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Can DSPS Ever Really Be "Cured"?

by Brooke
(San Francisco, CA)

My question is, can someone with DSPS (delayed sleep phase syndrome) ever really change their schedule successfully?


I’m 38 years old, and have been a night owl since at least my high school days. I’ve typically gone to bed around 2am and awakened for work or school around 7am, and then slept long hours on the weekends to make up for the lost sleep. During a period of unemployment in 2001, I eventually went to bed around 7am and woke around 3-4pm.

I was recently unemployed for 16 months, and went to a sleep schedule of 2-3am to 10-11am. I was blissfully well-rested – I felt like a million bucks every day!! It was a true gift to feel so rested. Then 5 weeks ago I started a new job, and have been trying to adjust my sleep schedule to roughly 10:30pm-6:45am.

I have very little trouble falling asleep, I think thanks to melatonin (3mg nightly). However, I typically wake up throughout the night from about 3am onwards, and don’t feel rested during the day.
I’ve been doing a sleep hygiene protocol for about 4.5 weeks. I use a light box in the morning (GoLite blue LED), I have bright lights in my office during the day, I don’t drink caffeine or alcohol, I get a modest amount of exercise daily (walking 1-2 miles a day, with hills), I start winding down at night around 9:30, I minimize my computer time at night (and use f.Lux to warm the color temperature of the screen), I don’t have a TV in the bedroom, the bedroom is dark and cool, etc. etc. I maintain my sleep schedule on weekends.

But except for about 4 nights when I managed to get about 7 hours of uninterrupted sleep I still can’t sleep through the night.

On various DSPS community boards, there are lots of miserable people who seem to think they can never really change their schedule. I’m terrified they’re right. So, does it just take a long time to adjust someone’s sleep schedule and I need more time? Or am I screwed?

Thank you for your help!!

Kevin's Answer

Hey Brooke,

Thanks so much for laying out your situation--you clearly have a pretty strong understanding already of DSPS and the treatments that are typically used to counteract it.

Let me just start by responding directly to your initial question: Can someone with DSPS change their schedule successfully? The answer is a definite yes.

In terms of the relationship between your biological clock and the outside environment, a delayed sleep phase is essentially like jet lag, right? Except without the vacation ;)

Your circadian rhythm is shifted so that your body is releasing hormones that keep you alert at night and hormones that make you tired during the daytime, similar to what happens for the first week or two when you fly halfway around the world and your body's rhythm does not match up in the traditional way with that of the sun and moon.

Interestingly enough, Mark Rosekind, who sits on the Advisory Board for this website (update 11/2010: Dr. Rosekind was recently elected to the National Transportation Safety Board & had to leave the board for governmental reasons), specializes in adjusting biological clocks when it is imperative to do so, like when an Olympic athlete is going to compete overseas or when a team of astronauts are preparing for a middle-of-the-night launch.

I remember him recently sharing stories with us of when he worked with Apollo Ohno to adjust his biological clock right before an international meet so he was at peak alertness, rather than wanting to be in bed, at the time he needed to compete.

He's also worked as director of the NASA Fatigue Countermeasures Program, and I recall him telling us about a specific mission where he had a group of astronauts getting ready to launch into space in the middle of the night. And of course, as tragic events have shown us in the past, the launch is a period of time when the entire team needs to be fully alert and prepared to make sure everything goes smoothly and is accounted for.

So essentially, he needed to turn night into day for these guys. From what I recall, the main thing they did involved having the astronauts gradually spend their nights in a room that was decked out with extremely bright light, and in a matter of time their circadian rhythms were shifted enough for them to feel fully alert during the launch.

The fact that both of these examples were successful and organizations like NASA are using their resources to shift biological clocks (NASA has also conducted a series of studies on the subject), shows that it is indeed possible to shift the biological clock, and therefore to swing DSPS back to a traditional sleep/wake schedule. (update 11/2010: my original comment here really doesn't do justice to the difficulties someone suffering from a circadian disorder faces. See Andrew's great comment below for more.)

But these of course are both really extreme examples involving the help of a professional. How does this translate to you and others on an individual level?

Dr. Rosekind's website has a lot of great information (you can get the NASA studies on there, as well as see the different products and services they offer) about how to shift one's biological clock and achieve optimal alertness. You can visit it at Alertness-Solutions.com.

