This was an eye-opener indeed. I've always felt that my day is longer than 24 hours, and has had to struggle with sleep all my life. The sleep inertia problem was prevalent until recently. I have a Wake Inertia too, having real problems getting into bed too. I have blamed this on an autistic inertia to change, but this video gives food for thought. Just the other day I asked a friend what would happen if I tried to live 6 days in a week instead, making one diurnal 28 hours. No Mondays! When it comes to DSPS and ASPS people, I listened to Dr. Michael Breus (The Sleep Doctor) many years ago. He names four types. Lion is the early bird, Bear is the chrono-normals, Wolves are night owls, and then there is the Dolphin type who seem to have strange or no pattern at all. He also mentions that there is practically nothing one may do about one's circadian rhythm. I'm also irked by the inevitable reflex by bystanders to try to fix the non-standard sleep patterns. Why not just shrug and say "good luck"? Or for bosses to invent some useful side of this effect outside of the regulations about working hours? Society is the norm, and God forbid that anybody strays from that.
References for treatments Rare Diseases Database, Non-24-Hour Sleep-Wake Disorder. Online article: rarediseases.org/rare-diseases/non-24-hour-sleep-wake-disorder/ 2. Gradisar et al, A randomized controlled trial of cognitive-behavior therapy plus bright light therapy for adolescent delayed sleep phase disorder. Flinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia (2011). Accessed online: pubmed.ncbi.nlm.nih.gov/22131604/ 3. Danielsson et al. Cognitive Behavioral Therapy as an Adjunct Treatment to Light Therapy for Delayed Sleep Phase Disorder in Young Adults: A Randomized Controlled Feasibility Study(2014) Accessed online: www.tandfonline.com/doi/abs/10.1080/15402002.2014.981817?fbclid=IwAR0NbB-8F9bM7vUDTphsxNUH5SWq0VnzyHaQTJnE9bm16SsL3kLc2GQctWA&journalCode=hbsm20 4. Harvard Health Publishing, Blue light has a dark side (2020). Online Harvard Health Letter: www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side 5. Kids Health, Does the Light From a Phone or Computer Make it Hard to Sleep? Online article: kidshealth.org/en/teens/blue-light.html 6. WebMD, Sleep and Blue Light. Online article: www.webmd.com/sleep-disorders/sleep-blue-light 7. Sleep Foundation, Does Blue Light Cause Sleep Issues in Children? Online article: www.sleepfoundation.org/children-and-sleep/how-blue-light-affects-kids-sleep?scroll=top&needAccess=true&journalCode=icbi20 8. Manchester University, Researchers discover when it’s good to get the blues (2019). Online article: www.manchester.ac.uk/discover/news/researchers-discover-when-its-good-to-get-the-blues/ References for melatonin information JF Roche, Effects of Melatonin on the Time of Onset of the Breeding Season in Different Breeds of Sheep (1985). Accessed online: link.springer.com/chapter/10.1007%2F978-94-009-5026-9_7 2. Niles, Wang, Shen, Lobb, & Younglai, Melatonin receptor mRNA expression in human granulosa cells (1999). Accessed online: onlinelibrary.wiley.com/doi/10.1111/rda.13188 3. Lampiao F., and Du Plessis S. S., World Journal of Obstetrics and Gynecology, New developments of the effect of melatonin on reproduction (2013). Accessed online: www.wjgnet.com/2218-6220/full/v2/i2/8.htm 4. Everyday health, Drugs & Supplements, Melatonin (Melatonin Time Release). Viewed online: www.everydayhealth.com/drugs/melatonin 5. Baby Sleep Science, Melatonin is a Hormone. Viewed online: www.babysleepscience.com/single-post/2015/05/19/Melatonin-is-a-Hormone 6. Masters A., Pandi-Perumal S. R., Seixas A., Girardin J., and McFarlane S. I., Melatonin, the Hormone of Darkness: From Sleep Promotion to Ebola Treatment (2019). Accessed online: www.ncbi.nlm.nih.gov/pmc/articles/PMC4334454 7. Fadden J., Melatonin: Why Less Is (Sometimes) More (2010). Online article: delayed2sleep.wordpress.com/2010/04/11/melatonin-less-is-sometimes-more 8. This is Why Melatonin Doesn’t Help Everyone Sleep. Accessed online: