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The current formal name established in the third edition of the International Classification of Sleep Disorders (ICSD-3) is delayed sleep-wake phase disorder. Earlier, and still common, names include delayed sleep phase disorder (DSPD), delayed sleep phase syndrome (DSPS), delayed sleep phase type (DSPT), and circadian rhythm sleep disorder. [37]
However, for a sleep phase delayed person, the time of biological morning and biological afternoon/evening might differ depending on the circadian clock shift in the affected person. This means that if melatonin is taken during the usual bedtime and wake-up time (i.e., usual nighttime), it may have no effect.
Circadian Rhythm Sleep Disorders: Circadian rhythm sleep disorder, delayed sleep phase type 327.31 G47.21 Circadian rhythm sleep disorder, advanced sleep phase type 327.32 G47.22 Circadian rhythm sleep disorder, irregular sleep-wake type 327.33 G47.23 Circadian rhythm sleep disorder, free-running (non-entrained) type 327.34 G47.24
A circadian rhythm is an entrainable, endogenous, biological activity that has a period of roughly twenty-four hours. This internal time-keeping mechanism is centralized in the suprachiasmatic nucleus (SCN) of humans, and allows for the internal physiological mechanisms underlying sleep and alertness to become synchronized to external environmental cues, like the light-dark cycle. [4]
Individuals may meet the criteria for FASP or FDSP if they have Advanced Sleep Phase or Delayed Sleep Phase and at least one first degree relative with the trait. Researchers have examined the human prevalence of FASP to be 0.33-0.5% by including individuals who have a sleep onset at approximately 8:30pm and offset at 5:30am.
Here is an example of how chronotherapy could work over a week's course of treatment, with the patient going to sleep 3 hours later every day until the desired sleep and wake time is reached. [1] Day 1: sleep 3:00 am to 11:00 am; Day 2: sleep 6:00 am to 2:00 pm; Day 3: sleep 9:00 am to 5:00 pm; Day 4: sleep 12:00 pm to 8:00 pm; Day 5: sleep 3: ...
Delayed sleep phase disorder can be misdiagnosed as insomnia, as sleep onset is delayed to much later than normal while awakening spills over into daylight hours. [23] It is common for patients who have difficulty falling asleep to also have nocturnal awakenings with difficulty returning to sleep. [24]
Sleep disturbances - insomnia, hypersomnia and delayed sleep-phase disorder - are quite prevalent in severe mental illnesses such as psychotic disorders. [25] In those with schizophrenia, sleep disorders contribute to cognitive deficits in learning and memory. Sleep disturbances often occur before the onset of psychosis.