II. Definitions

  1. Late sleep onset as well as late wake-up time
  2. Results in excessive Daytime Sleepiness and Insomnia

III. Epidemiology

  1. Prevalence: 7-16% of adolescents
  2. Onset in teen years with peak Incidence in early 20s
  3. Family History of Delayed Sleep Phase in 40% of patients

IV. Symptoms

  1. Shifted sleep schedule by at least 2 hours later that typical acceptable times
  2. Patient has a "night owl" sleep pattern
    1. Difficulty initiating sleep (e.g. prior to 1-2 am)
    2. Difficulty waking up by typical awakening times (e.g. prior to noon)

V. Diagnosis

  1. Sleep diary
    1. Log sleep times before and after intervention
  2. Actigraphy monitoring for at least 1 week
    1. Accelerometer monitors patients overnight movement
    2. Calculates actual patient sleep time

VI. Management

  1. See Sleep Hygiene
  2. See Insomnia
  3. Melatonin 3 mg orally at least 1.5 hours prior to desired bedtime
    1. Mundey (2005) Sleep 28(10): 1271-8 [PubMed]
  4. Limit bright light exposure prior to bedtime
    1. Avoid computers, handheld devices, television watching before bed
  5. Bright Light Therapy on awakening
    1. Exposure to 2000 lux for first 1-2 hours after awakening
  6. Transitioning to optimal sleep timing
    1. Shift Melatonin/light exposure 1 hour earlier every 5-7 days until desired schedule is achieved

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Ontology: Delayed sleep phase (C0854740)

Concepts Disease or Syndrome (T047)
Italian Fase del sonno ritardata
Japanese 遅延睡眠期, チエンスイミンキ
Czech Pozdní fáze spánku
English Delayed sleep phase, delay phase sleep, delayed sleep phase
Hungarian Késleltetett alvásfázis
Portuguese Atraso de fase do sono
Spanish Fase de sueño retrasada
Dutch vertraagde slaapfase
French Phase de sommeil retardée
German verzoegerte Schlafphase