www.parsleyhealth.com/blog/melatonin-doesnt-help-everyone-sleep 9. Circadian Sleep Disorders Network, Melatonin. Accessed online: www.circadiansleepdisorders.org 10. Sillers J., Alcohol and Teething: An Oral History. Online article: vinepair.com/articles/alcohol-and-teething-an-oral-history 11. Obladen M., Lethal Lullabies: A History of Opium Use in Infants (2015) journals.sagepub.com/doi/10.1177/0890334415594615 12. Stearns P. N., Rowland P., and Giarnella L., Children's Sleep: Sketching Historical Change (1996). Accessed online: www.jstor.org/stable/3789384?seq=1 Further information about melatonin WHY MICRODOSING MELATONIN CAN BE EFFECTIVE (AND WHY LARGER DOSES CAN ACTUALLY MAKE SLEEP DELAY WORSE) Edited from comments made by James Fadden, Vice President of Circadian Sleep Disorders Network There are basically two ways to take melatonin. Method #1. Take a *very* small dose several hours before bedtime. The best dose and time is around 0.25 to .5 mg around 6-8 hours before bedtime. You don't have to be very precise on either the exact dose (but no more than 0.5 mg) or the timing (any time between 3 and 8 hours before your current bedtime is ok.) This method might seem like it is doing nothing at first. But if you keep it up, it can slowly shift the time you fall asleep. It often takes many days or weeks for this to happen so you have to be patient. There is less data on the proper time to take timed-release melatonin but in theory it should be taken even earlier than immediate release melatonin, so probably 6 or more hours before current bedtime. Timed release melatonin could be effective if taken early enough. One complication is that cutting up timed release melatonin can sometimes cause it to release faster. Method #2. Take a large dose at bedtime or up to 1 hour before bedtime. (Anything above 1 mg is a large dose. 9 mg is very large.) This produces an immediate sedative effect which can help you fall asleep. This method works for some people but there are several problems: 1) melatonin is not a very powerful sedative. It is weak compared to most sleeping pills. 2) you often get used to (develop tolerance) to large doses and they gradually lose effectiveness. So you have to take more and more to get an effect. 3) there is often a rebound effect so you sleep a few hours and then wake up. The causes are a bit technical, but such large doses mean melatonin is still present in your body the next morning. In the long run this presence of melatonin in the body in the morning can cause your sleep time to drift later and later. So you might find melatonin helps at first but you are worse off in the long run. You find yourself falling asleep later, not earlier. Experts who have treated patients using melatonin have often found that rather than increasing the dose, the best strategy when melatonin stops working is to try a lower dose. It sound paradoxical but it often works. Finally, it must be said that melatonin is not effective for everyone. If you find you don't get results from either a small or large dose then melatonin may not work for you. But taking larger and larger doses to try to make it work is rarely a winning strategy. About James Fadden: I have had sleep problems since childhood which later turned into DSPS and then N24 at a time when doctors did not know anything about these disorders. These disorders had a major negative effect on my life so I set about learning everything I could about circadian rhythms and sleep, over many decades. I have copies of literally thousands of articles (paper and pdf) on the topic. It helped that I had a strong background in science (biochemistry degree with high honors from Harvard, including neurology classes at the medical school). My sleep is still horrible but at least I understand better why it is so bad. (Sad but true!) References for education impact 1. Boston Children's Hospital, Delayed Sleep Wake Phase Disorder. Online article: www.childrenshospital.org/conditions-and-treatments/conditions/d/delayed-sleep-wake-phase-disorder 2. Cleveland Clinic, Delayed