CHRONOTHERAPY

The original treatment for DSPS, chronotherapy involves going to sleep three hours later every day until you reach your desired bedtime.

Example:

• Day 1: sleep 4 am to noon
• Day 2: sleep 7 am to 3 pm
• Day 3: sleep 10 am to 6 pm
• Day 4: sleep 1 pm to 9 pm
• Day 5: sleep 4 pm to midnight
• Day 6: sleep 7 pm to 3 am
• Day 7 to 13: sleep 10 pm to 6 am
• Day 14 and thereafter: sleep 11 pm to 7 am

Chronotherapy is difficult, although for people with DSPS it is often much easier than just trying to wake up at 7 am from the first day. Other sleep-rescheduling methods are described under light therapy.

Advantages of Chronotherapy

• It works rapidly, especially if you are sleeping several hours later than you want to.
• Unlike other treatment methods, it has a beginning, a middle, and an end, so you can predict when it will work.
• It gives you a period to adjust psychologically to the new schedule. Sleeping earlier and getting up earlier means taking on a schedule that is unusual for you, whereas with chronotherapy, your schedule becomes strange for a few days, then becomes more and more like normal.
• During chronotherapy, patients often can fall asleep very quickly as soon as they get into bed, which helps their confidence.
• Chronotherapy is drug-free.

Disadvantages of Chronotherapy

• Staying awake until your next scheduled bedtime can be uncomfortable. During chronotherapy, you will probably be less productive than usual.
• You may wake up before you intend to and be unable to fall asleep again.
• You will have to take time off from your normal routine, perhaps using your vacation time.
• In some instances, individuals have remained on sleep cycles longer than 24 hours after chronotherapy - they develop non 24-hour sleep-wake syndrome. This does not always happen, but the degree of risk is unknown.

If you decide to go through chronotherapy, plan for it. Medical supervision is essential, and daily communication with a sleep specialist is strongly recommended while undergoing chronotherapy.

• Be sure to check with your doctor if you have another condition that chronotherapy could interfere with, such as if you're taking insulin or other regular medication.
• Try to have an activity scheduled every day, and get out of the house as much as you can to reduce the isolation.
• Make a list of places that are open early in the morning and late at night. Get lots of exercise. Take the opportunity to do things you wouldn't normally do, like watch the sunrise or stay up all night in a cafe.
• Make a list of things to do to keep yourself awake (watching videos is good). Tell your friends what you're doing. Turn off the ringer on the telephone when you need to sleep.
• During chronotherapy, you might feel unusually warm or cold at times.