Tuesday, November 27, 2012

Confessions of a Night Owl: Living with Delayed Sleep Phase Syndrome

"Dawn is when men of reason go to bed" 
~Ambrose Bierce

Recently I've moved from Perth, Australia to Los Angeles. O.K., so not literally, but definitely in terms of my sleep schedule.  As a result, I've spent the last week jet-lagged and adjusting to a "new to me" sleep schedule.

Let me explain...

Delayed Sleep Phase Syndrome

As I have mentioned before, I have something called delayed phase sleep disorder, more properly known as delayed sleep phase syndrome (DSPS).  As with a lot of my chronic illnesses, the cause of this disorder is not really known, although it does tend to run in families (possible genetic link) and it is associated with depression (not a problem I have.)

The disorder often begins in adolescence or adulthood and is rarely seen in children.

Many people with this sleep problem, including myself, refer to themselves as night owls.  But this isn't a sleep preference.  Studies show that there are actual physiological changes that occur with DSPS that demonstrate the body is actually geared up for sleeping at a later time.

Chronic illness can make this syndrome worse. I personally have had more problems with DSPS during my leukemia cancer treatment in 1988 and currently, during and after my Hepatitis C treatment this year.

DSPS Symptoms

The hallmark of this sleep disorder is the inability to maintain a typical sleep schedule, which for the purpose of this discussion we'll call 10 P.M. to 6 a.m.  Someone with DSPS will naturally become tired at midnight or later and, once asleep, will obviously have a lot of trouble waking up at 6 a.m.

This is a more serious problem then just being late to school or work: not getting enough sleep on a regular basis creates sleep deprivation and actually makes the person more prone to accidents.  In fact, there are numerous studies that show driving while sleep deprived is as bad as driving drunk.

Problems DSPS Causes

The main problem with DSPS is for those who need to maintain a "regular" schedule in order to participate in school or work.  Most people with DSPS try and do their best to muddle through, often taking naps when they can during the day.  They will also try to "make up" for lost sleep by sleeping in on the weekends.

Some will choose jobs on the swing or night shifts that fit better with their natural circadian rhythm.

Chronic illness can push the sleep cycle even further out of whack in people who have DSPS.

For me, DSPS means not being able to fall asleep until 4 to 6 a.m. in the morning and waking up in the afternoon.  Since I am disabled and currently not working, it is easier for me to roll with this and make the best of a not ideal situation.  It also means arranging transportation to my doctor's appointments, especially if they are in the morning, since I don't want to chance an accident caused by sleep deprivation.

My Recent "Move"

Things with my DSPS got really bad during Hep C treatment--I started going to bed in the late morning  and getting up as the sun went down.  I think it was the combination of taking chemotherapy drugs (interferon and ribavirin) and developing several different treatment-related infections, both of which served to throw off my circadian rhythm even further.

I knew I needed to do something about this new schedule which really wasn't working for me.  Here are some of the steps I took to get back to an earlier sleep time.

  • I pushed my sleep time back by 3 hours every day over a week's time until I got to my bedtime target of 2 a.m.  This is called "delaying the internal clock." So, for example, if I went to bed at 8 a.m. yesterday, I would go to bed at 11 a.m. today and 1 P.M tomorrow.
  • I eliminated naps while readjusting my sleep hours.
  • I only slept 8 hours at a time.  Normally, I need to sleep between 8 and 10 hours, and sometimes even 12 hours if I have been particularly active during the day, but I wanted to create some extra sleepiness to help me make the transition so I cut back a little on my sleep.
  • I made sure my bedroom was completely dark by using blackout curtain liners.  
  • I make sure I get plenty of sun exposure when I get up in the morning.
  • I avoid using my computer and other light-generating electronics 1 hour before bedtime.  
  • I use the hour before bed for winding down with ambient music, reading and sleep-related tasks: washing my face, brushing my teeth, changing into pajamas, taking medications, etc.

An Ongoing Challenge

I've been feeling pretty out of it since I made my move to an earlier bedtime.  My hubby keeps reminding me that I am most probably experiencing a form of jet-lag and he is probably right.  I just need to give myself more time to adjust and get used to this really big change from living on Perth, Australia time to living on Los Angeles time.

I also need to be super vigilant about getting to bed at my new 2 a.m. bedtime.  It is really easy to stay up later when you have DSPS and I don't want to have to repeat this process again since it is quite difficult to do.

I know with this move I still haven't quite gotten myself onto a "normal" sleep schedule when compared to most other people, but I am happy with where I am at for now.  Maybe with time I can try again and see if this night owl can ever become an early bird.

The hardest thing for me with this new change has been trying to figure out what time of day is best for writing.  Previously, I used to write in the early morning hours.  Now that I am sleeping during these hours instead, it really has been a struggle to find an alternative time for blogging.  So far, it seems the hours after I get out of bed are the best, but this will be something I'll need to experiment with for a while.

Until then, I hope you'll excuse me if my writing and editing suffer a bit during this transition.

PLEASE NOTE:  I am not a medical professional and sharing what works for me is not a substitute for professional advice.  Please consult a sleep specialist if you think you have delayed sleep phase syndrome for a proper diagnosis, medical advice and treatment.

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Migrainista said...

Gosh I wish you luck with this. Sounds like quite a challenge. Hopefully you will see great benefit in the near future.

Unknown said...

It really is a challenging condition! It is so hard to get your body to do things it really doesn't want to do. *fingers-crossed* getting rid of my chronic Hep C infection helps.

Unknown said...

I had never heard of this before and makes so much sense to me! I've totally been sleeping crazy hours lately. Good to hear there may actually be a reason my ideal bedtime has been 2am.

Anonymous said...

I'm so tired Selena.