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Delayed Sleep-Wake Phase Disorder (DSWPD)

Adam J. Sorscher, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Circadian rhythm sleep disorders (CRSDs) are a family of conditions that occur when an individual's preferred timing of sleep is at odds with commitments to job, school, family, or s...

DIAGNOSIS

HISTORY

  • People with DSWPD report both sleep initiation insomnia and excessive sleepiness in the daytime. They do not initiate sleep until 2 to 6 hours later than normative sleep times, and th...

TREATMENT

  • The goal of treatment in DSWPD is to help the individual consistently initiate sleep at an earlier time. The principal therapies that advance sleep onset are properly timed light and melaton...

ONGOING CARE

Remind patients to practice healthy sleep behaviors (see “General Prevention”) if they wish to maintain an earlier sleep/wake pattern. 

PATIENT EDUCATION

American Academy of Family Physicia...

REFERENCES

1
Wyatt JK, Stepanski EJ, Kirkby J. Circadian phase in delayed sleep phase syndrome: predictors and temporal stability across multiple assessments. Sleep.  2006;29(8):1075–1080. {L-End}...

ADDITIONAL READING

  • Barion A, Zee PC. A clinical approach to circadian rhythm sleep disorders. Sleep Med.  2007;8(6):566–577.

  • Kanathur N, Harrington J, Lee-Chiong TJr. Circadian rhythm sleep disord...

CODES

ICD10

G47.21 Circadian rhythm sleep disorder, delayed sleep phase type 

ICD9

327.31 Circadian rhythm sleep disorder, delayed sleep phase type 

SNOMED

80623000 Sleep-wake schedule disorder, delayed ph...

CLINICAL PEARLS

  • The tendency to become “night-owlish” with adolescence is, to a large extent, a biologically programmed phenomenon, not strictly a behavioral choice. Enlightened public policy would re...

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