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getting evaluated for Delayed Sleep Phase Disorder/Syndrome?


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Does anyone here have this diagnosis?

 

For an explanation, I haven't ever been diagnosed (my sleep problems have all just been labeled as "insomnia" since I was 10) but recently (and with too much free time during the day on my hands) I've been trying to see how I can get good sleep without being constantly exhausted during the day and waking up at least 2 or 3 times every night... still under the assumption that I was always just doomed to have crappy sleep forever, a little under two weeks ago I started going to bed when I was tired after taking my medicine—usually between 3:30-5am—and waking about 10 hours later, without more than 2 awakenings. I haven't experienced inappropriate daytime fatigue since. And my moods are consistently stable as well. 

 

Without any sleeping medications, I am not sleepy until about 7am or 8am the morning after the night I was supposed to sleep. 

 

But I can't go on like this forever obviously. The way I naturally rest. There will eventually need to be a time when I need to be somewhere in the morning. My current treatment (medications) leave me feeling in an exhausted limbo of sorts if I force myself to go to bed at a "normal" time. My moods also are bad when I make myself go to bed, probably because when I force it I get shitty sleep. 

 

If anyone has this diagnosis, how did you go about getting evaluated? From what I read, DSPD doesn't seem very well-known...? I've never been evaluated for sleep disorders, despite the fact that sleep is probably one of my biggest problems.

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At one of my worst MI points in life, I had chronic exhaustion & felt physically miserable all the time. My sleep schedule was also much of the same as yours, as well as my actual sleep was not satisfying in any way (physically, mentally or emotionally).

 

I went to the 'sleep doctor' and listed my symptoms, gave him a walk thru of my day, as well as told him some of my MI & other physical issues. He said he suspected DSPS & he ordered a sleep study.

 

What they do:

It was a one night evaluation, from 6PM to 10AM the next morning. They hook you up to several machines to measure your actual sleep phase, heart rate & breathing. Then they leave you in a room and wait until you sleep, and they watch you to monitor your physical, neurological & social sleep habits. I was in a private room, with the door shut (which was nice), however I had a intercom system which let me talk straight to the physician if I had any problems or questions.

 

I wouldn't say DSPS is not well known, it is just misunderstood. I was actually not diagnosed with DSPS. Considering all my different psychotropic medications, as well as my actual MI issues (anxiety, depression, ADHD), it was mainly sleep hygiene & medication side affects that were the big issue. Once those were addressed, my sleep pattern & quality changed drastically.

 

I am not saying that is your issue at all, that is just what came to be for myself. So seeing a sleep physician is a good idea, however just having consultation may not do you the most good. Mainly because the symptoms of actual DSPS and other sleep related issues can look similar. A actual sleep study may be needed to find the deeper issue (such as sleep apnea, chronic fatigue, sleep hygiene, medication related, etc.).

 

Good luck :)

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I was diagnosed with DSPS and Restless Legs Syndrome. The two are somewhat related in that RLS tends to be worst between 6 p.m. and 6 a.m. (give or take), so many people with RLS end up staying up until 5 or 6 a.m. and then sleeping until early afternoon.

 

However, DSPS has another component, and that is that your sleep architecture is different, and markedly better, in the morning vs.in the evening/early night because all of those hormones that ebb and flow during the night are on a delayed schedule.

 

So while it was semi-comforting to have a real doctor tell me that being a night owl wasn't just a personal preference, the best thing would be if there was a way to treat it. What has worked best for me is #1 finding a different job that allows me to work different hours than 8 a.m. to 4:30 p.m. and #2 really paying attention to my light exposure throughout the day. My sleep doc said to get exposure to bright light as early in the morning as possible, and to start to reduce light exposure after 5 p.m.

 

There is a recent study which would suggest that people with DSPS are actually just hyper-sensitive to light cues from their environment. When they took a bunch of people camping for a week, with no artificial light exposure, what they found was that the night owls' bodies adjusted to match the sun's schedule faster than those of the historically early-risers.

 

Also, before the week camping, the night owls kept producing melatonin in the morning, with the peak *after* waking, whereas the non-night owls' melatonin levels subsided prior to awakening, as it should be. After the natural light exposure, the night owls' levels also shifted to subside before awakening, suggesting that their bodies were responding to the dawn light.

 

I think I am going to try one of those alarm clocks that gradually increases the light intensity prior to your wake time and see if that helps. I know I stay up too late because I'm on my computer or iPad and the light means I never get tired, so i'm trying to work on that end as well.

 

Here is a link to that paper: http://www.cell.com/current-biology/retrieve/pii/S0960982213007641 "Entrainment of the human circadian clock to the natural light-dark cycle"

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