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Sleep variability in delayed sleep-wake phase disorder and insomnia disorder in youth: A case-control study

Yue Pan1, Forrest Tin Wai Cheung2, Joey Wing-Yan Chan3

  • 1Sleep Research Clinic & Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR.

Sleep Medicine
|February 26, 2026
PubMed

Insights

Youths with delayed sleep-wake phase disorder (DSWPD) and insomnia disorder (ID) exhibit greater sleep variability. This heightened variability is linked to delayed circadian rhythms and increased depressive symptoms in adolescents and young adults.

Area of Science:

  • Sleep Medicine
  • Chronobiology
  • Adolescent Psychiatry

Background:

  • Delayed sleep-wake phase disorder (DSWPD) and insomnia disorder (ID) are common in youth.
  • Intraindividual sleep variability, the day-to-day fluctuation in sleep patterns, is a poorly understood aspect of these disorders.

Purpose of the Study:

  • To compare intraindividual sleep variability between youths with DSWPD, ID, and healthy sleepers.
  • To investigate the association between sleep variability, depressive symptoms, and circadian measures.

Main Methods:

  • A comparative study involving youths with DSWPD (n=34), ID (n=40), and healthy sleepers (n=39).
  • Utilized sleep diaries, actigraphy for eight days, and dim light melatonin onset (DLMO) assessments.
  • Derived subjective and objective sleep variability from diary and actigraphy data.

Main Results:

  • Youths with DSWPD showed greater variability in bedtime, time in bed, and total sleep time compared to those with ID.
  • Both DSWPD and ID groups exhibited increased variability in sleep onset latency compared to healthy sleepers.
  • Later DLMO and higher depressive symptoms correlated with increased sleep variability.

Conclusions:

  • Youths with DSWPD and ID demonstrate significant sleep variability, associated with circadian delays and depressive symptoms.
  • Intraindividual sleep variability is clinically relevant in adolescent sleep disorders.
  • Further research is necessary to understand the mechanisms driving increased sleep variability.
Abstract

Keywords:
AdolescentsDelayed sleep phaseDelayed sleep-wake phase disorderInsomniaSleepSleep variabilityYouths

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