Predisposing factors in delayed sleep phase syndrome

Sleep Disorders Clinic, Seiwa Hospital, Neuropsychiatric Research Institute, University of Tokyo, Japan.
Psychiatry and Clinical Neurosciences (Impact Factor: 1.63). 07/2000; 54(3):356-8. DOI: 10.1046/j.1440-1819.2000.00713.x
Source: PubMed


We classified 64 patients with chronic delayed sleep phase syndrome (DSPS) into the primary (n = 53) and secondary (n = 11) group according to presence or absence of such signs as difficulty in waking up which appeared much earlier than the onset of DSPS. The age at the onset of the early signs concentrated in adolescence. The familial occurrence of DSPS was noted in 11 patients of the primary group. In human leukocyte antigen (HLA) typing, the incidence of DR1 positivity alone was significantly higher in DSPS patients than in healthy subjects. Minnesota Multiphasic Personality Inventory revealed high scores on depression, psychoasthenia and hypochondriasis. We suggest that a predisposition to DSPS includes biological, genetic, social and psychological factors, various combinations of which may lead to DSPS.

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    • "The prevalence rate for at least one symptom of insomnia in the adolescent sample was 30%, and the most commonly reported symptom was non-restorative sleep, followed by difficulties in initiating sleep. DSPS is associated with a wide range of problems, including inability to work or attend school, which can lead to job loss, truancy, school failure [75] [77] [82], daytime sleepiness, social difficulties, and depressed mood [75] [83]. Thorpy and colleagues [75] reported more than half of adolescent DSPS patients in their study had features of depression as measured by the Beck Depression Index (BDI), Minnesota Multiphasic Personality Inventory (MMPI), or psychological evaluation; 6 of the 22 patients had prior treatment for depression. "
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    ABSTRACT: Sleep/wake timing shifts later in young humans during the second decade of life. In this review we describe sleep/wake patterns, changes in these patterns across adolescence, and evidence for the role of environmental, psychosocial, and biological factors underlying these changes. A two-process model incorporating circadian (Process C) and sleep/wake homeostatic (Process S) components is outlined. This model may help us to understand how developmental changes translate to shifted sleep/wake patterns. Delayed sleep phase syndrome (DSPS), which has a typical onset during the second decade of life, may be an extreme manifestation of homeostatic and circadian changes in adolescence. We describe symptoms, prevalence, and possible etiology of DSPS, as well as treatment approaches in adolescents.
    Full-text · Article · Oct 2007 · Sleep Medicine
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    ABSTRACT: Le syndrome de retard de phase se traduit par un endormissement tardif associé à un réveil difficile le matin avec une fatigue ou une somnolence le lendemain, dès lors que la personne est dans une situation de contraintes horaires. En vacances, lorsque la personne se laisse aller à son rythme, le sommeil se décale franchement et il n’y a plus de conséquences sur la vigilance. Ce trouble se déclenche essentiellement à l’adolescence, à la fois pour des raisons biologiques qui tendent à favoriser le retard de phase, mais aussi en raison du comportement de l’adolescent qui favorise les activités dans la soirée. Des troubles psychopathologiques sont fréquemment associés comme des troubles de la personnalité et/ou une dépression. Les traitements font appel à différentes techniques : chronobiologie, photothérapie, mélatonine. Pour certains, ils sont mal codifiés et leurs résultats dépendent largement de l’adhésion et de la motivation du patient à changer ses habitudes de sommeil.
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