Never been a morning person? You might have delayed sleep phase syndrome

What is delayed sleep phase syndrome?

Delayed sleep phase syndrome (DSPS), also known as delayed sleep-wake phase disorder, is a type of circadian rhythm disorder, which means your body’s internal clock is disrupted and out of sync with your environment. Circadian rhythm disorders can be caused by external factors (as we see with jet lag or night shift workers) or internal factors (which is the case with DSPS).

As the name implies, DSPS means that your circadian rhythm runs on a delayed schedule. Typically, that means that your sleep-wake cycle is two or more hours later than what’s considered a “normal” sleep schedule. So, instead of going to sleep around 11 p.m. and waking around 7 a.m., your body might want to fall asleep around 1 a.m. and wake around 9 a.m.

DSPS is ultimately a timing problem. I’ve worked with thousands of night owls and have seen that when they can pick their own schedule, sleep quality and quantity improves. Of course, that’s not always possible when you have school, work, or other responsibilities to tend to.

For example, one of my patients prefers a sleep schedule of 4 a.m. to 12:30 p.m. and usually has no trouble sleeping in that window. But when they have to adjust their sleep schedule to get up at 7 a.m. for work, they’re so tired that they feel like they were hit by a truck in the morning with only three hours of sleep.

For people with DSPS, it’s so hard to fall asleep at a conventional hour because, biologically, it isn’t nighttime for you yet. It would be like someone without DSPS trying to fall asleep at 7 p.m. Then, just when you finally log a few hours, your alarm jolts you awake in the middle of your biological night.

DSPS is ultimately a timing problem. I’ve worked with thousands of night owls and have seen that when they can pick their own schedule, sleep quality and quantity improves.

Sarah Silverman, Psy.D.

What causes delayed sleep phase syndrome?

Although we don’t know exactly what causes DSPS, it’s thought to be an exaggerated reaction to the normal circadian rhythm shift that happens during puberty. In case you forgot, most adolescents experience this delay in their circadian rhythm (going to sleep and waking up later than what’s “conventional”). In fact, research suggests it affects between 1-16% of adolescents and young adults. But most people’s bodies shift back towards a “typical” sleep schedule as they approach adulthood, while adults with DSPS will continue to crave this later schedule.

Research suggests there’s a strong genetic component. A landmark study in the journal Cell identified a variant in the circadian gene CRY1 that lengthens the body’s internal day, running in families with DSPS. So for some people, a delayed body clock is actually inherited.

A recent review by leading circadian researchers describes DSPS as something that can vary from person to person, with high rates of overlap with depression, anxiety, ADHD, and autism. We need more research to determine which comes first, but if you’re living with any of these conditions and you’ve been fighting with your mornings for as long as you can remember, a delayed body clock might be part of the picture.

How to know if you have delayed sleep phase syndrome

While there’s no definitive test for DSPS, getting diagnosed requires a longstanding pattern of being unable to fall asleep and wake up at “conventional” times, lasting at least three months.

In my experience, most people who meet the criteria for DSPS identify as “lifelong night owls,” but here are a few other common signs:

• You can’t fall asleep at a “normal” bedtime, and you rarely feel sleepy before midnight.
• Mornings feel brutal, with multiple alarms set and heavy grogginess that doesn’t lift until much later in the day.
• When your schedule is free (weekends, vacations, time off), you naturally sleep later, and you sleep well when you do.
• Your energy, focus, and creativity peak in the evening. Your clearest thinking, best ideas, and most productive hours arrive after dinner.
• You constantly fight the urge to nap or doze off during the day.
• You carry sleep debt through the school or workweek and try to pay it back on weekends.
• Your breakfast time or first meal of the day is usually when most people have lunch.
• This pattern has been with you for years, often since your teens.

DSPS can be diagnosed by either a sleep medicine physician (often a sleep neurologist) or a behavioral sleep medicine specialist (often a sleep psychologist). You may need to get a referral from your primary care doctor if you’re unable to find a specialist on your own, or if your insurance requires it.

Diagnosis usually starts with a sleep evaluation, which is a detailed conversation about how you sleep, when the problem started, and what factors might be contributing to it. You’ll cover topics such as:

• Sleep history: when the problem started, what may have triggered it, how it’s changed over time, and what you’ve already tried
• Sleep schedule: your typical bedtime, wake time, napping habits, and how your weekends compare to weekdays
• Sleep environment: light, noise, temperature, bed partner, pets, and devices
• Daytime habits: caffeine, alcohol, meal timing, exercise, screen use, and morning/evening routines
• How you feel about your sleep: worries, frustrations, and beliefs that may make it harder to fall or stay asleep
• Health background: any medical conditions, mental health history, medications, supplements, surgeries, or prior sleep studies
• How it’s impacting your days: energy, mood, focus, and how sleep is affecting work, school, and relationships
• Screening for other sleep disorders: any signs of sleep apnea, restless legs, or other circadian rhythm issues that might warrant a sleep study or further evaluation.

You’ll also likely be asked to keep a sleep diary, often paired with a wrist-worn activity tracker (actigraphy) for at least two weeks.

If you think you might have DSPS and your sleep schedule has been messing with your ability to function during the day for at least three months, talk to your primary care provider about your concerns and ask for a referral (if needed), or search for a sleep specialist who’s well versed in treating circadian rhythm disorders.

