What is Delayed Sleep Phase Disorder?

I’ve struggled with sleep for nearly as long as I can remember. Since this week’s healthy goal is to get more sleep, I thought it would be appropriate to make an educational post about a specific type of sleep disorder, called delayed sleep phase disorder, that it often misdiagnosed as insomnia.

I was diagnosed with insomnia about 2 ½  years ago and have tried a couple of different medications to manage it. They worked in the beginning, but neither were the real solution I needed for normal, restorative sleep. So I’ve just continued struggling. Save for the nights I take melatonin, I don’t count on getting what you’d call a good night’s sleep.

Delayed Sleep Phase Disorder: An Under-Diagnosed Condition

About four or five years ago, before my insomnia diagnosis, I was researching sleep disorders. It was then that I came across a circadian rhythm disorder called delayed sleep phase disorder. Sitting at my computer around 3:00 a.m. reading an article, I began to cry. It was if the article was written about me! I wasn’t crazy! I wasn’t just stubborn or lazy or insane! There were enough other people with sleep troubles similar to mine for there to be an actual name for the problem.

Delayed sleep phase disorder is a condition in which a person has the ability to get a healthy amount of sleep when not interrupted by responsibilities and “normal” waking schedules, but a complete inability to initiate sleep during “socially acceptable” hours. For me personally, I typically fall off to sleep sometime between 5:00 and 6:30 in the morning when I leave my body to its natural rhythm. Attempts to change this rhythm without some type of sleep aid are ineffective and futile.

Delayed Sleep Phase Disorder and How it Differs from Insomnia

I honestly believe that I do have a touch of insomnia, but that it is not my primary sleep disorder. I believe that I have delayed sleep phase disorder with occasional insomnia. I pulled this overview of diagnostic criteria from Wikipedia—I know, I know…not the most reliable of sources, but I do double check information elsewhere. It describes me to the letter (click on the image to see it bigger...I couldn't get it to format large enough to where it wouldn't overlap the sidebars):

Source: Wikipedia.com

See, I can sleep just fine once I get to sleep. The problem is getting to sleep in the first place. This differs from insomnia because insomniacs often have difficulty both getting to sleep and staying asleep. If I’m allowed to sleep until I wake up naturally, I’ll typically wake up after about 9 hours…provided that I have not been up more than 15-18 hours before getting to sleep in the first place. When I do have to force myself to stay up during the day after not having slept the night before, I’ll crash out from sheer exhaustion and sleep up to 16 hours straight. Insomniacs can’t do that.

Why Do I Say Insomnia, Then?

I claim insomnia for two reasons: that’s my medical diagnosis and it’s just easier for people to understand. However, my diagnosis was from a nurse practitioner, not from a sleep specialist. And it was a diagnosis based on my description of symptoms, not as the result from a sleep study. So I remain skeptical that the diagnosis is completely accurate.

I say I think I have a touch of true insomnia because there are days that I am unable to fall asleep, even by my normal 6:30 a.m., and then have fitful sleep when I do get to sleep. It’s not the normal, but it does happen with enough regularity to be a problem.

The biggest indicator that I really have delayed sleep phase disorder rather than primary insomnia, aside from the fact that I am a walking example of the diagnostic criteria, is that melatonin helps me. Melatonin works by regulating the circadian rhythm. It can help to advance the sleep cycle depending on what time it is taken. It does not typically help insomnia.

That’s why true insomniacs often report that melatonin is useless for sleep disorders—they are trying to treat one type of sleep disorder with a method that is only effective for circadian rhythm disorders. And I have had times that I’ve taken melatonin and been sleepy, but still unable to fall asleep or stay asleep. These are the nights that my insomnia overpowers the delayed sleep phase.

Disclaimer to Cover My Rear End

I’m going to give you a bit of  a “do as I say, not as I do” lecture here. If you are having troublesome symptoms, go see a doctor. I don’t have health insurance and cannot afford to go to a doctor like I should. I also thoroughly enjoy researching and I know where to find accurate, reliable information. (Hint: It’s not from Wikipedia, WebMD, eHow, Livestrong, WrongDiagnosis, RightDiagnosis, or any other similar site. These are decent places to get you started in the right direction, but not to end your research.)

That doesn’t make me a medical doctor, or even an expert, but I am relatively confident that I have a reasonable understanding of a topic when I’m done with research. But then, I will spend days, weeks, and sometimes even months conducting research before forming a conclusion.

Even so, this does NOT replace medical advice and expertise. If you think you might have a condition that I talk about, ask your doctor if it’s a possibility and then work with him or her to treat it. My posts are for informational purposes ONLY, and are not intended as a diagnosis or recommendation for treatment for any medical condition.