The article was checked and commented by doctor-somnologist Sergo Tsentradze
What is delayed sleep phase syndrome
Sleep phase delay syndrome (SPSS) is a disorder of the circadian rhythm. Thanks to this mechanism, the body adjusts the physiological processes in our body. Daylight plays an important role in this. It is so important that people who suffer from vision problems can lose their regime. [one]
In a healthy person, the biological cycle lasts about a day. Usually in the morning his body is ready for vigorous activity, and in the evening fatigue builds up, and he feels the need to rest. In the case of delayed sleep phase syndrome, the circadian clock is lost, and the cycle increases to 26-28 hours. It is difficult for patients with this diagnosis to fall asleep at night, even if they feel tired. As a result, to plunge into a light doze, a person needs two hours or more. It often happens that you fall asleep well after midnight.
Another problem: with SPPS it is very difficult to compensate for a lack of sleep during the day, even in the evening. [2]
Getting up early in the morning is also difficult for such people. During the day, they feel lethargic and lethargic. They find it difficult to concentrate, memory problems appear, productivity drops, and so does their mood. Due to constant lack of sleep, patients have less control over their emotional state, they are prone to nervousness. As a result, not only workers but also personal relationships suffer. In severe cases, depression and anxiety may begin to develop [3]. However, this mechanism works in the opposite direction.
Risk factors
The nature of the development of the syndrome can be either congenital or acquired. There are several reasons for the failure of circadian rhythms.
- Genetics. According to American studies, 40% of patients with FPSS had relatives who suffered from the same symptoms.
- Psychological and neurological disorders. Delayed sleep phase syndrome can develop in those with diagnoses such as depression, anxiety, attention deficit hyperactivity disorder, obsessive-compulsive disorder.
- Chronic insomnia. In 10% of cases, the advanced stage can develop into SPSP. Often a violation of the regime occurs due to improper distribution of light during the day: in the morning a person sits behind closed curtains or in a dark office, and at night, on the contrary, turns on the lighting. In this regard, the flickering screens of phones, computers and TVs play a cruel joke on our body.
- Age. Very often, the syndrome manifests itself in adolescence. During puberty, the 24-hour circadian cycle may become longer. Because of this, the child goes to bed later and has difficulty getting up to school or college.
How to help yourself
The number of hours of healthy sleep varies by age. Teenagers need up to ten hours, adults - from seven or more, depending on the state of health. [four]
Nevertheless, each organism is unique, so it is better for a specialist to prescribe the therapy. However, even now you can help yourself by giving up bad habits. During the period when you are trying to establish a regimen, it is better not to consume alcohol, caffeine and other "doping". The phone and other gadgets must be turned off at least an hour before bedtime, otherwise the light will provoke the body to stay awake. Instead, new evening rituals need to be created. For example, you can take a bath or read a book before bed.
How to set up a regime
Reconfigure the internal clock. To do this, you need to get up and go to bed 15 minutes earlier than usual every day.
Apply light therapy. Immediately after waking up, turn on bright lamps if it is still dark or gray outside the window, and immediately open the curtains on a sunny day. It is important to be in bright light for the first 30 minutes, right after you open your eyes. This will help your inner clock to tune in to an active day faster.
Melatonin, a hormone that regulates circadian rhythm, can help you fall asleep. In people with SPSPS, the amount of this substance is reduced when falling asleep. [5] The drug can be taken at bedtime, but dosage should be discussed with your doctor.
Sergo Centeradze, neurologist, doctor-somnologist of the sleep medicine department of the N. N. A. Ya. Kozhevnikova
Sleep retention syndrome, like most circadian rhythm diseases, is a clinical diagnosis. In fact, it is a lifestyle. People with this disorder are often referred to as owls. To make a conclusion, the doctor does not need any instrumental studies. He focuses on the patient's complaints. It is important here to track the time of falling asleep, getting up, awake and sleeping during the day.
It is worth noting that delayed sleep phase syndrome is the fate of young people. It is estimated that approximately 15–20% suffer from this disorder. By the age of 30, these numbers decline, and only genetically determined owls remain. It is difficult for such people to get up in the morning and go to work, so they must shift the 24-hour rhythm, otherwise they will experience a constant lack of sleep during the day. And here the consequences can be the same as with insomnia: an increase in body weight, an increase in blood pressure, a drop in concentration, deterioration of long-term and short memory, a decrease in immunity, an increase in the risk of developing type 2 diabetes.
The main treatment in such cases is phototherapy. There is a special apparatus in front of which the patient sits for one hour in the morning and receives a bright light that suppresses the synthesis of melatonin, the sleep hormone, and helps the person to wake up qualitatively. But the main thing is that the shift in sleep phases should be very slow. A sudden change can provoke another illness, the so-called insomnia. In this state, the process of falling asleep is delayed in a person, night awakenings are observed. And the most important difference: with insomnia, there is no refreshing effect of sleep during the day. And with delayed sleep phase syndrome, if the patient has the opportunity to sleep in the morning, he feels rested.
As for medications, then you can add melatonin, a regulator of biological rhythms. You need to take it at the same time, somewhere at 23:00 - this is a prerequisite. Phototherapy can be combined with this method. An individual treatment plan is developed for each patient.
The results are not immediately visible, but when we can shift the round-the-clock rhythm by several hours. In adolescents and young people under 30 years of age, the results can be seen within a month. If a person is over 30 and delayed sleep phase syndrome is a genetic condition, that is, parents and other relatives suffered from this, then more effort will be required. It is possible to improve sleep by at least 50%, but the disorder cannot be completely cured.
If a person works in the afternoon, then owls do not experience big problems. These are absolutely healthy people, just with special regulation of round-the-clock rhythms.>