Can you make this night owl an early bird?
June 10, 2010 8:44 PM Subscribe
Delayed sleep phase syndrome: whats working for you? Can you be as productive living "normal hours"?
I'm about 99% certain I have delayed sleep phase syndrome. I've had sleep studies done showing no other sleep disorders, I don't use caffeine or other stimulants and as part of my job I teach others how to implement sleep hygiene and I practice what I preach.
So assuming I'm right, is this worth trying to treat? Most informational sites say its hard to treat. I am immune compromised and have an auto-immune disorder, which means I cannot safely take Melatonin or do chronotherapy. I'd try drugs but would prefer to avoid them, as I'm already taking a lot for my chronic medical condition. I'm game for trying bright light therapy, but it sounds like a hit-or-miss process.
I kind of like my schedule. I am in school and find myself most productive between 9pm and 3am, going to bed at 4am, waking at 10:30 or so, and taking a two hour nap in the late afternoon (usually around four). I can sleep traditional hours some days, but its not restful and I find myself needing to sleep during my usual hours in addition to feel rested.
If its possible that I could get on a "normal" schedule, I'm worried I'll be awake during my unproductive hours and missing the time that has been most useful for me getting work done. If you've gotten treatment, can you work better during the day now? Its inconvenient to live this way but workable, mostly. I'd rather get work done than sleep like a normal person, at this point at least, so your answer to this would be useful in determining if I should involve doctors.
So after that long intro: what has been your experience with treatments? Can you now function during the day or are you just able to sleep on a traditional schedule but not really at your best? Any insights to pass along, or doctors in the lower peninsula of Michigan to suggest?
I'm about 99% certain I have delayed sleep phase syndrome. I've had sleep studies done showing no other sleep disorders, I don't use caffeine or other stimulants and as part of my job I teach others how to implement sleep hygiene and I practice what I preach.
So assuming I'm right, is this worth trying to treat? Most informational sites say its hard to treat. I am immune compromised and have an auto-immune disorder, which means I cannot safely take Melatonin or do chronotherapy. I'd try drugs but would prefer to avoid them, as I'm already taking a lot for my chronic medical condition. I'm game for trying bright light therapy, but it sounds like a hit-or-miss process.
I kind of like my schedule. I am in school and find myself most productive between 9pm and 3am, going to bed at 4am, waking at 10:30 or so, and taking a two hour nap in the late afternoon (usually around four). I can sleep traditional hours some days, but its not restful and I find myself needing to sleep during my usual hours in addition to feel rested.
If its possible that I could get on a "normal" schedule, I'm worried I'll be awake during my unproductive hours and missing the time that has been most useful for me getting work done. If you've gotten treatment, can you work better during the day now? Its inconvenient to live this way but workable, mostly. I'd rather get work done than sleep like a normal person, at this point at least, so your answer to this would be useful in determining if I should involve doctors.
So after that long intro: what has been your experience with treatments? Can you now function during the day or are you just able to sleep on a traditional schedule but not really at your best? Any insights to pass along, or doctors in the lower peninsula of Michigan to suggest?
I've never been officially diagnosed, but I am 99% certain I have Delayed-phase sleep syndrome. It started as young as adolescence, and has made my life difficult ever since. I feel tired all day until it gets around 10-11pm, and then all of a sudden I'm awake and alert. It's just plain cruel, is what it is.
I've tried every pharmaceutical treatment out there. The only thing that worked robustly and consistently for me was an antidepressant called Remeron (mirtazapine). It's the ICBM of H1 antagonists, and it will knock you the fuck out, no questions asked. The only probably is that it will also make you hungry, and the hunger will make you eat, and the eating will make you gain weight. People tend to gain 20+ lbs on this drug on average, so miracle or not, it's not what you would call sustainable over the lone term. That's certainly why I quit.
Now I take Ambien (between 2.5 an 7.5mg a work-night) several nights a week. I also take 75mg/night of OTC diphenhydramine every night. Tolerance develops, but it's not as severe as with other drugs.
