Delayed Sleep Wake Phase Disorder

What is delayed sleep-wake phase disorder?

Does your child stay up very late and have great difficulty waking up for school in the morning? Does he or she seem tired during school hours, but then can't fall asleep until well after midnight? On school vacations, does your child naturally go to bed at 2 or 3 a.m. and sleep until after noon, waking up feeling refreshed?

It might be that your child is suffering from delayed sleep-wake phase disorder (DSWPD), a circadian rhythm disorder that occurs when a child's natural sleep and wake schedule is shifted later, by at least several hours, and thus conflicts with daily obligations such as school attendance.

Children with DSWPD typically cannot fall asleep at the appropriate or desired time of night, but are able to fall asleep readily around midnight or later. The natural morning wake time is similarly delayed, often making it extremely difficult to become alert before the late morning or early afternoon. The times of day when children “feel their best” are also shifted later, so that they may feel most alert and functional in the mid-afternoon or late at night. When allowed to sleep on their preferred later schedule, most children with DSWPD feel rested and can function well. However, when their natural schedule conflicts with normal school, work or lifestyle demands, delayed sleep-wake phase disorder can impair a child’s functioning during the day. Untreated, DSWPD can lead to social impairment, academic and behavioral problems and depression.

This disorder is most common in adolescents and young adults. Between 7 and 16 percent of adolescents exhibit symptoms of delayed sleep-wake phase disorder.

Care for delayed sleep-wake phase disorder

Specialists at Boston Children's Hospital's Sleep Center are experienced in treating children who have DSWPD, so your whole family can get a good night's sleep.

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