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DSPS Treatment SPECIFICS Lacking!

by Roxanne

Hi all

Unemployed, desperate to be able to function in daytime hours, you know the drill.

Did "the research project from hell", finally got a light for light therapy & got it on a stand. Now trying to determine treatment protocols. What time increments are best tolerated and is it better to go forward on the clock or back. What about melatonin? What dosages, what timing.

It is really frustrating that for all the suffering and commiserating on forums, much of it by really intelligent people obviously well-read on the subject-- nowhere does there seem to be a good, solid, comprehensive summary of the basics-- light technology and reputable sources, circadian rhythm basics, hormone cycles, light response curve, melatonin etc. The net is swimming in general "what is DSPS" stuff, but finding any specific guidance on treatment is difficult, & what little there is is scattered all over the place in various articles. I haven't been able to find comprehensive information anywhere. I know it's a relatively new area of research but there must be a synthesis of current knowledge and treatment protocols *somewhere*. I understand DSPS is persistent & don't expect miracles but for those who need to try & tackle it regardless-- *where* is the specific information??

It looks like best to try with just light, at first at least. Synthetic/bovine melatonin may
be risky to muk about with as these are complicated, interrelated hormonal systems. The key thing would seem to be not to use the light too early or you might get the opposite result, ie. further phase delay. Apparently there is a point where core body temperature is lowest and it has to be after that. But how to guess at it is the question. Apparently for "normal" people it would be about 4 am. So I figure I should add 5 or 6 hours. Presumably at some point you can move earlier but how do you know when.

For going forward on the clock ("chronotherapy"), most sources say to use 3 hour increments. However I've no idea what increments the body would best tolerate if trying to go back/ earlier instead? And in what period, ie. advance wake/sleep time by X minutes every day?/week?/month? If you go forward on the clock, do you use the light all along when you get up as you would if you were going backward?

And if you *were* to use melatonin, what are best practices re: dosages and timing??

Can anyone suggest a solid, credible publication or online source which actually lays out all the information, including the nuts and bolts? Or do you have your own summary of all this?

Many thanks & best of luck to all.

Comments for DSPS Treatment SPECIFICS Lacking!

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Nov 09, 2012
by: Carol

I wish there was some treatment that would just pop up on the search. My NP is looking into cortisol treatment so we will see what she finds out.

Dec 19, 2012
My treatment NEW
by: Lisa

Hi Roxanne,

I'm not sure when you posted this, so my comments may be coming in late in the game, but I thought I'd offer you what my doctor has suggested (my sleep phase is about 4AM-12PM and I need to move it to 11PM-7AM):

1. Improve sleep hygeine. (I tend to hang out in my room all evening, so I have to stop doing that so my brain will associate bed with sleep)

2. My doctor wants me to pull an all-nighter on Friday until 11PM Saturday.

3. Melatonin at 10PM every day, without fail. I take a 3mg melatonin + 200mg L-theanine in a combined tablet. It seems to do more for me than straight melatonin.

4. Light therapy at 7AM for 30 minutes.

I'm starting this weekend, so I can't tell you yet if it works for me, but I thought it might help answer some of your questions.

Feb 18, 2013
Why should we need treatment? NEW
by: Anonymous

The assertion this syndrome or disorder should be treated is ableism of the worst kind. It seeks to supress instead of accept the natural diversity of humanity and imposes "normalcy" on those "unfortunate" enough to be "different."

There's no known cure, it's just the way some people are. So why do we have to submit to therapies to temporarily alter our natural state of being? So we can conform to the norm?

Wheelies got laws changed in many countries so they could have the mobility and independence to access things like higher education, participation in meaningful employment, access to entertainment and social oportunities equal to "normal" people. The idea people should be excluded from these kinds of activities was recognised in international law as an infringment of their human rights. I have DSPS, thats a disabling condition, and I've every right to expect the same access to the same fundamental requirements for my actualisation and participation in life without first being forced to change who I am. Google Searchfor the UN Convention on the Rights of Persons with Disabilities and tell me I'm wrong.

Feb 18, 2013
you have the right NEW
by: am

It is not a bad thing to function against the clock of everyone else if you wish to do so.
However, most things you need to do are during day hours and not night hours, from taking walks to going to the bank, to having lunch with a friend etc... not mentioning, of course, working.

Apr 06, 2013
drives me crazy to NEW
by: Helen

I also suffer from this and have done so for my whole life. I own my business and start work at 1pm so its easier for me to function. The part I find the worst is that my husband is an early bird and gets up a few hours after I have gone to bed. Our weekends suck. I have always wanted to be "normal" and have tried all the tricks in the book along with melatonin, sleeping pills, dark and light feels hopeless and it gets me down. I wish someone could help, does anyone recommend a certain type of doctor or therapist?

Apr 06, 2013
Carol did the cortisol work? NEW
by: Helen

Just wondering if the cortisol worked for you Carol? I would be interested in an update from you.

May 18, 2015
How did u go Lisa? NEW
by: Christine

Lisa I am wondering how the combination of Melatonin and L-Theanine worked for you. I have a 16yo who sleeps all day and up all night. Melatonin does nothing for her either

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