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Delayed Sleep Phase Syndrome

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Sleep Disorders in Adolescents

Abstract

Among disorders of circadian rhythm, Delayed Sleep-Wake Phase Syndrome is common in adolescents and young adults, a population that has a natural endogenous shift towards later bedtimes. In the current edition of the International Classification of Sleep Disorders (ICSD-3) it is now listed as Delayed Sleep-Wake Phase Disorder (DSWPD). Genetic, environmental, social, and behavioral factors play important roles in the development and perpetuation of this disorder. Delay in the ability to fall asleep at conventional times in affected individuals gives the appearance of sleep-onset insomnia. However, the affected individuals sleep for a normal amount of time if they do not have a social obligation to wake up at a conventional time. Usually, no problems with sleep maintenance are described. If sleep is curtailed due to social obligations, daytime consequences of DSWPD may occur, including sleep inertia, excessive daytime sleepiness, mood changes, cognitive deficits, or decline in academic performance. These may trigger excessive caffeine intake or substance use. A comprehensive sleep history with sleep logs and actigraphy (if available) are essential for an appropriate diagnosis of DSWPD. A number of treatment options exist including phase shifting (advancing or delaying), melatonin, bright light therapy, and improvement in sleep hygiene. Comorbid sleep disorders must be carefully screened for and excluded. Successful outcomes hinge very much on school and family cooperation as well as the patient’s motivation for change.

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Abbreviations

AASM:

American Academy of Sleep Medicine

ADHD:

Attention-deficit/hyperactivity disorder

CBTmin:

Core body temperature minimum

CR:

Circadian rhythm

CRSWD:

Circadian rhythm sleep-wake disorders

DLMO:

Dim light melatonin onset

DLMOff:

Dim light melatonin offset

DSWPD:

Delayed sleep-wake phase disorder

EDS:

Excessive daytime sleepiness

H:

Hour

LD:

Light-dark

PRC:

Phase response curve

PSG:

Polysomnography

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Disclosure

None of the authors has any financial support or conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Pulmonary Medicine and Pediatric Psychiatry/Psychology, Northeast Ohio Medical University and Akron Children’s Hospital, 300 Locust Street, Akron, OH, 44302, USA

    Sasha D. Jaquez Ph.D.

  2. VCU Center for Sleep Medicine, Virginia Commonwealth University, 2529 Professional Road, Richmond, VA, 23235, USA

    Tushar P. Thakre M.D., Ph.D.

  3. Pulmonary Medicine, North East Ohio Medical University and Akron Children’s Hospital, 215 W. Bowery Street, Akron, OH, 44308, USA

    Jyoti Krishna M.D.

Authors
  1. Sasha D. Jaquez Ph.D.
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  2. Tushar P. Thakre M.D., Ph.D.
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  3. Jyoti Krishna M.D.
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Corresponding author

Correspondence to Jyoti Krishna M.D. .

Editor information

Editors and Affiliations

  1. NYU Comprehensive Epilepsy Center, NYU Langone Medical Center, New York, New York, USA

    Sanjeev V. Kothare

  2. Langone Comprehensive Epilepsy-Sleep Ctr, New York University Langone Medical Ctr., New York, New York, USA

    Rebecca Quattrucci Scott

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Jaquez, S.D., Thakre, T.P., Krishna, J. (2017). Delayed Sleep Phase Syndrome. In: Kothare, S., Quattrucci Scott, R. (eds) Sleep Disorders in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-319-41742-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-41742-4_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41741-7

  • Online ISBN: 978-3-319-41742-4

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