(Philadelphia, PA) - Every time “back to
school” season rolls around in the fall, Grace Pien,
MD with the University of Pennsylvania School of
Medicine's Division of Sleep Medicine, sees teenagers being
dragged into her office by parents. The teens complain it’s
hard to get to sleep at night. After several follow-up questions,
Pien often determines that these patients are suffering from a sleep
disorder called delayed sleep phase syndrome (DSPS) - when your
body’s circadian rhythm makes you want to go to bed much later
than what’s considered to be a normal bedtime.
“It happens in adolescents and young adults. When a patient
comes in, they think they’re suffering from insomnia, saying
they go to bed around 11 p.m. but have trouble falling asleep until
hours later. If you dig deeper with them, they’ll tell you
that on the nights they stay up late, they have no difficulty falling
asleep and once they do go to sleep, they stay asleep until late
morning or early afternoon,” Pien explains.
Pien adds that these so-called “night owls” have difficulty
making it to morning appointments or school. “The schedule
they are on is not the same schedule as rest of the world. They
have normal sleep cycles, but they just can’t fall asleep
until very late. Part of it is ‘how you’re wired’
and part of it is attributed to late-night social behaviors.”
Pien says the delayed sleep phase syndrome is treatable. For most
people, once an external schedule is imposed upon them for work
or school where they have to get up early, they are able to adjust
their sleep habits, go to bed earlier, and meet their obligations.
But for others, there is a real difficulty in adjusting to an earlier
sleep schedule and they should see a sleep physician for behavior
modification or bright light treatment.
As we gear up for this year’s “back to school”
season, Pien has this advice for the parents of teenagers, who have
been used to staying up late on those summer nights:
- Have your teen stick closely to a strict “sleep and wake
schedule” so your teen isn’t going to sleep too late.
- Align that schedule with where you want it to be (for example
- to bed at 10 p.m. and up by 7 a.m.).
- High School students still need 8-9 hours of sleep a night
to function well the next day.
- Be aware, sneaking in just one or two late nights can make
the body’s circadian rhythm slide right back into the old
- DSPS is a disorder of the body's circadian rhythm, perhaps
caused by a diminished capacity to change the times the body sleeps
and wakes on a daily basis.
- If you suffer from DSPS, you tend to fall asleep very late
at night and have trouble waking up at a normal time in the morning
for work or school.
- Approximately 7% of adolescents are estimated to have DSPS.
- Sleep doctors can diagnose DSPS through an interview and a
- DSPS has no known cure, however there are treatments to manage
the chronic sleep disorder.
One final note, Pien adds that in some parts of the country, there
is now a move underway to delay or push back the start time for
high school students because adolescents tend to suffer from lengthened
circadian rhythms. The thought behind this is that teenage students
would function better in school if they could sleep later in the
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