I also make a point of avoiding bright lights after minddight, and all caffeine after noon. I also exercise whenever I have the time. Each of these steps alone doesn't make much difference, but I believe together they add up to help, even if they don't entirely fix the problem.
posted by dephlogisticated at 9:26 PM on June 10, 2010
I've tried every pharmaceutical treatment out there. The only thing that worked robustly and consistently for me was an antidepressant called Remeron (mirtazapine). It's the ICBM of H1 antagonists, and it will knock you the fuck out, no questions asked. The only probably is that it will also make you hungry, and the hunger will make you eat, and the eating will make you gain weight. People tend to gain 20+ lbs on this drug on average, so miracle or not, it's not what you would call sustainable over the lone term. That's certainly why I quit.
Now I take Ambien (between 2.5 an 7.5mg a work-night) several nights a week. I also take 75mg/night of OTC diphenhydramine every night. Tolerance develops, but it's not as severe as with other drugs.
I also make a point of avoiding bright lights after minddight, and all caffeine after noon. I also exercise whenever I have the time. Each of these steps alone doesn't make much difference, but I believe together they add up to help, even if they don't entirely fix the problem.
posted by dephlogisticated at 9:26 PM on June 10, 2010
I think it is possible to train yourself to have a traditional sleep schedule based on my experience, but I am not sure why you want that based on what you wrote other than you think you should sleep "normal" hours. I think the best thing you can do for yourself is sleep hours that leave you with productive time and allow you to fit your obligations in at the time they are.
I have had all sorts of sleep schedules. I have been a midnight to 7am guy, when I lived on the west coast but traded, I was going to sleep at 9pm and waking at 3am. I had a job that was 10-6 and for that I was a 3am to 9am guy. Now, being flexible I often go to sleep at 4:00am and wake at 8:30 and take several 30 minute naps throughout the day. I too think I am most productive from around 11pm to 3am. I have spoken at length with my gp about this. He is a traditional guy who has a hard time grasping the concept that odd sleep hours cannot be adjusted to fit what "everyone else" is doing, but he says that the time during which you sleep is less important than the amount and type of sleep. He claims that you can adjust your sleep to fit whatever pattern you want and be productive. His only issue is that I get a certain amount of REM each night. For snoring reasons, I sleep with a CPAP machine. There is no doubt that when I use it, I am more rested than when I do not.
When I needed the west coast sleep pattern mentioned above, it was so "foreign" to my thought process, I used my own home brew light therapy to switch my hours and stay with them. At night I used blackout shades and blankets over the windows in both the living room and bedroom to "trick" myself into thinking it was middle of the night. I set timers and when my alarm went off at 3:07am, despite it being pitch black outside, my bedroom and bathroom had bright lights on. (My wife was not so down with the whole thing). Anyway, in hindsight, it had no effect other than helping me get out of bed on the first alarm rather than hitting the snooze button. When I got 6 hours, I was good to go. When I got much less, I was a miserable fuck all day.
I guess my question to you is why do you want a traditional or "normal" schedule if you don't have to have it and it doesn't suit your body? Just get enough sleep at whatever time so that you are rested and productive when you want and need to be.
posted by JohnnyGunn at 9:42 PM on June 10, 2010
I have had all sorts of sleep schedules. I have been a midnight to 7am guy, when I lived on the west coast but traded, I was going to sleep at 9pm and waking at 3am. I had a job that was 10-6 and for that I was a 3am to 9am guy. Now, being flexible I often go to sleep at 4:00am and wake at 8:30 and take several 30 minute naps throughout the day. I too think I am most productive from around 11pm to 3am. I have spoken at length with my gp about this. He is a traditional guy who has a hard time grasping the concept that odd sleep hours cannot be adjusted to fit what "everyone else" is doing, but he says that the time during which you sleep is less important than the amount and type of sleep. He claims that you can adjust your sleep to fit whatever pattern you want and be productive. His only issue is that I get a certain amount of REM each night. For snoring reasons, I sleep with a CPAP machine. There is no doubt that when I use it, I am more rested than when I do not.
When I needed the west coast sleep pattern mentioned above, it was so "foreign" to my thought process, I used my own home brew light therapy to switch my hours and stay with them. At night I used blackout shades and blankets over the windows in both the living room and bedroom to "trick" myself into thinking it was middle of the night. I set timers and when my alarm went off at 3:07am, despite it being pitch black outside, my bedroom and bathroom had bright lights on. (My wife was not so down with the whole thing). Anyway, in hindsight, it had no effect other than helping me get out of bed on the first alarm rather than hitting the snooze button. When I got 6 hours, I was good to go. When I got much less, I was a miserable fuck all day.