You're also very right to have put the word "cured" in quotation marks, for delayed sleep phase syndrome is really only a disorder when it is truly disruptive and getting in the way of someone's life. For example, your period of unemployment where you were falling asleep at 7am and waking up a few hours into the afternoon--clearly a delayed sleep phase, but maybe this was a perfectly fine schedule for you at the time. Maybe your nights were your most alert, productive time (socially, personally, what have you), and when you woke up in the afternoon you felt completely rested and ready to go again.

There have been many a mad genius who has produced his or her most inspired work, I'm sure, in the wee hours of the morning ;)

And in this case DSPS is can hardly really be considered a disorder. But when you then landed your job, and now have to wake up before 7 in the morning (the time you were once going to bed!), having a shifted sleep schedule is not conducive at all to obtaining enough sleep.

So, of course, the question then becomes how can you shift your biological clock back to a place where you can go to bed, sleep through the night, and wake up for your job with enough rest to keep you fully alert throughout the whole day?

As evidenced by the Olympic athlete and NASA examples above, it's clearly possible. There's evidence that some individuals with chronic DSPS have greater difficulty shifting their circadian rhythms, but even in light of this there is still so much to be said about the effects of environment and behavior.

Strategic bright light treatment, as you say, is regarded as the most effective treatment. But it takes a minimum of a 10,000 lux light treatment to show much of an effect at all. I'm pretty sure the Philips goLite that you use is right at that minimum, so it could be possible that your body requires a higher lux. Also, are you making sure to look at the light at an angle, out of your periphery? Because that too is another necessity for effectiveness.

I know I haven't laid out too many specifics for you, but I hope these stories have at least shined a little more light on your perspective of DSPS. If you have any follow up questions or comments, please share them with the "post comments" link below!

Warmly,
Kevin

Comments for Can DSPS Ever Really Be "Cured"?

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Aug 24, 2010
Melatonin
by: Margaret

Brooke,

Believe me, I share your frustration. I've lived with this disorder my entire life (almost 30 years now), and I still haven't found a solution. However, I did find a way to get to sleep (unless I'm having a severe bout of insomnia). Like you, I tried 3mg of Melatonin. And, like you, I kept waking up. Pretty much once every hour. Then I tried an extended release formula, same dosage. It works, and I don't wake up all the time. Sadly, even though it puts me to sleep, I still have the same difficulty waking up. But at least I get some sleep...and who knows, maybe it will work for you! Good luck and don't give up (I know I fight that urge every day)!

Margaret

Aug 24, 2010
Thank you!
by: Brooke

Margaret -- thank you for that suggestion!! I'm going to find some time-release melatonin and try it! :-)

Nov 23, 2010
Thank You
by: Kevin Morton

Hey Andrew, thanks so much for your thoughtful remarks and insight. I find myself learning consistently more and more about the stubbornness of permanent (or at least significantly lasting) shifts in someone experiencing a circadian disorder. My perspective is constantly being enhanced by the visitor-submitted stories I receive like this one and your own comment, and I'm thankful for it and cognizant that my own classroom-style reading and research is greatly supplemented by it.

Thanks a lot for the additional insight. Onward to progress, awareness, and discussion.

Warmly,

Kevin

P.S. I just updated my original comment to this page to call attention to your post down here.

Dec 28, 2010
Blocking Blue Light
by: Richard Hansler

One additional thing that might help in your transition to a new schedule is to block blue light for a total of 11 or 12 hours before your wake up time. Glasses that block blue light are available at www.lowbluelights.com. Good luck and Best wishes or a Happy New Year.

Richard L. Hansler, Ph.D.
Director
Lighting Innovations Institute
John Carroll University
20700 North Park Blvd.
University Heights, OH 44118
216 397 1657
.

Aug 07, 2011
Protocol
by: John Veteran

I have had DSPS for 40 years. I am now 46. I am working on a protocol to shift my body clocks to a diurnal existence using pre-modern light conditions both day and night.

https://sites.google.com/site/veteransleepwakeprotocol/

Jan 11, 2012
More publicity and more understanding needed for this disorder NEW
by: Anonymous

I have already commented elsewhere on this website that I feel that people who are affected by SPDS are not really understood by the general population.
I only discovered that my sleep problems had a name, last week, and I have had to live with the condition for over 60 years.
I feel sure that research is correct in saying that the condition can be managed by the use of special lights, melatonin etc but it also seems to me when I have had to adjust my sleeping hours in order to work full time, bring up children etc, that the natural body clock just resets itself into the pattern that is normal for the person concerned as soon as one lets up, even for a moment.
Extreme "night owl" behaviour seems to run in my family, to a certain extent, so it would seem to me to have a genetic factor.
What we need is more awareness of the condition, more publicity, more understanding.
If our families and employers understand what is going on with us, and that it is almost impossible for us to permanantly reset our body clocks life would be easier for us, and we would feel less ashamed about not being able to fit into other peoples timetables.

