The formal definition for Delayed Sleep Phase Disorder (DSPD) is characterised by difficulty falling asleep within two or more hours of the intended sleep time, resulting in excessive daytime tiredness (DSM-V). Unlike insomnia, individuals with DSPD have little trouble sleeping when allowed to follow their natural circadian rhythm. This condition often becomes more noticeable during adolescence, as the expectations placed on teenagers make the difficulties more apparent.
This is by no means a definitive reason for diagnosis, but it can be helpful to know that a challenge in falling asleep is a real condition. Those suffering from similar symptoms often feel guilt or shame for being unable to sleep at the expected time – feelings which unfortunately make it even harder to fall asleep.
The struggle to fall asleep can lead to a stressful bedtime routine and feelings of anxiety. If you experience resistance towards bedtime or find yourself engaging in activities to delay sleep, such as scrolling news or social media on your phone, or watching TV long after you intended, it may be an attempt to avoid the impending struggle of falling asleep. In children this resistance may be mistaken for defiance, sudden hunger or thirst, and a struggle to do any of the things that step ever closer to bedtime.
Whether formally diagnosed with DSPD or simply recognising a similar pattern, it is important to practice compassion for the sufferer and acceptance of the impact it has on sleep and daily functioning. It is common for DSPD to coexist with ADHD.
Suggestions to help those living with DSPD or who experience similar symptoms:
- Acknowledge the reality of the condition and show, and ask for, compassion. Inability to sleep is not enjoyable and can create stress.
- Try to avoid consuming sugar or caffeine at least a few hours before your intended bedtime. Also try to avoid doing things that stimulate your brain – like last minute work or homework, watching tv or using devices, or having conversations that leave you feeling agitated.
- Prioritise calming activities for the half-hour before bedtime. Things like sitting quietly with a family pet, doing some gentle stretches, or engaging in simple self-care activities such as washing your face and hands with warm water, can create a calm and mindful atmosphere.
- Establish a flexible sleep routine that includes being in bed at a regular time. Once in bed you can engage in quiet activities. These may include reading a book, drawing, listening to music, brown noise (for ADHD), listening to a podcast or audio book, practicing mindfulness or breathing exercises, and reading or writing your success list. This may last for half an hour, or more. This flexibility allows bedtime to become a calm, relaxing time to look forward to, rather than something to resist.
- When you decide to stop reading, etc, try removing any pressure to actually fall asleep so that the mind can remain calm. The aim is simply to relax the body – think of falling asleep as somewhat optional and allow it to happen naturally.
- If overthinking becomes a challenge late at night, you might like to try practicing simple mindfulness techniques.