I guess my question to you is why do you want a traditional or "normal" schedule if you don't have to have it and it doesn't suit your body? Just get enough sleep at whatever time so that you are rested and productive when you want and need to be.
posted by JohnnyGunn at 9:42 PM on June 10, 2010
I have the same problem. I've read a couple of articles recently that said that having breakfast at the same time each day (that is, when you break your 8-hour-long fast) will train your body to want food at that time every day and wake you. So in theory if you need to be up at 8am, stop eating after midnight and then force yourself to get up and have a bowl of cereal (or whatever you eat for breakfast) at 8, it will help.
posted by IndigoRain at 9:46 PM on June 10, 2010 [2 favorites]
posted by IndigoRain at 9:46 PM on June 10, 2010 [2 favorites]
You kind of like your schedule. You're in school, so as long as you're not sleeping through (too many) classes, why should you change it?
I've always been more productive in the late hours. I'm very lucky to be in a job with flexible hours now, and I'm just much happier if I don't try to force myself to wake up at 7 am. Or if I do wake up at 7 I generally go down for a nap around 10 am again. Who's to tell me otherwise?
Now, if you foresee a future in which you can't pick your hours, you might want to try some of the above techniques... but for now, why try to mess with your own natural hours?
posted by nat at 11:05 PM on June 10, 2010
I've always been more productive in the late hours. I'm very lucky to be in a job with flexible hours now, and I'm just much happier if I don't try to force myself to wake up at 7 am. Or if I do wake up at 7 I generally go down for a nap around 10 am again. Who's to tell me otherwise?
Now, if you foresee a future in which you can't pick your hours, you might want to try some of the above techniques... but for now, why try to mess with your own natural hours?
posted by nat at 11:05 PM on June 10, 2010
Can you control your meal times? Finish consuming any food before 7:00 PM. Set your alarm to wake up at 6:30 AM, eat breakfast no later than 7:00 AM - but don't eat or drink between the 7:00 PM dinner/supper and 7:00 AM breakfast. Keep at it for a few weeks. The idea here is to switch your biological clock. Basically, food consumption is connected with your sleep cycle, partially through the liver-glucose release connection. I sympathize as I've suffered from this for awhile, and I can get it under control when I eat as I described (though I eat only twice a day). Unfortunately, I don't always get the chance to stick to my eating schedule due to external obligations, and then it's back to the hell of out of whack sleeping cycle. The other thing that you need is exercise - daily, and keep your calories lowish - it will drain excess glucose from your system, allowing you to crash into sleep relatively early 11 PM - midnight, and hopefully stay asleep until it's time to get up. If the body is habituated to an early breakfast, then that's where the clock will set the wake time; in an energy deficit situation, there is extra pressure for the wake time, meanwhile the long break between the dinner/supper and breakfast will allow you to go to sleep and stay asleep. This won't work though, if you consume a lot of calories, because then your body can just keep up the energy late into the night - that's the point of the exercise and keeping the calories lowish... it pulls out excess energy from your system. Bonus: you might lose weight (if you need to) and low calories + exercise is associated with superior health outcomes. Good luck!
posted by VikingSword at 11:41 PM on June 10, 2010 [1 favorite]
posted by VikingSword at 11:41 PM on June 10, 2010 [1 favorite]
I have seen a number of specialists and tried a number of schedule-changing schemes for DSPS. Nothing works for more than a couple of weeks, and it is not a pleasant couple of weeks. My experience with chronotherapy, and routines and 'hygiene' and other clock-resetting hijinx, is that the second you are a tiny bit off -- you sleep in an extra hour on Saturday or something -- the entire deal is out the window. Not a pleasant or realistic way to live.
