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Sleep Education


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Delayed Sleep-Wake Phase


Diagnosis


It is easy to confuse DSP with normal variations of sleep and other types of insomnia. Consulting with a sleep specialist is your best bet to help clarify current sleep problems. He or she will also be able to help you develop a plan to correct these problems. A specialist can assess the factors that cause and make this problem worse. These include both social and behavioral factors.

The sleep doctor will do a thorough physical exam. He or she will also discuss with you the history of these sleep problems. It would be helpful to keep a sleep diary prior to seeing a sleep doctor. Bring this information with you to the appointment. A sleep diary is a systematic way to track your sleep pattern. You record the time you get into bed, the time required to fall asleep, and the time you wake up in the morning. Sleep diaries often show a regular pattern of difficulty falling to sleep. They often show few or no awakenings once asleep. They also tend to show a sleep duration that is reduced during the work week and lengthy on the weekend.

An overnight sleep study is not normally needed for someone who suffers from DSP. Your doctor may have you do an overnight sleep study if your problem is severely disturbing your sleep. This study is called a polysomnogram. It charts your brain waves, heart rate, and breathing as you sleep. It also records how your arms and legs move. This study will help determine if there are any objective sleep disorders related to your sleep problem.

Treatment


Timed melatonin use has been shown to be an effective treatment option in teens, and it may be somewhat effective in adults. Melatonin is a hormone that is widely available in supplement form. The hormone is naturally produced by your body and plays an important role in sleep. It helps regulate your sleep-wake cycle by signaling to your body when the time for sleep is approaching.

Melatonin dosage and timing should be discussed with a sleep specialist to ensure the most effective treatment strategy.

Bright light therapy is another proven technique for changing one’s internal circadian rhythms. But its specific use for DSP has not been well validated. In theory, exposure to bright light should occur shortly after waking up at the desired time in the morning. Then bright outdoor light in the evening hours should be avoided. Light therapy combined with behavioral therapy for children and adolescents may be a treatment option. Cognitive behavioral therapy (CBT) helps you change actions or thoughts that hurt your ability to sleep well. It helps you develop habits that promote a healthy pattern of sleep.

Reference: Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders

Updated Sept. 30, 2016