Treatment for DSPS

Treatment for DSPS is specific. It is different from treatment of other typesof insomnia, and recognizes the patient's ability to sleep well while addressingthe timing problem. Nightly use of sedative and hypnotic drugs is rarely usefulin DSPS, and surgery is unheard of.

There is no permanent cure for DSPS. The treatment methods described herehave all been reported in the scientific literature to relieve DSPS in some patients. This does notnecessarily mean you should try them; it only means these methods are takenseriously as options for treating DSPS. No particular treatment will relieveDSPS in all cases, and you and your doctor may decide that some of thestrategies listed below are too risky or too uncomfortable to be worthwhile. And please take note of the appropriate use disclaimer.

If your DSPS is properly diagnosed and treated, you should be able to sleepand to function just as well with the early sleep schedule as you do with a lateone. Stimulant drugs (including caffeine) to keep you awake during the day should not be necessary.

The first part of DSPS treatment is stabilization of the sleep/wakeschedule, for a week. That means sleeping regularly, without napping, at thetime which is most comfortable for you. It is important to start treatmentwell-rested. Mild cases of DSPS can be controlled by waking up and going to bed15 minutes earlier every day until the desired sleep schedule is reached, andthen maintaining a strictly regular sleep/wake schedule seven days a week. Ifthis doesn't work for you, see a doctor.

Treatment Methods:

Lifestyle Adjustment

Working the evening or night shift, or working at home, can make DSPS lessof an obstacle. Some people nap, even taking four hours of sleep a day and fourat night. Long daytime naps are discouraged by almost everyone because they'rebelieved to promote nighttime sleeplessness, but you may decide that a regularnap to make up for lost sleep at night is an acceptable pattern for you. Ifyou're a student, ask for an arrangement to take exams at times when yourconcentration is good.

Some Methods Unlikely to Work

Avoid alcohol at bedtime. It disrupts sleep.

Don't try to fall asleep if you're not sleepy. You could spendhours tossing and turning, making yourself miserable. If after twenty minutes,you don't feel any closer to falling asleep, get out of bed and do somethingelse to occupy yourself until you start to feel sleepy.

Avoid excessive caffeine, especially within two hours of bedtime. Asidefrom melatonin, sleeping pills (e.g. barbiturates, benzodiazepines,antihistamines, and over-the-counter "sleep-aids") usually will notmake you sleepy if you take them before your body is ready to sleep. If they doinduce sleep, the DSPS symptoms usually return the next night anyway.

Good Luck With It...

DSPS is a difficult sleep disorder to treat. Some people outgrow DSPS aftera few months, years, or decades, as their circadian systems mature. Unlessthis happens to you, you will always have a tendency to drift to later sleepingtimes, and you will then have to reset your body clock one way or another if youwant to sleep and wake up at "normal" hours. Treating DSPS can be alifelong adventure.

The most important way to prevent drift is to maintain an outrageouslyregular sleeping schedule, going to bed and getting up at the same time sevendays a week. That means having to deal with the alarm clock every day - butthe alarm clock will become much less of an enemy if your biological rhythmshave been properly entrained. The main problem is that things inevitably happenin life that temporarily disrupt your sleep schedule - e.g. taking care of smallchildren, occasional anxiety, illness or pain, and accidentally sleeping in. You can try to minimize the disruptions, but they will happen.

If you have had DSPS for many years, starting to sleep at earlier times willalso demand a major psychological adjustment for you. You may have adapted yourlifestyle to your night owl tendencies, and giving up your time alone in theearly morning hours can be a difficult sacrifice. Remember that although it isimportant for you to sleep regularly seven days a week, you don't have to dothat twelve months a year. It might be possible and worthwhile for you tosleep early when you need to, e.g. when you have to work, and then choose tostay up late during vacations. You just have to be willing to go throughsleep-rescheduling again at the end of your vacation. However, it would beeasier on you and your body if you sleep as regularly as possible. Resetting the sleep phase to earlier times is difficult for people with DSPS!

'Tis a gift to be gentle, 'tis a gift to be fair

'Tis a gift to wake and breathe the morning air

And every day to walk in the path we choose

- 'Tis the gift that we pray we may ne'er come to lose.

-traditional Shaker hymn