Delayed Sleep Phase Syndrome

2 January 2010

Saturday


I just watched Alan Berliner’s film Wide Awake, a documentary about insomnia. While I have never experienced insomnia, I still found the film to be of interest as several items Berliner mentioned about his life (it is a very self-centered film) are things I experience in no relation to insomnia. Berliner is obviously what most people call a “night owl” and said that he routinely stays up until four or five in the morning. Berliner also said in the film that he does all of his work at night. Well, me too.

From the film I learned that doctors that specialize in sleep disorders (of which one would suppose insomnia is the most common, but would also include conditions like narcolepsy) have a clinical term for being a night owl: Delayed Sleep Phase Syndrome. Apparently, I “suffer” from delayed sleep phase syndrome, also known as delayed sleep-phase disorder (DSPD) or delayed sleep-phase type (DSPT). The reader will understand that I put “suffer” in quotes (as in “I ‘suffer’ from…”) because I really don’t consider it a disorder.

The Wikipedia article on delayed sleep phase syndrome states that the syndrome is, “a chronic disorder of the timing of sleep, peak period of alertness, core body temperature, hormonal and other daily rhythms relative to societal norms. People with DSPS tend to fall asleep some hours after midnight and have difficulty waking up in the morning.” I plead guilty on all counts. Not only do I sleep out-of-phase with societal norms, I know that my mind is at its peak performance late at night, say between 10:00 pm and 2:00 am, and I do all my best work at this time.

The key phrase in the Wikipedia definition is, “relative to societal norms.” I hope that the reader finds this incoherent mish-mash as puzzling as I do. The “definition” mixes clinical physiological issues like core body temperature and hormonal rhythms with sociological issues like societal norms. Since when is core body temperature a societal norm? I have known people who have had an average body temperature of either more or less than 98.6 F throughout their lives. This is what individual variation (one of the drivers of natural selection) is all about. A body temperature of 98.6 F is a biological and physiological norm, but it is not a societal norm. The failure to distinguish between physiological norms and societal norms exhibits a high order of sloppy thinking, but it is certainly not unique in this.

In the June 1992 issue of the Journal of Medical Ethics, there was a very amusing article titled, “A Proposal to Classify Happiness as a Psychiatric Disorder,” by Richard P Bentall. In the article, Bentall cited the well-known phenomenon of “depressive realism” — the fact that people suffering from depression often have a more accurate understanding of themselves than those not suffering from depression — and adds: “Although the lack of these biases in depressed people has led many psychiatric researchers to focus their attention on what has come to be known as depressive realism, it is the unrealism of happy people that is more noteworthy, and surely clear evidence that such people should be regarded as psychiatrically disordered.”

Bentall goes on to argue (rightly, though perhaps tongue-in-cheek) that happiness might be rejected as a mental illness because it is not of “clinical interest,” which is an obviously circular criterion of illness, and that happiness might be rejected as a mental illness because it is not negatively valued, which is equally obviously an evaluative rather than a scientific criterion. Bentall openly acknowledges that his proposal to include happiness as a psychiatric disorder may be counter-intuitive, but that it is scientifically sound.

On all of this, agree with Bentall. But now I have a moment of hesitation. While I would not be so bold as to claim that I am happy simpliciter, I am certainly happy with being a night owl. Not only am I happy with being a night owl, but I would resist any attempt to try to cure me or relieve me of my “disorder.” I have had a great many people tell me that I could change my schedule if I wanted to. Two responses to this: 1) my schedule comes naturally to me, and I don’t want to change it, and 2) I worked a split shift for ten years and it never felt natural or normal; I never got used to it. There is a certain plasticity in an individual’s circadian rhythm, but not an absolute plasticity; there are limits to the extent that any one individual can force themselves to adopt a given schedule.

Certainly, under duress, even the most dedicated night owl could adopt the schedule of a morning lark. As I noted above, I lived a split shift for ten years, and while it wasn’t pleasant, it certain was possible. Similarly, a morning lark under duress could force themselves to go to bed after 2:00 am and sleep until 10:00 am or so. Again, it wouldn’t be pleasant, but it would be possible. If the morning lark were to respond that it wouldn’t matter how late they went to bed they would still wake up with the sun, it is equally true that the night owl, no matter how early he gets up will likely stay away late into the night. It goes both ways folks.

The few times I have attempted to discuss this with others, I find the discussion rapidly deteriorates into charges and counter-charges. People have a hard time being objective about sleep patterns, especially (at least in my experience), morning people who can’t conceive of any other possible way of life and would like to see their natural schedule forced upon others.

