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

Do you also go to bed at around 10 pm and wake up at 1 or 2 am? Do you have an alarm to wake you up at 6 am, but do you turn it off and go back to sleep? Are you always late for school or work because of this? You may not be able to get any work done properly because you feel sleepy and tired during the day. While you may think this is just a 'bad habit of sleeping at night' or 'laziness', it could be a deeper medical condition. That's what we're talking about today.

What is Delayed Sleep Phase Syndrome (DSPS)?

Simply put, Delayed Sleep Phase Syndrome (DSPS) is a condition that disrupts your sleep and wake schedule. This causes your sleep pattern to shift two hours or more behind the average person. This directly affects your body's natural clock.

Think about it, we all have a naturally working clock inside our bodies. In medicine, we call this the Circadian Rhythm . This clock is what signals us to stay awake during the day and to fall asleep at night. So, the clock in a person with DSPS is like a wall clock that has gone back in time. That is, if a person normally goes to bed at 10 pm and wakes up at 6:30 am, then with DSPS you fall asleep at 1 or 2 am. So waking up on time in the morning becomes a dream.

Some people may think, "I'm a 'night owl', so I can only work at night." But this is different. Someone who simply likes to work at night doesn't feel overly tired, sleepy, or unable to concentrate during the day like someone with DSPS. DSPS is not a choice, it's a change in the way the body's clock works.

What are the main symptoms of this condition?

The symptoms of DSPS are easy to recognize, but the impact it has on daily life is not insignificant. Let's take a look at these symptoms and what their consequences are.

Sometimes these symptoms can be confused with other sleep disorders, such as narcolepsy (a condition in which you suddenly fall asleep during the day), so it's important to see a doctor for an accurate diagnosis.

What causes DSPS? Is this my fault?

Not at all. It's not your fault, nor is it laziness. Research has shown that the main cause of DSPS is genetic . This means that it may be something that runs in your family. Because of a small change in your DNA , your body's natural clock cycle is a little longer than the average person's. That's why your bedtime is later.

However, some things can make this situation worse:

• Having a frequently changing sleep schedule: Irregular habits, such as going to bed at 11 p.m. one day and going to bed at 3 a.m. the next day.
• Exposure to excessive light before bed: especially blue light emitted from phones, tablets, and TVs.
• Not being exposed to enough light in the morning.
• Drinking caffeine-containing beverages like coffee and tea close to bedtime.

Who is most likely to develop this condition?

Although this condition can affect anyone of any age, it is most common in adolescents and teenagers . This is because during puberty , the body's natural clock ('circadian rhythm') naturally shifts slightly back. However, in a child with DSPS, this is much further back than normal.

Additionally, if someone in your family has this condition, you are more likely to develop it too.

What happens if this is left untreated?

DSPS is not a life-threatening condition, but if left untreated for a long time, it can have a significant impact on your quality of life.

• Depression: When we don't get enough sleep every day, it directly affects our mental health. Studies have found that more than 60% of people with DSPS suffer from depression.
• Drug and alcohol use: Some people are tempted to overuse things like coffee and energy drinks to stay awake during the day, and to turn to sleeping pills or alcohol to fall asleep at night.
• Impaired academic and work performance: Frequent lateness and inability to concentrate on work can lead to decreased academic and work performance.

How does a doctor diagnose this?

When you go to see a doctor about these symptoms, he will first ask you a complete history. After that, he can do the following to confirm the diagnosis.

1. Sleep Diary/Log: You will be asked to keep a 'sleep diary' for a week or two. This means writing down things like the time you go to bed, the time you fall asleep (approximately), the number of times you wake up at night, and the time you wake up in the morning.

2. Actigraph device: You may be given a small device (an `actigraph`) that you wear on your wrist, like a watch, for 7-14 days. This will record your sleep and wake times.

3. Special tests: If necessary, a special sleep test ( Polysomnography or Sleep Study ) may be performed, as well as tests that measure the body's sleep-promoting hormone melatonin .

Okay, so what are the treatments for this?

There are several effective treatments for managing DSPS. You can use one or more of these together to improve your sleep patterns.

1. Changing sleep habits (Sleep Hygiene)

This means developing good habits necessary for healthy sleep.

• Keep your bedroom cool, dark, and quiet.
• Stop using devices like phones, tablets, and TVs at least an hour before bed. Their blue light suppresses the production of the sleep-inducing hormone melatonin.
• Get into the habit of going to bed and waking up at the same time every day, regardless of weekends or holidays.
• Don't have coffee, tea, or chocolate after 4 pm.
• Avoid excessive exercise and drinking alcohol close to bedtime.

2. Setting a sleep schedule

What you do is gradually bring your body clock back to the right time. There are two ways to do this.

• Gradually moving your bedtime earlier: This involves going to bed 15-20 minutes earlier every night. For example, if you go to bed at 12 tonight, move your bedtime forward gradually, to 11:45 tomorrow, and 11:30 the day after tomorrow.
• Chronotherapy: This is a bit of a strange method. What you do here is to shift your bedtime back by 1-3 hours every day. For example, someone who goes to bed at midnight would go to bed at 3 am the next day, then sleep until 6 am, and then go through a full 24-hour cycle until they wake up at the time they want (e.g. 11 pm). This requires a few days off.

3. Light Therapy

Light is a key factor that controls our body clock.

• This treatment involves standing in front of a light box for about 30 minutes upon waking in the morning . This light signals our brain that it is daytime and time to wake up.
• Otherwise, it's also very good to spend about 30 minutes outside in the sun as soon as you wake up in the morning .
• It is also important to dim the lights in your home a few hours before bed and create a dark environment .

4. Drug use

This should only be done on medical advice.

Your doctor may recommend that you take a melatonin supplement. Melatonin is a hormone that our bodies naturally produce to help us fall asleep. It is not a sleeping pill. It should be taken a few hours before you plan to go to bed. However, never take this without consulting a doctor. It is important to know the exact dosage and time to take it.

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