Sleep phase syndrome is understood as a permanent disturbance of the time of sleep. Doctors distinguish between two forms.
What is sleep phase syndrome?
Sleep phase syndrome is also known by other names such as delayed sleep phase syndrome, circadian sleep-wake rhythm disorder, or delayed sleep phase disorder . The sleep disorder is divided into two different forms. See biotionary for What does NBA stand for.
These are delayed sleep phase syndrome (DSPD) and advanced sleep phase syndrome (ASPS). The abbreviation DSPS stands for the English term “Delayed Sleep-Phase Syndrome”, while ASPS is used for “Advanced Sleep-Phase Syndrome”. People with delayed sleep phase syndrome fall asleep very late and therefore have great problems getting up on time.
In the case of an advanced sleep phase syndrome, tiredness sets in at a very early stage in the affected person. As a result, they wake up early after sleep and cannot fall asleep afterwards. However, the second form occurs relatively rarely.
Causes
Around 7 to 13 people out of 10,000 suffer from delayed sleep phase syndrome, making it the most common form of circadian rhythm sleep disorders. Young people are particularly affected by DSPS. The sleep phase syndrome is particularly pronounced up to the age of 21.
On the other hand, premature sleep phase syndrome, which primarily occurs in middle-aged people, is much less common. Although ASPD occurs less frequently, experts expect the number of unreported cases to be higher because it causes fewer social conflicts. The exact causes of sleep phase syndrome are not known.
Basically, every person has an individual sleep-wake cycle. This rhythm causes him to sleep or be awake at certain intervals. It is not uncommon for external influences to disrupt the sleep-wake cycle.
This can be shift work, night work or jet lag. But disturbances in the internal clock or diseases such as dementia are also sometimes responsible for sleep phase syndrome.
Symptoms, Ailments & Signs
The symptoms of sleep phase syndrome vary depending on the form. In the case of advanced sleep phase syndrome, the affected people go to sleep between 6 p.m. and 8 p.m., which means they wake up again early in the morning around 4 a.m. After that, they can’t go back to sleep.
In the evening they are tired again and fall asleep again early. This can be a disadvantage in jobs that need to be done in the early evening. With delayed sleep phase syndrome, sufferers are unable to fall asleep until early morning. However, you can always sleep at the same time of the day.
If there are no other sleep disorders, the affected people sleep well and feel a natural need for sleep. However, because they only slept for a short time in the early morning, they find it difficult to get up. If they can follow their own sleep schedule, their sleep duration is from around 4 a.m. in the morning until midday.
Diagnosis & course of disease
Diagnosing sleep phase syndrome is not always easy. Due to the constant tiredness of DSPS, misdiagnoses such as depression sometimes occur. Inappropriate medications such as sleeping pills or antidepressants are often prescribed. It is therefore advisable to visit a specialist in sleep disorders.
This allows the patient to keep a so-called sleep diary. In it, the person concerned keeps the most important data about his sleeping habits for a few weeks. Among other things, it is entered what time he goes to bed, when he wakes up and when he gets up again.
The degree of tiredness when going to bed and when getting up is also important. The same applies to any medicines taken and additional sleeping times during the day. Actigraphy can be performed to record the patient’s sleep-wake times.
Polysomnography can be used to check other bodily functions. It is also useful to measure your body temperature regularly. Delayed sleep phase syndrome is when normal dates are delayed by about two hours. The course of sleep phase syndrome varies. DSPS occurs predominantly in adolescents, with it returning to normal in early adulthood. In other people, however, it can last for the rest of their lives.
Complications
Due to the sleep phase syndrome, those affected suffer from significant sleep disorders. These have a very negative effect on the health of those affected and can lead to irritability or even to psychological problems and depression. The social life of the affected person is often significantly restricted by the sleep phase syndrome, so that the syndrome can have a negative impact on relationships with friends or partners.
Likewise, some jobs may no longer be possible or may be very limited due to the sleep phase syndrome. However, if the sleep phase is only shifted and not disturbed by the sleep phase syndrome, there are usually no special complications or symptoms. However, in many cases, patients also suffer from fatigue that occurs throughout the day.
