Do you also fall asleep late at night? Do you have difficulty waking up in the morning? Let's talk about (Delayed Sleep Phase Syndrome)

Do you sometimes find yourself going to bed too late at night? Do you find yourself unable to wake up at the right time in the morning and feeling tired all day? You may think, "I'm just a night owl." But, that's not always the case. Today we're going to talk about a condition that can cause this problem, called `Delayed Sleep Phase Syndrome - DSPS` in medical science.

So what is this delayed sleep onset syndrome (DSPS)?

Simply put, `(Delayed Sleep Phase Syndrome)` is when your body's natural clock (we call it `(Circadian rhythm)`) works a little late. To be precise, you start falling asleep at least two hours later than your normal bedtime. Think about it this way. If a normal person goes to bed around 10 pm and wakes up around 6.30 am, a person with `(DSPS)` doesn't fall asleep until after 12 am, maybe 1 or 2 am. So it's very difficult to get up in the morning to go to school or work on time. If such people keep a `(Sleep diary)` about their sleep times, it will show that they sleep very little during the week (but they sleep continuously without waking up frequently at night) and that they sleep until noon, maybe 1 or 2 am on the weekends. You might think, "I'm just a night owl." But DSPS is different. If you're just a "night owl," you won't be as sleepy and inattentive during the day as someone with DSPS. Someone with DSPS can't control when their body tells them to go to sleep. Doctors sometimes call this "Delayed Sleep Phase Syndrome" or "Delayed Sleep-Wake Phase Disorder."

What kind of sleep disorder is this?

DSPS is a sleep disorder that falls under the category of circadian rhythm sleep disorders. Your circadian rhythm is your body's internal clock that runs 24 hours a day, helping you stay awake during the day and sleep at night. This cycle controls many things, including your body temperature and digestion.

Are there main types of DSPS?

Yes, there are two main types of DSPS. This is determined by the timing of the release of the sleep-promoting hormone Melatonin into your circadian rhythm. This signal tells your body clock that it's time to sleep.

• Circadian aligned DSPS: Here, the hormone `( Melatonin )` starts to work less than two hours before you go to sleep.
• Circadian misaligned DSPS: Here, the hormone `` Melatonin' ' is activated more than two hours before you go to sleep, or after you fall asleep.

Although this classification may seem a bit complicated, it can be important for a doctor to plan treatment.

What are the symptoms of (DSPS)?

A person with ``(DSPS)`` may experience symptoms like:

• Not being able to sleep when you want to, or when it's generally accepted by society.
• It's hard to wake up in the morning at the time you want, or at the time generally accepted by society.

This can lead to further problems:

• Feeling excessively sleepy during the day.
• Difficulty with memory, attention, and concentration.
• Changes in behavior and/or mood, for example, irritability.

Sometimes, the symptoms of DSPS can be difficult to distinguish from other hypersomnolence sleep conditions, such as narcolepsy and idiopathic hypersomnia.

Why does this (DSPS) occur?

`(DSPS)` is mainly caused by genetic factors . This means that the condition can be caused by a change in your `(DNA)`. Although doctors cannot test for these genes, many people find some relief when they learn that the cause of their symptoms is not "laziness", but a genetic change. Research has shown that this genetic influence causes your body's natural `(Circadian rhythm)` to be slightly longer than normal. This is why the body does not want to go to sleep at the right time.

What makes the (DSPS) situation worse?

Some things can make your symptoms of ``(DSPS)'' worse:

• Jet lag (time difference) when traveling to another country.
• Resting in bed for a long time.
• Having an irregular sleep schedule.
• Bad sleep habits (for example, drinking things like coffee before bed).
• Exposure to excessive light before bed and low light exposure during the day.

Who is at higher risk of developing (DSPS)?

DSPS is most common in adolescents and young adults . This is because the body's natural circadian rhythm changes during puberty. It can also affect adults, especially women between the ages of 40 and 60. One study found that 90% of adults diagnosed with DSPS had these symptoms as children. If someone in your family has the condition, you are more likely to develop it.

