Delayed Sleep Phase Syndrome

Its Behavioral and Societal Roots

Society's role in a common sleep problem

Delayed sleep phase syndrome (DSPS) is a disorder where your body's desire to sleep is delayed beyond a point that is considered acceptable by society. When society or circumstance pressures these individuals to wake up early they often experience brain fog and difficulties getting to school or work on time. This sleep problem is particularly widespread among adolescents. This syndrome describes the inability to fall asleep and wake up at preferred times. It can be caused by both physiological differences in our hormones and behavioral factors like erratic bedtimes and wake times. For instance, teens naturally have their sleep cycle shift towards later in the night as they break away from their parents.  Yet school in the United States begins very early. So teens often find themselves unable to fall asleep until late in the night and unable to wake up with their alarm in the morning for a school day that is usually too early for their bodies. My colleague, Wendy Troxel gave a great TED Talk on this subject.

Individuals with DSPS might be considered extreme night owls, which is not necessarily a bad thing. Many evolutionary anthropologists believe that our society evolved to have a population with diverse desires on the timing to fall asleep, or chronobiology. The reason for this is so there is someone always awake in a small tribe, protecting the tribe from predators. So in a way, this disorder represents the tension between our genes and modern day societal pressures. 

Treatments for delayed sleep phase syndrome are best attained when working with a sleep disorder specialists. You can also take steps to shift your sleeping patterns that include.

1) Shifting your bedtimes to be more regular
2) Bright light therapy: Getting 10,000 lx of light or natural sunlight at the right time to shift your rhythm as desired
3) Chronotherapy: Delaying your sleep period about 2 hours each day (please consult with a sleep disorder specialist for this solution). 

Our Sleep coaches are trained to help you set your sleep schedule and create the environmental cues to entrench this new schedule. 


Above is an example of a sleep diary that represents a typical pattern for individuals with this syndrome. What is happening in this example of a teenagers sleep is they aren't tired until late at night, which is particularly pronounced on weekends when they socialize. Their erratic schedule is then combined with pressure to wake up earlier for school on weekdays. Shift workers are another group of people who have some similarities to this syndrome in terms of the symptoms, but the cause is different. Whether its your hormones that are those of an extreme night owl, if you are someone who is a late night socializing, or you have work-based pressure, there are simple solutions to adjusting your schedule. These include adjusting your light exposure time, wind down time with melatonin, exercise time, and meal time to address this issue. 

Symptoms of DSPS

Symptoms of DSPS can include difficulty falling asleep, waking up late, excessive daytime sleepiness, and difficulty functioning in the morning. It is essential to treat DSPS because it can have a significant impact on an individual's quality of life, affecting their academic or work performance and their social life.

The Circadian Rhythm and DSPS

The reason delayed sleep phase syndrome is so disruptive is because it confuses your body's naturally occuring circadian rhythm. Our bodies work on a 24 hour clock largely dictated by the sun. By controlling cues, called zeitgebers, that our environment exposes us to like exercise, sleep times, meal times, and sunlight times, we can further counteract delayed sleep phase syndrome. The more regular we are with these habits the healthier everyones sleep can be.

Solutions for Delayed Sleep Phase Syndrome

The cause of DSPS is not entirely understood, but it is thought to be related to a problem with the timing of the body's internal clock, which regulates the sleep-wake cycle. Treatment options for DSPS include light therapy, behavioral therapy, and medication.

Light therapy is the most common treatment for DSPS. It involves exposing the individual to bright light in the morning and avoiding bright light in the evening to shift the body's internal clock earlier. The bright light exposure in the morning can help reset the body's circadian rhythm, making it easier to fall asleep at a more conventional time.

Behavioral therapy can also be effective in treating DSPS. This therapy involves establishing a consistent sleep schedule, avoiding caffeine and alcohol before bedtime, and creating a relaxing bedtime routine. A consistent sleep schedule helps the body establish a regular sleep-wake cycle, making it easier to fall asleep and wake up at a conventional time.

Medications can also be used to treat DSPS. The most commonly prescribed medication for DSPS is melatonin. Melatonin is a hormone produced by the body that helps regulate the sleep-wake cycle. It can be taken in supplement form to help regulate the body's internal clock and improve sleep quality.