Treatment for delayed sleep phase syndrome

The good news is, not everyone with DSPS needs treatment. If your life aligns with your body clock (whether you can set your own hours or have a job that starts after noon), you may not need to change anything about your sleep schedule. DSPS only becomes a disorder when the circadian rhythm disruption causes real distress on a regular basis and gets in the way of your work, relationships, mood, and daily life.

Unfortunately, most people with DSPS can’t actually stick with the sleep schedule their body wants, thanks to the realities of living in a 9-5 world. In fact, that’s the main reason I started my private practice—so I could live, sleep, and work in alignment with my biology. While I’m not saying everyone with DSPS needs to start their own business, it was the best decision I could’ve made for my overall well-being.

But I realize not everyone can arrange their life around a delayed sleep schedule. In those cases, treatment for DSPS makes sense when the circadian mismatch is costing you—you’re chronically sleep deprived during the week, always running late to school or work, and forever hoping to “catch up” on weekends but never really do.

DSPS only becomes a disorder when the circadian rhythm disruption causes real distress on a regular basis and gets in the way of your work, relationships, mood, and daily life.

Sarah Silverman, Psy.D.

Evidence-based approaches for managing DSPS include:

Strategically timed microdose of melatonin

This isn’t the same as using melatonin as a traditional sedative at bedtime. When taken at low doses, several hours before your target bedtime, melatonin acts less like a sleeping pill and more like a timing signal that nudges your body clock earlier. One randomized, placebo-controlled trial found that 0.5 mg of melatonin, combined with a structured sleep schedule, improved sleep onset in people with DSPS. It’s also the strategy backed by the American Academy of Sleep Medicine’s (AASM) clinical practice guidelines.

The catch is that timing and dosage are key. Taking too much melatonin at the wrong time for your body clock can actually backfire, which is why it’s worth checking in with a sleep specialist before starting melatonin on your own.

Bright light therapy

Light is your body clock’s strongest cue, and getting bright light soon after waking up can help shift your circadian rhythm earlier. Natural sunlight exposure as well as artificial light lamps and light therapy glasses are commonly used to adapt the body clock, making it easier to wake up at a more desired rise time.

Again, timing is key, so this is another therapy that’s best started in consultation with a sleep specialist. It’s also worth noting that artificial light products may not be recommended for people with a history of bipolar disorder, seizures, and dementia/Parkinson’s disease.

Cognitive behavioral therapy (CBT)

While genetics certainly plays a role, DSPS can also be heavily influenced by your lifestyle habits. CBT can help identify the behaviors and thought patterns that may be making things worse, while teaching you coping strategies to help improve your relationship with sleep. In one randomized trial of 102 teens, light therapy alone didn’t do much, but adding CBT increased sleep duration by nearly 45 minutes of sleep per night.

Finding the right treatment may take time

When working with my patients, treatment is highly personalized and involves some trial and error. Anecdotally, I have seen better success when using the combination of timed microdose melatonin several hours before bedtime and bright light therapy upon waking to “bookend” the patient’s preferred sleep-wake schedule. I have also seen benefits to shifting meal times and exercise times earlier in the day.

It’s worth noting that these treatments can make DSPS more manageable, but relapse is common. Most people will shift back to their natural sleep window without any management tools in place (something I see all the time).

So remember that DSPS isn’t a “fix it once” condition. It’s something you manage long-term—until you’re able to realistically sleep within your natural sleep window. That’s truly the best “treatment” in my opinion, because when you can finally sleep according to your body clock’s preferred schedule, you’ll get your best sleep.

Tips for living with delayed sleep phase syndrome

If you’re living with a later body clock but can’t quite sleep on your own time right now, here are a few helpful things you can do that don’t require a sleep specialist.

Protect your mornings. Get outside, or near bright light, as early as you realistically can. Aiming for light first thing is the best way to tell your brain that it’s time to be alert.

Dim your evenings. Bright light at night can push your body clock later, making it harder to fall asleep. Dim the overhead lights and your screens, ideally starting after sunset (or aim for at least a few hours before you want to be asleep).

Resist the weekend swing. Sleeping in until noon on Saturday feels like relief, but it can drag your body clock even later just in time for Monday. Try to keep weekend wake times within an hour or two of weekdays to minimize this “jet lag” effect.

Don’t force sleep. Lying in bed awake and frustrated at 10:30 p.m. trying to will yourself unconscious teaches your brain that your bed is a place of struggle. If you’re wide awake, get up, move to another room, keep the lights low, do something calming, and return to bed when you’re sleepy.

Advocate for your schedule. A later start time or flexible school or work hours might be the most effective solution available. Even an hour later start time in the mornings can make a big difference in how you feel throughout the day.

Recognize that it isn’t about willpower. Try to let go of the shame or guilt you might feel for being a night owl. You’re not lazy or doing this on purpose. Your body clock is simply set to a different time zone. That’s not caused by a lack of discipline.

Start a sleep diary (as long as it doesn’t stress you out). Track when you get into bed, when you think you fell asleep, when you woke up, and how you felt (including on your days off), for at least two weeks. It’s the single most useful thing you can bring to an appointment with a sleep specialist, if you decide to go that route.

Finally, give yourself some grace. It’s not easy being a night owl in an early bird world, and if you suspect you’ve been fighting your biology for years, you’re not alone. It’s time to honor your chronotype.