What are the possible complications of (DSPS)?

`(DSPS)` can cause complications such as:

• Depression : Your sleep patterns can affect your mood and energy levels. More than 60% of people with DSPS suffer from depression.
• Substance use disorder : Many people with substance use disorder (DSPS) tend to overuse coffee, sleeping pills, or alcohol to help them stay awake or fall asleep.

In addition, ``(DSPS)`` can affect schoolwork and work performance. It can also cause you to be late for or unable to attend important events.

How to recognize (DSPS)?

To diagnose ``(DSPS)``, a doctor or specialist will ask you about your symptoms and ask you to keep a ``sleep diary`` or ``sleep log`` . A sleep diary is where you:

• Time to go to bed.
• Bedtime (approximate)
• Wake up time

To record things like this. Keep a notebook and pen by your bed so you don't forget to write down the time. Since you can't write down the exact time you went to sleep, write it down in the morning as a rough reminder. Your doctor will tell you how long you should keep this diary. To confirm the diagnosis, your doctor may ask you to wear a device called an ` Actigraph`. This records your cycles of rest and activity. This can help you determine when you go to sleep and wake up. You will need to wear this device for about 7 to 14 days. In addition, your doctor may also perform tests such as a `Dim Light Melatonin Onset (DLMO)` , a `Polysomnography - PSG` or `sleep study`, and a `Multiple Sleep Latency Test (MSLT`) . These tests can help distinguish DSPS from other sleep disorders, such as Narcolepsy. Common sleep disorders, such as Obstructive Sleep Apnea (OSA), can make DSPS worse. Your doctor will also diagnose and treat those conditions.

How is (DSPS) treated?

To treat DSPS, a doctor may recommend the following:

• Changing your sleep habits.
• Setting your sleep schedule .
• Light therapy.
• Taking medication.

Changing sleep habits

Your doctor may recommend changes to your sleep habits, such as:

• Keep your bedroom or sleeping area cool. For example, don't use heavy blankets in the summer, or use a quiet fan in the room.
• Close the window curtains or blinds to block out light. You can also use an eye mask.
• Relax before going to bed. For example, take a hot bath.
• Turn off electronic devices like cell phones , televisions, and video games an hour before bed. The blue light emitted by some devices interferes with the way your body produces the hormone melatonin.
• Get into the habit of following the same sleep schedule on weekdays as you do on weekends. This also applies to holidays.
• Avoid consuming caffeine-containing foods and drinks, such as coffee, chocolate, and tea, in the evening and especially before bed.
• Avoid consuming stimulants like alcohol, nicotine, and high-intensity exercise an hour before bed.

It can be difficult to change nighttime habits that have been ingrained for years. To make the transition easier, pick one or two new habits and incorporate them into your routine until they feel natural. Then add one or two more. It will help you get used to the changes gradually rather than trying to change everything at once.

Setting a sleep schedule

Setting a sleep schedule means setting a consistent time for when you wake up. If your body is used to a certain schedule, it will take time to adjust to a new one. The key here is to set your wake-up time earlier. Then your bedtime will automatically come earlier. There are two ways to change your sleep schedule:

• `Advancing your internal clock` : You can go to bed a few minutes earlier each night until you reach your preferred bedtime. For example, if you go to bed at 12 one night, go to bed at 11:45 the next night, then at 11:30 the next night, and so on.
• Delaying your internal clock (Chronotherapy): You can go to bed one to three hours or more later each night until your preferred bedtime. For example, you could change your bedtime from 12pm to 8am, from 3am to 11am, from 6am to 2pm, and so on until you reach your target (perhaps 11pm to 7am). This will require a few days off from social activities or commitments. You can try this during a vacation or while taking time off from school or work. The idea behind this method is that it is easier for your body to get used to going to bed later than going to bed earlier.

