Sleep has important benefits for health and wellbeing, but not everyone is able to get as much sleep as they’d like. For some individuals, sleep does not come easy. One particular problem encountered by a few unfortunates is what is termed ‘delayed sleep phase syndrome’ (DSPS). Here, individuals can take hours (literally, hours) to get off to sleep. They, perhaps not surprisingly, find it difficult to get up in the morning too. Someone with DSPD can find trying to do a job with ‘normal’ work hours very challenging indeed.

I’ve found in practice that individuals with DSPS can often be helped using quite-natural strategies. One of these concerns the use of bright light. Sunlight-simulating devices are the most practical option here, and the light is best administered in the morning (around the time the individual usually gets up) [1]. In addition, it makes sense not get too much light exposure in the evening (light suppresses the secretion of the chief sleep hormone melatonin). With regard to this, someone recently alerted me to a free piece of downloadable software which automatically dims one’s computer screen around the time the sun goes down. See here for more details.

Another useful treatment for DSPS is melatonin. This can promote sleep, and there’s some thought that it might even help to ‘re-set’ the sleep-wake cycle. It requires a prescription in the UK, but is available over-the-counter in some other parts of the world including the US.

One of the reasons I like melatonin (other than the fact that it often helps promote sleep in those who have difficulty getting off) is that it is, to my mind, quite a natural treatment. It is, after all, a natural body constituent. One could argue that in that sense, it’s even more natural than, say, a medicinal herb such as valerian: Sleep problems may be due to insufficient melatonin at the right time, but won’t be due to a valerian deficiency. I have written about the use of melatonin for the treatment of insomnia here.

Disorders of melatonin secretion may not just impact on sleep either – there is evidence that they can be a factor in depression[2].

I was interested to come across a recent study in which the impact of melatonin in individuals with DSPS was assessed [3]. Individuals in this study were treated with both melatonin and, at another time, placebo. Each treatment period lasted 4 weeks, and there was a week of no treatment between these. Melatonin treatment was found to improve sleep as evidenced by tests conducted by polysomnography.

Some of the participants in the study had depressive symptoms, while others did not. And interestingly, those with depressive symptoms saw improvement in those symptoms as a result of treatment with melatonin.

This study was small (20 participants), but its results suggest that melatonin therapy has the capacity to improve sleep and mood in those suffering from DSPS.



References:

1. Gooley JJ. Treatment of circadian rhythm sleep disorders with light. Ann Acad Med Singapore 2008;37(8):669-76.

2. Srinivasan V, et al. Pathophysiology of depression: role of sleep and the melatonergic system. Psychiatry Research;165(3):201-14

3. Shadab A, et al. Antidepressant action of melatonin in the treatment of Delayed Sleep Phase Syndrome. Sleep Medicine 2010;11(2):131-136