The use of antidepressants can promote further complications if they are prescribed by the doctor due to a misdiagnosis. Sleep phase syndrome can be treated with a variety of therapies. However, independent therapy by the patient is also necessary in order to completely limit the symptoms. The life expectancy of the patient is usually not negatively influenced or reduced by the sleep phase syndrome.
When should you go to the doctor?
A doctor is not always needed for sleep phase syndrome. If the affected person can still structure their everyday life well due to the changed sleep phases and does not suffer any impairments, there is no need to see a doctor. If you succeed in reconciling professional and private activities with your own physical needs, there is no need for action.
A doctor is only needed when the patient is suffering. If insufficient sleep leads to concentration and attention deficits, an increased stress level or constant tiredness, the cause should be clarified. In the case of low mood, low blood pressure, loss of well-being and headaches, it is advisable to seek the assistance of a doctor.
If everyday tasks and obligations cannot be fulfilled, if the person concerned feels inner heaviness or listlessness, changes are necessary. The sleep schedule should be optimized in consultation with a medical professional to improve quality of life and alleviate dissatisfaction.
If the complaints persist over a long period of time, an increase in irregularities can be expected. Therefore, a doctor should be consulted if functional disorders appear, the general risk of accidents increases in everyday life or if you become weak. In the event of cardiac arrhythmia, medical help is indicated as soon as possible.
Treatment & Therapy
As part of the therapy for sleep phase syndrome, an attempt is made to adapt the patient to his internal clock. This means that the person concerned looks for a job that fits his sleep-wake cycle, compensates for his sleep deficit on weekends and days off, or instead sleeps during the day and works at night.
In addition, there is the option of changing the wake-sleep rhythm so that the patient can get up at normal times. For this purpose, a special chronotherapy is carried out. As part of this, the person concerned goes to bed three hours later every day.
If he has reached a suitable sleeping time, he sticks to it consistently. Improved sleeping conditions, which include avoiding nicotine, also contribute to sleep hygiene. Another treatment option is light therapy.
The patient is exposed to light of around 2500 lux for around 60 minutes in the early morning. One problem, however, is that the effects of these treatments are often only temporary.
Prevention
In order to prevent the consequences of a sleep phase syndrome, it is recommended to choose later working hours. Even an hour or two can make a significant difference. In some cases, working at home is also possible.
Aftercare
Patients with sleep phase syndrome should be accompanied by follow-up treatments and examinations. As part of aftercare, it is necessary to maintain sleep hygiene. Alcohol and caffeine should definitely be avoided before going to bed.
Drugs that promote falling asleep and staying asleep should only be taken for a short time due to the potential for dependency and should be discontinued as quickly as possible. It is necessary for the patient to adjust to the normal sleep-wake cycle over the long term. This is possible by gradually postponing bedtime.
Thus, the patient’s waking phase is gradually lengthened until the normal bedtime time is reached. With accompanying medical follow-up treatment, light therapy can help normalize the day-night rhythm. Strong light sources are used during therapy for this purpose. It is necessary that the times of going to bed and the times of getting up are strictly observed.
In doing so, the patient must reduce bed times in order to increase the pressure for sleep. This stabilizes the normal sleep-wake cycle. Regular physical activities in the fresh air also positively control the rhythm. By documenting the sleeping and waking phases, the patient assumes a partial control of his behavior and thus deals with the syndrome in a self-determined manner.
You can do that yourself
People who suffer from sleep disorders should review their lifestyle and make necessary corrections. Medication should be checked for side effects. In addition, the interactions of the various preparations must be found out and discussed with a doctor.
Regular sleep and a review of sleep hygiene are necessary to see improvements. The sleep phase should correspond to the natural needs of the organism. Check the mattress on which you sleep, the quality of the duvet, pillow and linen, and the temperature of the sleeping area. Ambient noise should be avoided, as should glaring light. The daily routine is also to be checked and should be improved if possible. Eating greasy foods should be avoided immediately before bedtime. The consumption of alcohol, drugs and nicotine should also be avoided. A balanced and healthy dietand getting enough exercise throughout the day help improve sleep quality.
In the case of mental stress, processes to reduce mental stress are necessary. In the context of self-help, techniques such as autogenic training, yoga or meditation can be used to reduce stress and cope better with everyday life. Cognitive training also helps to reduce symptoms such as circling thoughts.