I would stay the course with sleeping when it works best until/unless you hit a point in your life where you need to sleep 'normal' hours, and, in that case, drugging; you may find it does not take much to get the job done. I have taken Imovane throughout most of my adult life, with no increased tolerance or other hassles.
posted by kmennie at 6:13 AM on June 11, 2010 [2 favorites]
I would stay the course with sleeping when it works best until/unless you hit a point in your life where you need to sleep 'normal' hours, and, in that case, drugging; you may find it does not take much to get the job done. I have taken Imovane throughout most of my adult life, with no increased tolerance or other hassles.
posted by kmennie at 6:13 AM on June 11, 2010 [2 favorites]
Re: lightboxes. What you need is full spectrum light of about 10,000 lux shined on your face, but not directly into your eyes. There's nothing that makes lightboxes different from other lights except that they're specifically designed to meet those criteria. But if you already have a light that meets those criteria, try it out.
posted by decathecting at 8:09 AM on June 11, 2010
posted by decathecting at 8:09 AM on June 11, 2010
I have this. Sleep cues and circadian rhythm are really complicated. The few prescriptions I've tried had side effects (stuttering, mood) or were ineffective or countereffective. My cousin has it as well and uses the light in her Canadian winter and she says it is effective, when I tried the light actually exacerbated the problem.
Interestingly (for me anyway) I've lived from Alaska to Louisiana and found that the closer to the equator I am the easier it is to be consistent on any schedule and the more I exercise the easier it is to be consistent. I also need to stay away from late night gaming. No matter what though my brain still defaults to staying up too late. If I could go back 28 years and talk to my 18 year old self I would tell me that I would find myself happier if I could find work that accommodates my natural schedule rather than try and force my natural schedule to accommodate work hours. Trying the latter has caused my quality of life to suffer. Your experience may be different though as it was for my cousin and many others.
There is a spectrum of how effective any treatment can be so I'd advise that you try some of the less drastic therapies* soon while you have the bit of latitude that going to school grants you and pay attention to your baseline mood. You need to know now if you can maintain and be happy working "regular" hours to make the right decisions for the future.
The wiki article is well done I think.
*Skip the beer one though.
posted by vapidave at 8:26 AM on June 11, 2010
Interestingly (for me anyway) I've lived from Alaska to Louisiana and found that the closer to the equator I am the easier it is to be consistent on any schedule and the more I exercise the easier it is to be consistent. I also need to stay away from late night gaming. No matter what though my brain still defaults to staying up too late. If I could go back 28 years and talk to my 18 year old self I would tell me that I would find myself happier if I could find work that accommodates my natural schedule rather than try and force my natural schedule to accommodate work hours. Trying the latter has caused my quality of life to suffer. Your experience may be different though as it was for my cousin and many others.
There is a spectrum of how effective any treatment can be so I'd advise that you try some of the less drastic therapies* soon while you have the bit of latitude that going to school grants you and pay attention to your baseline mood. You need to know now if you can maintain and be happy working "regular" hours to make the right decisions for the future.
The wiki article is well done I think.
*Skip the beer one though.
posted by vapidave at 8:26 AM on June 11, 2010
My experience with chronotherapy, and routines and 'hygiene' and other clock-resetting hijinx, is that the second you are a tiny bit off -- you sleep in an extra hour on Saturday or something -- the entire deal is out the window.
I used to agree wholeheartedly with this, until I realised that the trick for me is in bedtimes, not in getting-up-times. eg, say you are trying to get up at 9am, so you're making bedtime midnight. What I'd do was:
Day one:
Bedtime: Midnight
Fall asleep: 4am
Up: 9am.
Day two:
Have been shattered all day from lack of sleep, so
Bedtime: 9pm.
Up: 9am
Day three:
Have had way too much sleep from previous night, so
Bedtime: 2am
Fall asleep: 4am
Up: 9am.
And so on in a vicious cycle. The only way to break it is to work out what your bedtime is (time you want to wake up - avg time to fall asleep + hours of sleep desired) and then never go to bed before that time. I've also found it very helpful to not shine any serious lights, especially screens, on your face in the hours before bedtime.
Once you break the see-saw sleep cycle, things become much easier. However: don't expect miracles. People with DSPS, in my opinion, see the rest of the world and imagine that they hop out of bed at a time of their choosing and fall asleep as soon as their head hits the pillow. Now, there are a very few people who do this, but they're the exception.
