can remember I felt more active in the evenings and am able to get things done then. In the mornings I am sluggish, always have been and hate to have appointments before at least 10am. Therefore getting to school before 8 am was hell for me and the first 4 classes of the day I was not conscious of. At University it got better as most classes start at 9 or 10am at the earliest. I am saddened by the world not being flexible enough as to take into account people who are a different chronotype. The past few years I’ve experimented with sleep calculators and they help marginally but do help with oversleeping. Also I have a software installed on my computer that limits the blue light at evening time and helps with sleepyness. Now for the coming winter however, I am keen to try out a day light lamp for the mornings. Maybe it’ll do the trick?

  6. Jaz Nicol Reply

    Good morning, I am making contact for my 7year old who has some major sleep issues , currently prescribed 4mg melatonin, and can’t wait for our referral any longer. Can Bryn please contact me Wendy referred me.

  7. Sharon Moore Reply

    Hi, I have had trouble keeping falling asleep for at least 10 years, started from when we had a 7.3 earthquake very scared in case we have a other big one

  8. Penny Cunningham Reply

    Loved the article!
    I am the opposite . I fall asleep 8-9 o’clock then awaken about 1-130
    Am for the day. I do
    Nap. If you
    Write an
    That. I
    Have migraines every day for 30 years thanls

    • Anonymous Reply

      It’s in there, click on the link gor advanced phase syndrome near the top of the article.

      • Min Reply

        I have it since I was a kid, always hated life, I hate school, work it hell for me. The fact I have to get up in the morning makes me cry every day, I just want to sleep. People who are close to me always tells me to sleep early, stop massing ur sleep, but they talk with no little understanding that I’m not them, I go to bed in the night, try to sleep but I can’t, I hate to say that but my bed at night is a jail but in morning is heaven, when Covid hit and I had to stay home, that was my time of life, it’s was a life that I would never forget. My grade in
        School was amazing, I worked on things which I never thought I could do it only when I notice I can only function in night. My night was morning and my morning is night, I would love to find a job that I can work at night and bye morning people I don’t know you and I don’t understand u just like how u don’t understand me.

  9. Jan Reply

    I have this too. But I call it late chronotype. For millions of years it was very useful and appreciated that about 15% of the tribe was alert during the night to keep an eye out for predators (of animal or human kind). Now they call it a disorder. It’s like calling people who have darker skin to protect them from sunlight “surplus melanin disorder”. For 30 years I suffered because of this. Got fired twice. Every night dreading to go to sleep, lying awake for hours and then dragging myself through another sleep deprived day. The best solution is to find a job that accommodates your normal rhythm. If that is not possible, what seems to work for me is put on 10000 lux light therapy glasses at 7 am for at least an hour, preferably the whole morning until noon. And then after 4 pm avoid all daylight and blue light from screens by putting on blue light blocking glasses (the dark ones that filter out 98% of blue light, not the yellow ones). That way I still am an evening person, but I feed myself the daylight pattern of Uzbekistan in stead of Brussels, so getting up at 7 am feels like 11 am and falling asleep at 12:30 am feels like 4:30 am (my most natural bedtime). It works for now. I go to sleep a 11 pm, I still lie awake until 12:30 am, but I do fall asleep around 12:30 these days, which was impossible for decades. Living like a vampire after 4 pm sucks though. And not being able to enjoy my favorite netflix shows in full color (everything looks sepia with the glasses) takes a while to get used to. For once I actually want the social justice warriors to jump on something: chronodiversity! Looking down on people and discriminating them because of different genetics is basically the same as racism.

    • Andrea Reply

      I totally agree. I am tired of people telling me ” just go to bed earlier” Like its that easy to fall asleep. To me its like telling these “morning people” just sleep longer until 9-10 am! they cant just like we cant fall asleep early. This runs in my family and i cant help it. I live my life deprived of my much needed rest and sleep. Its totally no natural to wake up with an alarm and fore our bodies to wake up before we recovered from the day before

  10. Cora Reply

    I am 21. I don’t really remember when it started that I wasn’t able to fall asleep at a decent time but I know I was in high school when I started to notice it. I was ok with staying up until 1am or later doing school work then wouldn’t be able to fall asleep until much later. I busted a blood vessel in my eye doing school so late but once it healed, I kept doing it because I couldn’t focus on it at other points in the day. I tried switching where I sleep and now sleep full time on the couch because it’s easier to fall asleep on the couch than it is to fall asleep in my bed. A few months ago I broke down crying because I got home at 1145 from my job and didn’t fall asleep until after 4am. My boyfriend got me Melatonin that day. It helps every once in a while but there have been many times that it does absolutely nothing. I have found that I can fall asleep earlier if I am extremely active that day. For example I hiked 9 miles one day and came home to clean the house and that night I was able to fall asleep around 1230. But then there are days that I don’t do anything and fall asleep at 1130, these are the days that I wish I had more of. My sleep quality doesn’t seem that great. I wake up absolutely exhausted even on the lucky nights every once in a blue moon. I am currently majoring in psychology so maybe someday I can help all of us that are frustrated with our sleep cycle. Until then, I’ll keep telling myself that sleepless nights are God giving us a chance to talk to Him because He misses us.

  11. Merlin Marshall Reply

    I am 63 and only tonight found a name to describe what I am going through. I have long been a night owl, but able to function fairly normally until the last 10 years or so. Its 3:43 am, and I am not particularly sleepy. When I can sleep what my body wants to sleep, it seems I am awake later and later, like my internal “day” is longer than 24 hours. I can be exhausted all day, have gotten 4 or less hours of sleep the night before, go to bed at 10pm, and not be able to sleep before 2-3am. So frustrating! I work a regular daytime schedule, have done so for 15 years, and this still does not reset my internal clock. All that junk about good sleep hygiene resetting your clock is a crock, it doesn’t happen if you have this. All the normal researchers make it sound like some sort of personal failure of character or willpower, if you just go to bed at the same time each night, you will be fine. BS! I would love it if this happened! It doesn’t. I can’t will it to happen. I start to perk up at about 6pm. I am most productive between 8pm and 1am. My best, deepest sleep is from about 7am to 11am. I have a regular daytime job. It is so hard not to fall asleep at my desk in the mornings. I often take caffeine doses to get through the morning. I generally get less than 5 hours of sleep during the work week. I do let myself try to make up some on holidays and weekends. If I didn’t, like the ” experts” say you shouldn’t, I’d be dead. 10 days of 5 hours of sleep a night doesn’t make me able to fall asleep earlier, or get up earlier.

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