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Delayed sleep-wake phase disorder.

Alexander D Nesbitt1,2,3

  • 1Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Journal of Thoracic Disease
|February 16, 2018
PubMed
Summary
This summary is machine-generated.

Delayed sleep-wake phase disorder (DSWPD) is a common circadian rhythm issue causing difficulty initiating sleep and waking. Treatment involves applying knowledge of sleep and circadian physiology.

Keywords:
Sleep wake disorderscircadian rhythmmelatonin

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Area of Science:

  • Sleep Medicine
  • Chronobiology
  • Circadian Rhythm Sleep-Wake Disorders

Background:

  • Delayed sleep-wake phase disorder (DSWPD) is the most prevalent circadian rhythm sleep-wake disorder (CRSD).
  • DSWPD is frequently misdiagnosed as sleep-initiation insomnia and typically emerges during adolescence, persisting into adulthood.
  • Individuals experience significant difficulty initiating sleep at conventional times and subsequently struggle with morning awakenings.

Purpose of the Study:

  • To review the current understanding of DSWPD epidemiology, associations, and pathophysiology.
  • To discuss the application of sleep and circadian physiology knowledge to DSWPD treatment strategies.

Main Methods:

  • Literature review focusing on epidemiology, pathophysiology, and treatment of DSWPD.
  • Synthesis of current knowledge on sleep and circadian rhythms relevant to DSWPD.

Main Results:

  • DSWPD is characterized by a significant delay in the major sleep episode relative to the natural light-dark cycle.
  • Individuals with DSWPD often experience chronic sleep restriction when adhering to societal schedules, with compensatory longer sleep on free days.
  • Sleep duration and quality are normal when schedule constraints are removed, indicating a phase delay rather than a primary sleep deficit.

Conclusions:

  • Understanding the epidemiology and pathophysiology of DSWPD is crucial for effective management.
  • Applying principles of sleep and circadian physiology can guide the development of targeted treatments for DSWPD.
  • DSWPD management requires addressing the underlying circadian phase delay to improve sleep timing and reduce associated sleep deprivation.