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Wednesday, September 21, 2011

Delayed Sleep Phase Syndrome: Cant sleep at night !!!!!


I cant remember the last time I slept like a baby at night. I cant remember the last time I did not toss and turn in my sleep all night and woke up feeling tired and drowsy. I cant remember the last time when I had a really fresh day, one where I didn't feel sleepy even once......

Its been years and years now that I have had to hear from people close to me how lazy I am that I don't get up 'early' by instinct, that I am not perfect since I'm a late sleeper and a later riser. That there's something wrong with me because I don't follow the 'natural' pattern of 'early to bed early to rise.' Not that I never tried, its just that my body clock has never adjusted to this routine, and no matter how much I try, I can never fall asleep before at least 2:30-03:00am. and many times I am happily awake till even 5.30, when I finally begin to feel drowsy.Through the week I sustain on a maximum of 4, or if I'm lucky, then 5 hours of sleep a day. And on weekends, I try and recover as much of it as I can, though its not much really. I mean, how much can you sleep on a weekend anyway? I get irritated, sad, depressed, angry and upset that all my efforts to get into a 'proper' routine don't work, and hurt at the constant complaints about my schedule. Finally, my body gives up once in a month or so, and I simply am unable to get up from the bed, and have to sleep it off no matter what. This is also accompanied by body ache and fever, one that comes and goes for a few days, and finally, I feel a little refreshed, again to go back to that 4-5 hours of sleep forever....

So it was sort of an eye-opener when I read an article in the Mumbai Mirror today. I learnt that I was not the only one who was going through this tremendously strenuous routine. And I learnt that this 'lazy' and 'imperfect' lifestyle that I've been accused of having all my life is actually a medical condition which has finally been given a name. I am copying out the entire article here for your benefit. This is from the Mumbai Mirror edition of September 21 2011.

The article:

The world is divided into morning people and night people. For the latter, nothing makes sense until noon. They may be awake but they can't be roused, not even with the harsh tags of 'night owl', 'sleepyhead' or 'downright lazy'.

But at least for some, the inability to get into bed before 3 am or 4 am and out of it until the sun is high overhead could well be a disorder. A person suffering from Delayed Sleep Phase Syndrome (DSPS) finds it very challenging to fit into the mainstream sleep schedule of the world. Sleep medicine specialist Dr. Preeti Devnani, from Sleep Disorders Clinic, Khar, says DSPS is not easy to diagnose and is often confused with insomnia but is actually quite different.

Day Or Night

The internal body clock of a person with DSPS is typically out of whack with the sun. In other words, it is a disruption of their circadian rhythm. They can't follow the typical sleep-at-night, rise-in-the-morning routine that the rest of humanity follows.
They sleep late, often in the pre-dawn hours, and wake in the late morning or in the afternoon. And because they have to fall in line in order to get to work and be productive members of the economy, they often end up building up a huge 'sleep debt'. They may have difficulty thinking clearly and functioning optimally. This could, over time, lead to to clinical depression or other stress-related problems. However, if such people are allowed to follow their instincts, they wake up refreshed.
The problem is, DSPS patients find it very difficult to shift their routine, unlike 'owls' and 'larks'. Which is why you may find them working night shifts or in industries that allow them to start the day late. Joining Batman is probably one alternative.
Forced to work 9 to 5, these people may get only a few hours every night and then 'catch up' on the weekends, when they are not likely to opt for a morning trek. Some say this is like living with a jetlag.
The life of DSPS patients becomes a constant struggle. "It can lead to mood swings and depression. Sometimes, people end up self-medicating with alcohol," Dr Devnani says.

What Causes It?

For may, the night owl pattern is evident from childhood. They are unable to adjust to school hours. For others, the disorder develops during adolescence, sometimes because of late study hours. Research is relatively new in the area and some suggest this problem may be genetic. Studies show that the eye has a receptor that is sensitive to light. It is possible that some blind people maintain a regular schedule because they have this receptor. Similarly, some normally sighted people are deficient in this third kind of receptor and so do not entrain their schedules well to daylight. Also, body temperature varies on a daily cycle, rising during the day, peaking in the evening, and falling at night. For most people with DSPS, this temperature pattern shifts.

Treatments

While some specialists suggest there is no real cure for DSPS, Dr Devnani says the situation is not entirely hopeless. The condition can be managed with treatment.
The first step, of course, is to follow good sleep hygiene. Some of the other treatments include bright light therapy, which entails going out in the sunlight early in the morning or sitting in front of a bright light designed for this purpose. People suffering this disorder are also prescribed melatonin, the chemical that regulates the circadian rhythm. In chronotherapy, a person is asked to shift sleep time later instead of earlier. Typically, sleep time is shifted three hours later each day, all the way around the clock, until the desired schedule is reached.

CaseStudy:

Kalpesh Shah, 31, Mumbai:
I guess the price of living in this city is that you have trouble with sleep. No matter how early I got up, I couldn't sleep until 2.30 am or 3 am. I am a builder and need to get to work by 9am. As a result, I was running low on rest.
I suffered from anxiety, lethargy throughout the day as well as severe acidity. Even while I was asleep, my mind remained active and I kept tossing and turning. I thought it was insomnia. I looked it up online and decided I could do with some help.
The doctor at the Sleep Disorders Clinic asked me to maintain a sleep log. She also asked me to use a device for an actigraphy study, which monitors rest and wakefulness, and monitored the light in my room.
Dr Devnani told me I had DSPS. I didn't even know such a disorder existed. She gave me a lot of reading material.
While I was growing up, I would watch television late into the night. I used to work late and eat late. So my lifestyle was the culprit. I had to make major changes in my routine to get enough sleep at the right time.
I am not allowed tea after 4pm and don't smoke in the evenings. I have to finish dinner two hours before bedtime. I shower just before sleeping and have warm milk. I avoid light in the evening. My bedroom is for sleep only, no laptop or cellphone is allowed inside it. I have also started practising Yoga. I am now able to sleep earlier and feel fresh.'

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And like I always believe in and say:
"Heal the world we live in
Save it for our children" - MJ

Debolina Raja Gupta