Sleep-Wake Phase Disorder (DSWPD) in Children and Adolescents. Online article: my.clevelandclinic.org/health/diseases/14295-delayed-sleep-phase-syndrome-dsps-in-children-and-adolescents 3. Gradisar M., and Crowley S. J., Delayed Sleep Phase Disorder in Youth (2013). Accessed online: www.ncbi.nlm.nih.gov/pmc/articles/PMC4142652/ 4. World Economic Forum, 10 reasons why Finland's education system is the best in the world. Online article: www.weforum.org/agenda/2018/09/10-reasons-why-finlands-education-system-is-the-best-in-the-world 5. Independent Australia, Isn't it about time? Schools should be starting later. Online article: independentaustralia.net/life/life-display/isnt-it-about-time-schools-should-be-starting-later,12523 References for health impact 1. Technology Networks. Gene Switches Could Turn Early Birds Into Night Owls. (May 2021) Online article: www.technologynetworks.com/neuroscience/news/gene-switches-could-turn-early-birds-into-night-owls-348454?fbclid=IwAR05NcomTkTsaXxnSH7FGQX011hLDvgWgfdBSqOPttzf9_cPSptnB78eaIY 2. Kamei et al, Clinical characteristics of circadian rhythm sleep disorders (2008). Url: onlinelibrary.wiley.com/doi/abs/10.1111/j.1440-1819.1998.tb01049.x 3. Coles et al, Sleep, Circadian Rhythms, and Anxious Traits (2015). Url: pubmed.ncbi.nlm.nih.gov/26216591/ 4. Depner et al, Metabolic consequences of sleep and circadian disorders (2015). Url: www.ncbi.nlm.nih.gov/pmc/articles/PMC4308960/ 5. Reitz C. J. and Martino T. A., Disruption of Circadian Rhythms and Sleep on Critical Illness and the Impact on Cardiovascular Events (2015). Url: pubmed.ncbi.nlm.nih.gov/26144940/ 6. Liu L. and Ancoli-Israel S., Sleep Disturbances in Cancer (2008). Url: www.ncbi.nlm.nih.gov/pmc/articles/PMC3021374/ 7. Choy E. H. S., The role of sleep in pain and fibromyalgia (2015). Url: pubmed.ncbi.nlm.nih.gov/25907704/ Support resources Circadian Sleep Disorders website: www.circadiansleepdisorders.org/ List of doctors who have diagnosed DSPS and.or Non-24: www.circadiansleepdisorders.org/doctors.php Facebook support groups: DSPS (Delayed-Sleep-Phase-Syndrome): facebook.com/groups/2227764796/ Non-24-Hour Sleep-Wake Disorder Support Group: facebook.com/groups/30934017332 PDA (group open to parents and professionals, and admired entirely by adult PDAers): facebook.com/groups/PDAinc
I’m curious, is there a way to get an official diagnosis of either of these? I’ve struggled with sleep my entire life, been made to feel lazy by the rest of “rise with the sun” society, also considering it could be that my brain fights sleep due to childhood trauma.. only at 40 realizing I probably have pda accompanying my AuDHD..and DSPS sounds incredibly likely, rather than a moral deficiency “if I could just force myself to go to sleep I could be a morning person.” I’ve been on sleeping pills most of my adult life, otherwise I would be awake all night
This was an eye-opener indeed. I've always felt that my day is longer than 24 hours, and has had to struggle with sleep all my life. The sleep inertia problem was prevalent until recently. I have a Wake Inertia too, having real problems getting into bed too. I have blamed this on an autistic inertia to change, but this video gives food for thought. Just the other day I asked a friend what would happen if I tried to live 6 days in a week instead, making one diurnal 28 hours. No Mondays!
When it comes to DSPS and ASPS people, I listened to Dr. Michael Breus (The Sleep Doctor) many years ago. He names four types. Lion is the early bird, Bear is the chrono-normals, Wolves are night owls, and then there is the Dolphin type who seem to have strange or no pattern at all. He also mentions that there is practically nothing one may do about one's circadian rhythm.
I'm also irked by the inevitable reflex by bystanders to try to fix the non-standard sleep patterns. Why not just shrug and say "good luck"? Or for bosses to invent some useful side of this effect outside of the regulations about working hours? Society is the norm, and God forbid that anybody strays from that.
