Sleep Delayed Phase Syndrome

People with delayed sleep phase syndrome are unable to adapt to socially established sleep-wake schedules. Due to the lack of information and understanding of this disorder, they are often labeled as lazy by the people around them.

The sleep-wake pattern follows a circadian rhythm, that is, it fluctuates regularly every 24 hours. This oscillation is determined by an internal biological clock that has the help of certain external synchronizers.

Social elements, such as working hours and meals, serve to more precisely adjust sleep and wake periods. However, the most powerful external synchronizer is the light-dark cycle.

The problem arises when there is a mismatch between the body’s own circadian system and the requirements of the surroundings. In the case of delayed sleep phase syndrome, the person’s usual nighttime sleep period is delayed compared to the conventional time.

People who suffer from this syndrome feel the need to go to bed and get up (chronically) at least two hours later than most people. This is most common during adolescence; however, the prevalence in adults is significant.

When everyday obligations force a person to follow a common schedule, he will suffer chronic sleep deprivation, being unable to sleep at the desired time. All of this translates into sleepiness and fatigue during the day, affecting the academic and professional performance of those who suffer from this disorder.

During holiday or holiday periods, when people can freely choose their sleep schedule, it becomes adequate both in quantity and quality. Insomnia and difficulty getting up disappear and the person gets restful rest.

Features of delayed sleep phase syndrome

Some of the most common features of delayed sleep phase syndrome are:

• The person can maintain adequate sleep hygiene and still not be able to sleep at the desired time.
• There are no personal or professional situations, anxiety or depressive symptoms that prevent the person from falling asleep.
• Once you’ve managed to sleep, those who suffer from this syndrome have no difficulty staying asleep. It is continuous and there are no maintenance insomnia awakenings.
• Due to lack of sleep, there is drowsiness and reduced alertness during the first half of the day. This situation improves as the peak of vigil approaches, which for these people is at dusk.
• Being able to choose their preferred times, the person sleeps without difficulty and wakes up rested.

Treatment of delayed sleep phase syndrome

behavioral interventions

The first step includes certain interventions in the individual’s habitual behavior. This should aim to maintain the best possible sleep hygiene. Take care of the environment in which you sleep, avoid the consumption of stimulant substances and evaluate the activities you perform before bedtime.

In this sense, it is especially important that the person has fixed times to go to bed and wake up. It is essential to follow them every day, even on holidays and vacations. In addition, this habit must be maintained even when the person has reached their goal, to avoid relapses.

Phototherapy

Decreasing light exposure at dusk and increasing it in the morning  can help advance the biological clock. To do this, it is important to use a dim light during the last hours of the day, as well as avoid using screens.

On the other hand, it is advisable to sleep with the blinds raised in order to favor greater exposure to sunlight in the minutes after waking up.

melatonin

Taking melatonin (1-5mg) a few hours before bedtime helps advance the sleep-wake cycle. The combination with phototherapy increases its effectiveness.

Chronotherapy

This procedure consists of gradually delaying bedtime and waking up. The person goes to bed a little earlier each day until they are able to fall into the desired sleep schedule. From there, the challenge is to keep it.

The main difficulty resides in the fact that it takes several days to change the sleep schedule until it reaches the fit, which can interfere with professional or school responsibilities.

Be that as it may, the delayed sleep phase syndrome is an alteration in which we have strategies to prevent it from becoming a disabling limitation in our daily lives.