Mar 18, 2013
Circadian Rythm screwed up with Light Pollution NEW
by: Rena

We have more sleep disorders in society and diseases of all kinds in society than ever before (diabetes, heart problems, cancer etc). Many of these are directly tied in to 'Light Pollution'. We are not living in harmony with the natural -light/day...dark/night patterns of planet earth. Artificial lights were only invented 130 years ago and in that short time we have polluted our environments with artificial lights which we know know disrupt our circadian rhythms - the brains master clock and subsidiary clocks that the master clock regulates. Researchers who study brain disorders and circadian rhythms are well aware of the link between disease and light pollution. Blue light is deadly on the brain. Go out and get a real dose of sun shine during the day and avoid lights at night. Even a clock radio shining in your bedroom will throw off your circadian rhythm. Melatonin (the hormone of well being) is ONLY produced in the absence of light - at night in the wee hours of the morning. Any light emitting device (lap tops etc) should be removed from the bedroom). IF you have to have a light to go to the bath room use a red flash light with a low red beam. Red is as close to 'dark' as you can get and is the best choice. Also use roller shades (room darkening ones). Get informed about light pollution. A good site is IDA (International Dark Sky association). Call your City administrators and talk to them about good lighting practice - be pro active! Give these suggestions a try and pleasant dreams! Rena

Aug 26, 2013
Foolishness NEW
by: Sonja

Rena, your comments are naive and just the type of attitude we don't need. Politics have no place in the diagnosis or treatment of any disease, but this issue especially. Light in NO WAY works to trigger the cues for us for a sleep/wake cycle and if a stupid red lightbulb could fix the problem, the stores would be sold out tomorrow. Understanding what the problem is before you go whining to our leaders might help, but I doubt this is even an issue for you.

Jan 28, 2014
DSPS is not Bipolar NEW
by: Anonymous

I have relatives of both conditions and they are not connected. You need specialists to confirm this.

Jan 28, 2014
Light does indeed affect circadian rhythm NEW
by: Brooke

Sonja, I'm afraid you are incorrect and Rena is correct about light affecting human circadian rhythms. Studies do keep confirming this connection. You can find information by googling, but below are some links below you can check out:

http://www.nytimes.com/2011/07/05/health/05light.html
http://www.ncbi.nlm.nih.gov/pubmed/22850476
http://www.ncbi.nlm.nih.gov/pubmed/21552190
http://well.blogs.nytimes.com/2012/09/10/really-using-a-computer-before-bed-can-disrupt-sleep/
http://www.ncbi.nlm.nih.gov/pubmed/21415172
http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2012/May/blue-light-has-a-dark-side
http://www.health.harvard.edu/press_releases/light-from-laptops-tvs-electronics-and-energy-efficient-lightbulbs-may-harm-health
http://www.cell.com/current-biology/retrieve/pii/S0960982213007641

Jan 01, 2015
No NEW
by: Anonymous

I am 57 and I can not change my sleep phase. I go to sleep about when the sun comes up and I sleep for 8 or 9 hours with no problems.

I think my cavemen ancestors used to guard the cave at night and I think it is genetic, I do not react to sunlight at all. Blue lights make me manic.

So no, you can't change your sleep phase. Just adjust your life to it.

Don't do melatonin, you will OD on it, you already have plenty of melatonin, just at the wrong time. Inconvenient but a reality.

Jan 01, 2015
No it is not "curable" NEW
by: Anonymous

Your comment is ridiculous. People with this disorder don't actually respond to sunlight. We don't! Our sleep phase has nothing to do with sunlight. I can have direct sunlight in my eyes while sleeping and sleep like a log for hours.

If you think it is curable by changing the lighting then you don't have DSPS and don't understand it at all. Nothing works, melatonin, blue lights, nothing.

We need to sleep when our bodies want us to. We have no control over it. It is not curable. Our friends, family and life need to adjust for our sake.

If they love you and you are flexible with work, you can have a good night's sleep every night for a change.

Jan 26, 2016
Not a problem NEW
by: Anonymous

I always wonder how healthy it is to go up against your biological clock for a long period, night owls can adjust their sleep times but I really think it reduces the quality of life. Even in this article the person shares how alive they felt on their natural sleep schedule, studies done on people with this disorder show a very high relapse rate. I think that providing night people with more flexible schedules would be far more humane then making them feel disordered and restless for long periods is.

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