Journal of Sleep Disorders & Therapy
Open Access

Deserted Sleep Phase Disorder: A Silent Struggle with Sleep-Wake Alignment

Henry Abbey^{* *}Correspondence: Henry Abbey, Department of Neurology, Capital Medical University, Beijing, China, Email:

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Description

Sleep disorders are often misunderstood and misdiagnosed, and one of the lesser-known conditions that affect sleep patterns is Deserted Sleep Phase Disorder (DSPD). Also known as Delayed Sleep Phase Disorder (DSPD), this condition causes a significant misalignment between an individual’s internal biological clock and the external environment. As a result, people with DSPD experience delayed sleep onset and an inability to wake up at conventional times, leading to disrupted sleep cycles and daytime impairment. Although DSPD is not as widely discussed as insomnia or sleep apnea, it can severely impact an individual’s physical health, mental well-being, and overall quality of life.

Deserted Sleep Phase Disorder (DSPD) is a circadian rhythm sleep disorder, meaning it involves a disruption of the body's natural 24-hour sleep-wake cycle, also known as the circadian rhythm. Unlike those who struggle with sleep-onset insomnia or other common sleep issues, individuals with DSPD typically fall asleep very late in the night-often well into the early morning hours-and find it extremely difficult to wake up at socially acceptable times.

Causes of deserted sleep phase disorder

The exact cause of DSPD remains unclear, but several factors contribute to its development.

Genetics: Research suggests a genetic predisposition to DSPD. Certain genes that regulate the circadian rhythm can cause an individual to have a naturally delayed sleep-wake cycle. This means that their body’s internal clock is set to a later time, making it harder for them to fall asleep early and wake up at typical times.

Environmental factors: Exposure to artificial light, particularly blue light from screens, can shift the circadian rhythm. Light is a powerful cue for regulating the body’s internal clock, and excessive exposure to light in the evening-whether from smartphones, computers, or televisions-can delay the onset of sleep. People with DSPD may also struggle with irregular schedules, such as shift work or frequent travel across time zones, which disrupt the natural sleep-wake cycle.

Psychological stress: Mental health issues like anxiety and depression are often associated with DSPD. The stress and emotional strain can exacerbate the difficulty of maintaining a regular sleep schedule. People with these underlying conditions may also find themselves awake late at night due to racing thoughts or heightened anxiety.

Lifestyle choices: Lifestyle habits, such as consuming caffeine late in the day or engaging in stimulating activities before bed, can also influence the onset of DSPD. Late-night habits can prevent the body from winding down, making it harder to fall asleep at an appropriate hour.

Symptoms of deserted sleep phase disorder

The primary symptom of DSPD is difficulty both falling asleep at the desired time and waking up in the morning. Some of the most common symptoms include:

Late sleep onset: People with DSPD often find themselves unable to fall asleep until very late in the night, sometimes as late.

Excessive daytime sleepiness: Due to the delayed sleep schedule, those with DSPD often feel fatigued or drowsy throughout the day, which can lead to difficulty staying awake during meetings, school, or social events.

Difficulty waking up: Even after staying up late, individuals with DSPD still struggle to wake up in the morning. They may feel weak or disoriented upon waking and have trouble getting out of bed.

Impaired cognitive function: Chronic sleep deprivation due to DSPD can impair concentration, memory, and decision-making, making it difficult to perform daily tasks or meet work and academic deadlines.

Mood disturbances: The frustration and stress of constantly fighting against one’s own internal clock can contribute to feelings of irritability, anxiety, or depression.

Social and occupational disruption: DSPD can interfere with a person’s social and professional life. Individuals may miss early meetings or social events, and they often find it challenging to keep up with a regular work or school schedule.

Diagnosis and treatment of deserted sleep phase disorder

Diagnosing DSPD often involves evaluating the patient's sleep patterns and sleep history. A sleep study, or polysomnography, may be recommended to assess the sleep-wake cycle in greater detail. In some cases, home sleep tests or actigraphy (a device that tracks sleep patterns) can also be used. Once diagnosed, there are several treatment options available to help manage the disorder:

Cognitive Behavioral Therapy for Insomnia (CBT- I) : This structured therapy is aimed at modifying negative sleep behaviors and thoughts. CBT-I helps individuals with DSPD develop better sleep hygiene practices, such as sticking to a consistent bedtime routine and reducing exposure to screens before bed. CBT-I has been shown to be effective in improving sleep quality and realigning circadian rhythms.

Chronotherapy: Chronotherapy is a method that gradually shifts the sleep-wake cycle to a more conventional schedule. By adjusting bedtime and wake time in small increments over several days, it is possible to realign the internal clock with societal norms. However, this process should be done under the guidance of a healthcare provider to avoid further disrupting the sleep cycle.

Light therapy: Exposure to bright light in the morning can help reset the circadian rhythm by signaling to the body that it’s time to wake up. On the flip side, reducing light exposure in the evening (especially blue light) can help promote sleep. Light therapy is often used in combination with other treatments to help shift the sleep-wake cycle.

Melatonin supplements: Melatonin is a hormone that helps regulate sleep. Taking melatonin in the evening, about 30 minutes before bedtime, can assist in falling asleep earlier. However, it is essential to use melatonin cautiously, as improper use can disrupt the body’s natural rhythm further.

Sleep hygiene practices: Maintaining a consistent sleep schedule, creating a comfortable sleep environment, and avoiding stimulants like caffeine and alcohol before bedtime are critical to managing DSPD. Additionally, establishing a relaxing pre-sleep routine can make it easier to fall asleep and stay asleep.

Conclusion

Deserted Sleep Phase Disorder (DSPD) is a hidden yet impactful sleep disorder that affects individuals’ daily functioning and overall health. It is often misunderstood as mere insomnia or laziness, but the misalignment between the body’s internal clock and societal expectations can create serious disruptions in sleep patterns. Recognizing the symptoms of DSPD and seeking appropriate treatment, such as light therapy, chronotherapy, and cognitive behavioral therapy, can help individuals realign their sleep schedules and improve their quality of life. With the right support, those struggling with DSPD can regain control of their sleep and overall well-being.