It's important to stay focused and work towards your goals when doing these things. It's easy to forget your bedtime on weekends and holidays. But your body clock only works properly if you get used to it. While you can regulate your body clock by sticking to a strict bedtime and wake-up time , it won't "cure" the tendency to have a delayed sleep-wake cycle. After a few months of working on a consistent schedule, you can make some changes on special occasions.

Light therapy

Some doctors recommend light therapy as a treatment for DSPS. This involves purchasing a special light box. You should wear it for about half an hour in the morning. This helps reset your body clock. Your doctor will advise you on what kind of light box to buy and how to use it. Another option your doctor may suggest is to spend 30 minutes outside in the sun after waking up in the morning. It can also help to reduce your exposure to light from electronic devices in the evening.

Medications for (DSPS)

Your doctor may recommend that you take a melatonin supplement to help you adjust your circadian rhythm. Your body naturally produces melatonin to help regulate your sleep-wake cycle. The pineal gland in your brain secretes most melatonin at night. You may need a little extra melatonin to help you get back on track with your sleep schedule. Your doctor will recommend the right dose of melatonin for you. For example, a low dose (0.5 to 1 mg) is usually the starting dose. This is not a medication to take before bed; it should be taken about four hours before your expected bedtime. Always check with your doctor before adding any medication to your routine. Always follow your doctor's instructions to use this medication safely.

How long does (DSPS) last?

DSPS will not go away completely. It requires ongoing treatment to manage it. It can take weeks to months for your sleep-wake cycle to re-establish itself. To keep your schedule on track, you need to continue working on your treatment plan.

Is there a permanent cure for (DSPS)?

No, there is no permanent cure for DSPS. However, treatment can help reduce your symptoms and improve your sleep.

What is the outlook for the (DSPS) situation?

Many people can get better results if they follow a treatment plan that helps them adjust their sleep schedule. If left untreated, DSPS can affect your daily life. You may feel tired all the time, making it difficult to stay active, or doing things you enjoy. Many people with DSPS also experience depression. If you are feeling depressed because you are not getting enough sleep, talk to your doctor. He or she may recommend additional treatments, such as Cognitive Behavioral Therapy (CBT).

When should I see a doctor?

If you have trouble falling asleep at night and have trouble waking up in the morning, see a doctor. If you have been diagnosed with DSPS and changes to your sleep habits aren't helping your symptoms, tell your doctor. He or she can help you make changes to your treatment plan.

What questions should I ask my doctor?

• Should I buy a light box? How do I use it?
• How can I change my sleep habits?
• Should I take melatonin supplements? If so, how much and when should I take it?
• Are there any side effects from taking Melatonin supplements?
• Could I have another sleep disorder, such as Narcolepsy or OSA?

Is (DSPS) a part of (ADHD)?

Changes in your sleep cycle can affect your attention and performance during the day. Studies estimate that up to 75% of people diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) have a condition that affects their circadian rhythm. When you can't fall asleep and can't get up in the morning, you may not feel like participating in daytime activities. It can be frustrating when your body isn't ready to go to sleep, even when you're physically and mentally tired. The important thing is to understand that Delayed Sleep Phase Syndrome (DSPS) is not a deliberate behavior. A doctor can help you adjust your sleep schedule to suit you and help you start the day feeling refreshed.

The most important things to remember (Take-Home Message)

Okay, so I hope you now have a better understanding of the ``Delayed Sleep Phase Syndrome - DSPS'' we talked about.

The important thing is, your difficulty falling asleep at night and having trouble waking up in the morning may not be just "laziness" or a "bad habit." It could be a problem with your body's internal clock, caused by genetic factors.

• If you have these symptoms, seek medical advice. They can diagnose the exact problem and prescribe the right treatment for you.
• This condition can be managed well with things like sleep habits, changing schedules, light therapy, and, if necessary, melatonin.
• This is not something that will heal overnight. It is important to be patient, follow medical advice, and keep trying.
• You are not alone. There are many people with similar problems. So don't be afraid to ask for help.

If you correctly identify your sleep problem and apply the right solutions, you too can get a good night's sleep and spend the day refreshed.

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