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Correcting Delayed Sleep Phase Disorder (DSPD)

May 13, 2016

DSPS

Getting enough sleep and high-quality sleep is critical to mental, emotional and physical health. Deep sleep is when your body makes the most growth hormone–the body’s own fountain of youth that keeps your body and mind feeling young and facilitates recovery from stress, injury and disease.

First off, identifying and treating sleep apnea and snoring that may be disturbing sleep is key. There are now fairly inexpensive home-tests that measure pulse oxygen and nasal breathing as a fairly accurate screen for apnea that is far more convenient that a full, overnight sleep study. You still need to get the test from a doctor, but health insurance is often covering these convenient home screens. Depression, anxiety, peri-menopause, menopause, and andropause can also cause sleep disturbance and these are also all treatable with functional and naturopathic medicine.

Now, I want to focus on night-owls. If you have trouble winding down and getting to sleep before midnight or 1AM and have trouble waking up, you may have something called “delayed sleep phase disorder” (DSPD). Treating DPSD is important. More than just causing fatigue, poor concentration and memory, DPSD is often accompanied with anxiety and depression and attention defect disorder (ADD).  If this sounds like you, there are ways to adjust your sleep cycle.

Night_Owl

Most people with DPSD have tried melatonin an hour before bedtime to induce sleepiness, and it works for many but not all people. What most people with DSPD don’t know is that there can be significant benefit from taking small doses of melatonin up to 6-7 hours before bedtime. Many people are concerned about melatonin dependence, but because there is no negative feedback on melatonin secretion from the pineal gland, there is no dependence or withdrawal with melatonin.

If you have DPSD, it’s also important to avoid napping and to get significant morning light. Morning light exposure either outside with sunlight or with 30-60 minutes of using a light box will help set and correct your sleep cycle forward.

Evening light exposure, especially blue light, is a powerful wakefulness signal that disrupts the production of melatonin and other key parts of the circadian rhythms. Some people wear amber (blue blocking sunglasses) later in the day to help them fall asleep sooner.

Let’s talk about screens. While it is best to avoid screen-time altogether within 2 hours of bedtime, there are ways to decrease the impact of screens around your bedtime. Most smart phones, tablets, and laptops can use add-on applications to automatically decrease the brightness and the amount of blue light after dark. If you have DSPD, you should avoid screens or use one of these.

Bed with Phone

At the other end of the spectrum, people with DPSD can benefit from sunlight exposure early in the day. If sunlight is not possible, 30-60 minutes of using a light boxe (or other  sources with ample blue light) can be a key aid to correcting a delayed sleep cycle.

There are many sleep tracking applications for smart phones. I use Sleep for Android, and it has a full suite of features including motion detection, estimation of sleep phase (light, deep, REM, etc.) audio recording of snoring, snoring detection and interruption, and alarms tuned to wake you up at the end of a sleep cycle.

Waking up in the middle of a sleep cycle (usually 90-minutes) is the cause of “waking up on the wrong side of the bed”. My favorite feature of smart phone sleep apps, is a scale-able alarm range that that adjusts to wake you up at the end of a sleep cycle (determined through initiation of spontaneous movement).

It’s fairly easy to measure your melatonin hourly throughout the day with salivary samples. It costs about $150. Actigrpahy is another way to measure your motion (and sometimes light exposure) over 24 hours at sleep.

At the other end of the spectrum, we have the “morning larks.” If you have a sleep midpoint before 2AM, then you may have an “advanced sleep cycle”. In these cases, getting ample light later in the day is helpful and time release melatonin taken close to bedtime can help.

It’s almost impossible to feel well without ample good sleep, so if you have sleep concerns, fix that first and do what it takes to get great sleep, like my daughter here.

2015-09-05 15.52.11

 

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2 Comments leave one →
  1. September 12, 2017 3:58 pm

    How would I acquire an in-home melatonin test? As far as I know, there are no in-home tests that effectively determine DLMO.

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