How Delayed Sleep Phase Syndrome Affects Teenagers

If you struggle to get your teenagers to bed at a reasonable hour and fight to get them out of bed in the morning, you may be dealing with teens who have delayed sleep phase syndrome (DSPS). This relatively common condition can be accentuated during adolescence when the pressures of a school schedule conflict with changes in the body’s circadian rhythm among teens who are naturally night owls.

Learn how DSPS affects the sleep of teenagers and how this can lead to both insomnia and morning sleepiness.

The Circadian Rhythm and Adolescence

As children get older and enter the teenage years, the timing of their desire to sleep changes. Many teens develop delays in desired sleep onset and offset, resulting in a shift to later bedtimes and sleep periods. As such, it is not uncommon for teenagers to stay up past 11 p.m.—or even to as late as 2 a.m. or 3 a.m. Moreover, if left to their own devices (especially on weekends or days off), they may want to sleep in until 9 a.m. or 10 a.m. (or even much later).

This occurs because of a shift in their circadian rhythms. The circadian rhythm is the synchronization of the body’s functions to the natural light-dark cycle. It helps to coordinate our periods of sleep to the nighttime. When this becomes delayed, it may result in DSPS.

What Causes Delayed Sleep Phase in Teenage Night Owls?

Teens who experience DSPS will often begin having difficulties at the onset of puberty. There may be underlying genetic factors involved that affect the suprachiasmatic nucleus, which is in part of the brain called the hypothalamus, though further studies are needed. Other factors—like increased sensitivity, exposure to light at nighttime, or decreased exposure to light in the morning—may also play a role. It is thought that between 5% and 10% of teens have DSPS. It can persist well into adulthood in some people.

Symptoms of Delayed Sleep Phase Syndrome in Teenagers

Significant sleep deprivation may result during the week, leading to a set of problematic symptoms. It is important to recognize the symptoms that may suggest DSPS, which include:

• Feeling at their best in the evening
• Difficulty falling asleep (insomnia)
• Excessive daytime sleepiness, especially in the first few hours of the morning
• Chronic school tardiness or absenteeism
• Depression
• Avoiding school

Other Conditions Resembling Delayed Sleep Phase Syndrome

Overlap occurs in the symptoms of DSPS and other medical and psychiatric conditions. As the treatments will differ, it is necessary to recognize the distinctions. Many teens simply do not get the sleep that they need and may benefit from tips to improve teen sleep. Some have an underlying sleep disorder that is contributing to their difficulties, such as insomnia, restless legs syndrome, or even sleep apnea.

In addition, psychiatric illnesses, such as anxiety and depression, may masquerade as a sleep disorder. These should be considered and ruled out by a board-certified sleep physician who is familiar with managing younger patients.

Diagnosis and Treatment of Teens with a Night Owl Tendency

Aside from answering a few questions, it can be helpful to do some basic investigative testing. One option is to look at the patterns of sleep and wakefulness with a monitoring method known as actigraphy. This small device records movement, and with the information collected, a doctor can determine whether DSPS is likely to be present. As a complement to this, the use of a sleep-wake diary may be useful in accounting for the patterns over several weeks.

Depending on the particular symptoms associated with your teen's sleep disturbance, additional testing may be indicated. The treatment will depend on the cause, but teens with DSPS may respond to cognitive behavioral therapy for insomnia (CBTI), phototherapy with a light box, or simply getting natural morning sunlight for 15–30 minutes upon waking. Over-the-counter natural sleep aids like melatonin also may help. Melatonin must be taken several hours before bedtime in order to be effective.

A Word From Verywell

As there can be significant consequences from DSPS, including disruption of school performance and activities, it is important to get affected teenagers the help that they need. Keeping a regular sleep schedule (including on weekends), getting morning sunlight upon waking, and going to bed when feeling sleepy can be highly effective.

The condition usually improves in adulthood with a strict adherence to a regular sleep-wake schedule, but it may return if a regular schedule is not required, such as in retirement.