My mind is blown. Thank you for sharing this info. I have a new rabbit hole to go down. LoL
References for treatments
Rare Diseases Database, Non-24-Hour Sleep-Wake Disorder. Online article: rarediseases.org/rare-diseases/non-24-hour-sleep-wake-disorder/
2. Gradisar et al, A randomized controlled trial of cognitive-behavior therapy plus bright light therapy for adolescent delayed sleep phase disorder. Flinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia (2011). Accessed online: pubmed.ncbi.nlm.nih.gov/22131604/
3. Danielsson et al. Cognitive Behavioral Therapy as an Adjunct Treatment to Light Therapy for Delayed Sleep Phase Disorder in Young Adults: A Randomized Controlled Feasibility Study(2014) Accessed online: www.tandfonline.com/doi/abs/10.1080/15402002.2014.981817?fbclid=IwAR0NbB-8F9bM7vUDTphsxNUH5SWq0VnzyHaQTJnE9bm16SsL3kLc2GQctWA&journalCode=hbsm20
4. Harvard Health Publishing, Blue light has a dark side (2020). Online Harvard Health Letter: www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side
5. Kids Health, Does the Light From a Phone or Computer Make it Hard to Sleep? Online article: kidshealth.org/en/teens/blue-light.html
6. WebMD, Sleep and Blue Light. Online article: www.webmd.com/sleep-disorders/sleep-blue-light
7. Sleep Foundation, Does Blue Light Cause Sleep Issues in Children? Online article: www.sleepfoundation.org/children-and-sleep/how-blue-light-affects-kids-sleep?scroll=top&needAccess=true&journalCode=icbi20
8. Manchester University, Researchers discover when it’s good to get the blues (2019). Online article: www.manchester.ac.uk/discover/news/researchers-discover-when-its-good-to-get-the-blues/
References for melatonin information
JF Roche, Effects of Melatonin on the Time of Onset of the Breeding Season in Different Breeds of Sheep (1985). Accessed online: link.springer.com/chapter/10.1007%2F978-94-009-5026-9_7
2. Niles, Wang, Shen, Lobb, & Younglai, Melatonin receptor mRNA expression in human granulosa cells (1999). Accessed online: onlinelibrary.wiley.com/doi/10.1111/rda.13188
3. Lampiao F., and Du Plessis S. S., World Journal of Obstetrics and Gynecology, New developments of the effect of melatonin on reproduction (2013). Accessed online: www.wjgnet.com/2218-6220/full/v2/i2/8.htm
4. Everyday health, Drugs & Supplements, Melatonin (Melatonin Time Release). Viewed online: www.everydayhealth.com/drugs/melatonin
5. Baby Sleep Science, Melatonin is a Hormone. Viewed online: www.babysleepscience.com/single-post/2015/05/19/Melatonin-is-a-Hormone
6. Masters A., Pandi-Perumal S. R., Seixas A., Girardin J., and McFarlane S. I., Melatonin, the Hormone of Darkness: From Sleep Promotion to Ebola Treatment (2019). Accessed online: www.ncbi.nlm.nih.gov/pmc/articles/PMC4334454
7. Fadden J., Melatonin: Why Less Is (Sometimes) More (2010). Online article: delayed2sleep.wordpress.com/2010/04/11/melatonin-less-is-sometimes-more
8. This is Why Melatonin Doesn’t Help Everyone Sleep. Accessed online: www.parsleyhealth.com/blog/melatonin-doesnt-help-everyone-sleep
9. Circadian Sleep Disorders Network, Melatonin. Accessed online: www.circadiansleepdisorders.org
10. Sillers J., Alcohol and Teething: An Oral History. Online article: vinepair.com/articles/alcohol-and-teething-an-oral-history
11. Obladen M., Lethal Lullabies: A History of Opium Use in Infants (2015) journals.sagepub.com/doi/10.1177/0890334415594615
12. Stearns P. N., Rowland P., and Giarnella L., Children's Sleep: Sketching Historical Change (1996). Accessed online: www.jstor.org/stable/3789384?seq=1
Further information about melatonin
WHY MICRODOSING MELATONIN CAN BE EFFECTIVE (AND WHY LARGER DOSES CAN ACTUALLY MAKE SLEEP DELAY WORSE)
Edited from comments made by James Fadden, Vice President of Circadian Sleep Disorders Network
There are basically two ways to take melatonin.
Method #1. Take a *very* small dose several hours before bedtime. The best dose and time is around 0.25 to .5 mg around 6-8 hours before bedtime. You don't have to be very precise on either the exact dose (but no more than 0.5 mg) or the timing (any time between 3 and 8 hours before your current bedtime is ok.)
This method might seem like it is doing nothing at first. But if you keep it up, it can slowly shift the time you fall asleep. It often takes many days or weeks for this to happen so you have to be patient.
There is less data on the proper time to take timed-release melatonin but in theory it should be taken even earlier than immediate release melatonin, so probably 6 or more hours before current bedtime. Timed release melatonin could be effective if taken early enough. One complication is that cutting up timed release melatonin can sometimes cause it to release faster.
Method #2. Take a large dose at bedtime or up to 1 hour before bedtime. (Anything above 1 mg is a large dose. 9 mg is very large.) This produces an immediate sedative effect which can help you fall asleep.
This method works for some people but there are several problems:
1) melatonin is not a very powerful sedative. It is weak compared to most sleeping pills.
2) you often get used to (develop tolerance) to large doses and they gradually lose effectiveness. So you have to take more and more to get an effect.
3) there is often a rebound effect so you sleep a few hours and then wake up.
The causes are a bit technical, but such large doses mean melatonin is still present in your body the next morning. In the long run this presence of melatonin in the body in the morning can cause your sleep time to drift later and later. So you might find melatonin helps at first but you are worse off in the long run. You find yourself falling asleep later, not earlier.