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Addendum added 02.25.2010

On the Science Daily website there is an article, “Liberals and Atheists Smarter? Intelligent People Have Values Novel in Human Evolutionary History, Study Finds,” in which the following, relevant to the above, is to be found:

An earlier study by Kanazawa found that more intelligent individuals were more nocturnal, waking up and staying up later than less intelligent individuals. Because our ancestors lacked artificial light, they tended to wake up shortly before dawn and go to sleep shortly after dusk. Being nocturnal is evolutionarily novel.

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6 Responses to “Delayed Sleep Phase Syndrome”

  1. Right. If you aren’t suffering, and do not desire or need to be able to wake up in the morning, you don’t have DSPS. By definition. Societal norms be damned.

    Life situations may change, however. At least one parent of a baby must be able to get up early. Single parents have been threatened with having children taken from them and even jail for not being able to get a child to school on time.

    In my case, youthful resilience let me get through college and the beginning of a teaching career. Forcing myself up after 3-4 hours sleep was hell and I often came in late, but it sort of worked for a couple of decades. My last 10 years teaching required accommodations and I got every contagious sickness + allergy flare-ups.

    Learning that it has a name, DSPS, was a revelation. Perhaps I should have understood earlier that I wasn’t going to get over the problem. Societal norms suggest that everyone should be able to work the day shift. It can be hard to admit that one cannot.

    • geopolicraticus said

      Thanks for your comment.

      Certainly anyone placed in the role of a personal caregiver, whether to an infant or to the elderly, must subordinate their schedule and even their personal comfort to the responsibilities of their position.

      I don’t want to sound like I’m nit-picking with your comments, since I agree with you, but I want to point out that with a situation of caregiving it is flexibility rather than early rising that counts. Many people find themselves made profoundly uncomfortable when their infant sleeps away the day and stays awake all night. For the person who naturally has a night schedule, this does not present a problem. But both infants and the elderly tend to sleep in short naps and awake any time of the day or night. As long as you can rise to meet their needs, and can nap when they do, you’ll do OK.

      I find it of the greatest interest that you write that, “Learning that it has a name, DSPS, was a revelation.” There is an on-going controversy among those who deliver psychiatric services over the status of “psychiatric labeling.” Some people, who have suffered for long periods of time, not even knowing they have a medical condition, find a formal diagnosis liberating. Some people, on the other hand, find themselves oppressed by a formal diagnosis, that is to say, given a psychiatric label.

      I personally never found it difficult to admit that I could not realistically work a “day shift” (which ought to be called a “morning shift”), but that’s me.

      Best wishes,

      Nick

      • True that flexibility is a different parameter. Both larks and owls can be flexible or inflexible.

        The formal diagnosis was indeed liberating. I’d never before heard of such a disorder. Suddenly it wasn’t just me being lazy, inconsiderate etc. A tremendous relief. It may be different with psychiatric labels. (Earlier DSPS was classified as a mental health issue; it is now neurological.)

  2. Aaron said

    Finally, I’m not alone.

    I’ve tried many times to “Reset” my sleep schedule, it never works. I usually end up staying awake for almost 30 hours, then trying to fall asleep, say, around 11pm. If I do manage to finally fall asleep, I usually wake up around 2am and can’t get back to sleep. Or else I’ll feel like shit ALL day long. But if I’m left to my own devices I sleep like a baby between about 4am-Noon. And I usually feel about 10 times better too.

    But one thing I’ve learned is that you won’t get one single ounce of sympathy from any morning person. To them you’re just a lazy bastard, even if you’re at work while they’re sleeping. They just don’t get it.

    I personally think WAY more people are night owls than they realize, they just self medicate with butt loads of coffee, sugary sodas, and other stimulants to keep them going. I’ve never had one coffee in my entire life. You just gotta listen to your body.

    Not only that, but there must have been night owls back in prehistoric days or whatever. What? Did everyone just automatically agree to not invade neighboring villages during night time because they didn’t want to wake up their potential targets for raping and pillaging? Stupid morning people would want you to think so I bet.

    • geopolicraticus said

      That’s right — you’re most definitely not alone. We are the temporal minority (or, if you prefer, the circadian minority), though, as you point out, probably many more people are night owls but self-medicate and do not know what they are. We need conscious-raising in order to bring the word to everyone that it is OK to be a night owl to all our fellow night owls.

      I urge all night owls to “come out” to their family, friends, and colleagues, openly acknowledging that they belong to a circadian minority.

      Moreover, I completely agree with you about listening to your body. And, like you, I’ve never had any coffee.

      Best wishes,

      Nick

  3. dsps2 said

    You have said it all! It is not a disorder. When I get the sleep I need WHEN I need it, I am as right as rain. Waking up after 5 or 6 hours of sleep M-F is what made me crazy and miserable. Still, I’d like to be able to have lunch with friends, see the ocean in the morning, go for an all day sail…..

    We are missing a lot.

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