You might not ever make it as easy as they do, and it'll never be as easy as sleeping precisely what your body wants to. What you can aim for is to make it as difficult as everyone else finds it -- ie, a bit of a drag getting up at 8am for work, but not utterly out of the question without three days' prep like it has been so far.
I'm worried I'll be awake during my unproductive hours and missing the time that has been most useful for me getting work done.
Yeah, this is a fear. But you have to give your clock a few serious months to readjust before you can make this call. On top of that, the advantages gained by getting to work in absolute peace and quiet massively outweigh any minor biological advantages you're getting. If you can create yourself a haven to work in, this shouldn't be a huge issue.
I'd also recommend getting started now: while you're a student it's still possible to get away with this lifestyle. In the working world, it's much harder. Careers where you can make it acceptable are the exception, not the norm.
posted by bonaldi at 9:42 AM on June 11, 2010
I used to agree wholeheartedly with this, until I realised that the trick for me is in bedtimes, not in getting-up-times. eg, say you are trying to get up at 9am, so you're making bedtime midnight. What I'd do was:
Day one:
Bedtime: Midnight
Fall asleep: 4am
Up: 9am.
Day two:
Have been shattered all day from lack of sleep, so
Bedtime: 9pm.
Up: 9am
Day three:
Have had way too much sleep from previous night, so
Bedtime: 2am
Fall asleep: 4am
Up: 9am.
And so on in a vicious cycle. The only way to break it is to work out what your bedtime is (time you want to wake up - avg time to fall asleep + hours of sleep desired) and then never go to bed before that time. I've also found it very helpful to not shine any serious lights, especially screens, on your face in the hours before bedtime.
Once you break the see-saw sleep cycle, things become much easier. However: don't expect miracles. People with DSPS, in my opinion, see the rest of the world and imagine that they hop out of bed at a time of their choosing and fall asleep as soon as their head hits the pillow. Now, there are a very few people who do this, but they're the exception.
You might not ever make it as easy as they do, and it'll never be as easy as sleeping precisely what your body wants to. What you can aim for is to make it as difficult as everyone else finds it -- ie, a bit of a drag getting up at 8am for work, but not utterly out of the question without three days' prep like it has been so far.
I'm worried I'll be awake during my unproductive hours and missing the time that has been most useful for me getting work done.
Yeah, this is a fear. But you have to give your clock a few serious months to readjust before you can make this call. On top of that, the advantages gained by getting to work in absolute peace and quiet massively outweigh any minor biological advantages you're getting. If you can create yourself a haven to work in, this shouldn't be a huge issue.
I'd also recommend getting started now: while you're a student it's still possible to get away with this lifestyle. In the working world, it's much harder. Careers where you can make it acceptable are the exception, not the norm.
posted by bonaldi at 9:42 AM on June 11, 2010
Response by poster: Thanks for the suggestions. It is possible for me to pick a job where I can work hours that fit that, but I'd also like to have a family which might change that as well. Maybe I'll really give this routine thing a try. And I could definitely use more exercise. Any more comments on productivity levels when on a "normal" diurnal cycle would be awesome though.
posted by gilsonal at 10:51 AM on June 11, 2010
posted by gilsonal at 10:51 AM on June 11, 2010
Try to control your light exposure, get enough light during the day and make sure that you reduce exposure to blue light at night. If there is not enough sunlight, try light therapy. Get your body clock back in order.
There is a finding about another light receptor in our eyes that is connected to our body clock mechanism in the brain. Some people are more sensitive than others.
Read this page and this page. The second site is about bipolarity, but it will help you to understand how the human body works.
posted by bbxx at 2:11 PM on June 11, 2010
There is a finding about another light receptor in our eyes that is connected to our body clock mechanism in the brain. Some people are more sensitive than others.
Read this page and this page. The second site is about bipolarity, but it will help you to understand how the human body works.
posted by bbxx at 2:11 PM on June 11, 2010
This thread is closed to new comments.
Also, for those of you with light therapy experience, is there something magical about the light boxes out there (besides the sticker price) or can I just use the lights I use to keep my indoor plants happy during the winter (hydroponic grow lights). I presume they are fairly-sun like.
posted by gilsonal at 8:50 PM on June 10, 2010