Experts who have treated patients using melatonin have often found that rather than increasing the dose, the best strategy when melatonin stops working is to try a lower dose. It sound paradoxical but it often works.
Finally, it must be said that melatonin is not effective for everyone. If you find you don't get results from either a small or large dose then melatonin may not work for you. But taking larger and larger doses to try to make it work is rarely a winning strategy.
About James Fadden: I have had sleep problems since childhood which later turned into DSPS and then N24 at a time when doctors did not know anything about these disorders. These disorders had a major negative effect on my life so I set about learning everything I could about circadian rhythms and sleep, over many decades. I have copies of literally thousands of articles (paper and pdf) on the topic. It helped that I had a strong background in science (biochemistry degree with high honors from Harvard, including neurology classes at the medical school). My sleep is still horrible but at least I understand better why it is so bad. (Sad but true!)
References for education impact
1. Boston Children's Hospital, Delayed Sleep Wake Phase Disorder. Online article: www.childrenshospital.org/conditions-and-treatments/conditions/d/delayed-sleep-wake-phase-disorder
2. Cleveland Clinic, Delayed Sleep-Wake Phase Disorder (DSWPD) in Children and Adolescents. Online article: my.clevelandclinic.org/health/diseases/14295-delayed-sleep-phase-syndrome-dsps-in-children-and-adolescents
3. Gradisar M., and Crowley S. J., Delayed Sleep Phase Disorder in Youth (2013). Accessed online: www.ncbi.nlm.nih.gov/pmc/articles/PMC4142652/
4. World Economic Forum, 10 reasons why Finland's education system is the best in the world. Online article: www.weforum.org/agenda/2018/09/10-reasons-why-finlands-education-system-is-the-best-in-the-world
5. Independent Australia, Isn't it about time? Schools should be starting later. Online article: independentaustralia.net/life/life-display/isnt-it-about-time-schools-should-be-starting-later,12523
References for health impact
1. Technology Networks. Gene Switches Could Turn Early Birds Into Night Owls. (May 2021) Online article: www.technologynetworks.com/neuroscience/news/gene-switches-could-turn-early-birds-into-night-owls-348454?fbclid=IwAR05NcomTkTsaXxnSH7FGQX011hLDvgWgfdBSqOPttzf9_cPSptnB78eaIY
2. Kamei et al, Clinical characteristics of circadian rhythm sleep disorders (2008). Url: onlinelibrary.wiley.com/doi/abs/10.1111/j.1440-1819.1998.tb01049.x
3. Coles et al, Sleep, Circadian Rhythms, and Anxious Traits (2015). Url: pubmed.ncbi.nlm.nih.gov/26216591/
4. Depner et al, Metabolic consequences of sleep and circadian disorders (2015). Url: www.ncbi.nlm.nih.gov/pmc/articles/PMC4308960/
5. Reitz C. J. and Martino T. A., Disruption of Circadian Rhythms and Sleep on Critical Illness and the Impact on Cardiovascular Events (2015). Url: pubmed.ncbi.nlm.nih.gov/26144940/
6. Liu L. and Ancoli-Israel S., Sleep Disturbances in Cancer (2008). Url: www.ncbi.nlm.nih.gov/pmc/articles/PMC3021374/
7. Choy E. H. S., The role of sleep in pain and fibromyalgia (2015). Url: pubmed.ncbi.nlm.nih.gov/25907704/
Support resources
Circadian Sleep Disorders website: www.circadiansleepdisorders.org/
List of doctors who have diagnosed DSPS and.or Non-24: www.circadiansleepdisorders.org/doctors.php
Facebook support groups:
DSPS (Delayed-Sleep-Phase-Syndrome): facebook.com/groups/2227764796/
Non-24-Hour Sleep-Wake Disorder Support Group: facebook.com/groups/30934017332
PDA (group open to parents and professionals, and admired entirely by adult PDAers): facebook.com/groups/PDAinc
Well, that’s me probably!
I’m curious, is there a way to get an official diagnosis of either of these? I’ve struggled with sleep my entire life, been made to feel lazy by the rest of “rise with the sun” society, also considering it could be that my brain fights sleep due to childhood trauma.. only at 40 realizing I probably have pda accompanying my AuDHD..and DSPS sounds incredibly likely, rather than a moral deficiency “if I could just force myself to go to sleep I could be a morning person.” I’ve been on sleeping pills most of my adult life, otherwise I would be awake all night