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Slept Debt Doesn't Work With DSPS

See the paper "Poor Compensatory Function for Sleep Loss as a Pathogenic Factor in Patients with Delayed Sleep Phase Syndrome" Uchiyama, et al. (2000) Sleep. Vol 23, No. 4

Kevin's Thoughts

Thank you very much for the reference. For those visitors wanting to see the paper mentioned you can find it in the archives of the Journal Sleep, right here. To see the whole paper simply click "View Full Text" in the gray box to the right.

Unfortunately, it's not as easy as saying simply that sleep debt does not work to help a delayed sleep phase. In fact, it can work quite well if used properly as a strategy in many mild cases, particularly in adolescents. To see why this is, one has to understand how our homeostatic sleep drive operates.

Our homeostatic sleep drive is the internal process that governs our bodies' drive to sleep at any given time during the day. That drive is counterbalanced by two factors: clock-dependent alerting, the mechanism controlled by our biological clock that releases chemicals that make us tired or alert, and sleep debt. In a nutshell, these factors compete against each other to determine whether we feel sleepy or wide awake. If our sleep debt is low and our clock-dependent alerting is high we will be awake with a very low tendency to fall asleep. But as our sleep debt increases it will take less and less clock-dependent alerting to make us sleepy.

As the name implies the sleep drive functions to maintain a homeostatic state when it comes to the amount of sleep we obtain. If we need more sleep (i.e. we have a large sleep debt) the drive to sleep increases against clock-dependent alerting so that hopefully our body obtains that sleep so it
can function at a higher level.

In a traditional sleep schedule an individual would have a high sleep drive at night and a low sleep drive during most of the day. In a delayed sleep phase schedule, an individual's clock-dependent alerting is stronger late at night, making it difficult to fall asleep while that alerting is still strong. To combat that high clock-dependent alerting, a higher sleep debt can be used so that as soon as the scale tips to favor sleep, and before the clock-dependent alerting gets too high late in the night, the individual is able to fall asleep.

Of course, this method does not work for every case, particularly in chronic cases of delayed sleep phase syndrome where sleep debt is already astronomically high. If it's already huge then other treatment options must be sought out. But for transient delayed sleep phases, particularly in adolescents, college students, or individuals with low sleep debts obtained by sleeping in, the technique can be highly effective. It takes diligence and conscious effort, but it can be done.

Naturally and importantly, the argument arises here as to what exactly qualifies as delayed sleep phase syndrome, rather than just a delayed sleep phase. Necessarily, there's a lot of semantics involved, but you can see some budding thoughts on the topic, including two varying points of view, here if you're interested.

As this argument about semantics indicates, saying that sleep debt can work in some cases of DSPS is not in disagreement with the article, but rather just recognizes that there are some people with persistent and unwanted delayed sleep phases who don't necessarily have an inability to compensate for lack of sleep.

Do you follow? Feel free to object or add more of an argument to any point of view using the "Post Comments" link below.

Comments for Slept Debt Doesn't Work With DSPS

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Nov 16, 2010
Sleep debt doesn't help!
by: Anonymous

My record of not sleeping was 56 hours. You would think that immediately I got home I would fall asleep. I was still puttering around and it took me two hours before i fell asleep.
This week I stayed up Sunday night to finish a project and had to be in a review the whole of Monday. So I was awake for about 32 hours I got home at 5pm and I was truly exhausted. . I fell asleep at 5:30. Guess what, I woke up at 9pm and couldn't fall asleep till 1am!!
I can't get my body to sleep.

Nov 30, 2010
Prefer paradoxical intention + light therapy
by: Anonymous

I've deliberately tried applying the sleep debt principle probably 9 or 10 times, and have found it actually painful on each occasion. I've also experienced, each time, an anxiety-provoking alertness around the time I'm meant to sleep. All in all it takes a difficult week, and it's easy for the new pattern to be disturbed. It's just not worth it.

Have had more success - and less distress - by combining 'paradoxical intention' with a dawn simulating alarm clock, together with generally reasonable sleep hygiene.

Nov 30, 2010
Sleep debt vs sleep restriction
by: Anonymous

I just posted, offering up paradoxical intention as an alternative to what I thought was *sleep restriction*. Sleep restriction is horrible.

Haven't tried sleeping *more*.

May 24, 2013
Sleepier=later to bed NEW
by: Holly

I have always found that the tireder/sleepier I am, the later I go to bed. I am 58 now, and have had DSP syndrome/disorder all my life (though it worsened when I hit puberty), and all along, being tireder has delayed my sleep by sometimes up to 6 hours, such as when I'm truly exhausted and nodding off repeatedly where I sit. My OCD seems to interact strongly here. Sleep debt and drowsiness-inducing meds are certainly not the answer for me.

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