How I Live With Delayed Sleep Phase Syndrome as an Adult

I’d always thought of myself as an extreme night owl. As far back as I can remember, I had trouble waking up for school and I was useless for the first couple of morning classes. (Why did they schedule math so early, anyway?)

By the end of the day, as everyone else was winding down for the night, I was hitting my stride: My brain seemed clearest and most alert after 10 p.m. Instead of going to bed, I’d stay up late to do homework, and that’s when all my creative ideas flowed.

All my life, my internal clock just hasn’t synced up with everyone else’s. Left to my own devices, I’d go to bed somewhere around 4 a.m. and wake up around 11 a.m. Of course, that’s not an option if you’re in school or have a 9-to-5, and it’s definitely not an option if you’re a parent or have people in your life who depend on you—all of which became realities for me eventually.

It’s been a constant battle trying to conform to a more socially acceptable bedtime routine. I’ve always known I’m wired differently. It wasn’t until adulthood, though, that I discovered it wasn’t just insomnia I was dealing with, but a circadian rhythm disorder called delayed sleep phase syndrome. And I found out in maybe the most ironic way possible.

How I learned I had delayed sleep phase syndrome

Now here’s the funny part. As a ghostwriter for most of my career, I’ve written books about almost every topic imaginable, from bullying to celebrity autobiographies. Around 2006, I began working with a sleep medicine doctor on a book about sleep disorders. I wrote most of it between the hours of 11 p.m. and 4 a.m. And yes, I saw the irony in that.

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One night, I was reviewing my client’s research about circadian rhythm disorders when I came across something that stunned me: the phrase “delayed sleep phase syndrome.” The more I read about it, the more I recognized myself and the way I’d been living.

I brought this up to the doctor I was working with, and he agreed: I had delayed sleep phase syndrome and had gone undiagnosed for decades.

Delayed sleep phase syndrome (also known as delayed sleep phase disorder or delayed sleep-wake phase disorder) is a condition in which a person’s sleep is delayed by two hours or more beyond what’s considered an acceptable or conventional bedtime, per Stanford Medicine.

“If you’re finding it hard or impossible to fall asleep until very late at night (between 2 a.m. and 6 a.m.) and struggle to wake up in the morning despite getting enough sleep, you might have delayed sleep phase syndrome,” says Shelby Harris, MD, a sleep medicine expert and director of sleep health at Sleepopolis. “This pattern must last for at least three months and cause problems in your daily life to be considered a disorder.”

Sometimes the disorder is the result of certain lifestyle factors, such as working a night-shift job, but if it’s a long-term issue like mine, the exact cause is largely unknown, per the Mayo Clinic. Although about 40 percent of people with the disorder have a family history, so there may be a genetic component, per the American Academy of Sleep Medicine.

We do know that it usually appears or worsens in adolescence and is more common in young people, with about 7 to 16 percent of adolescents and young adults affected, according to Stanford Medicine (the rate in the general population is less clear, with estimates ranging from 0.2 to 10 percent). This could be due to natural biological shifts that tend to happen after puberty, which bump the internal clock forward by about two hours, per Nationwide Children’s Hospital (so a teen who used to go to bed at 9 p.m. may not be able to drift off until 11 p.m., for example, and may then struggle to get up for school in the morning).

“Living with this disorder can really put you at odds with the rest of society. It has always been challenging for me to get the rest I need while trying to conform to other people’s needs and schedules.”

It’s different from just being a “night owl”

The key difference between just being a “night person” and having a disorder is whether or not it creates problems in your everyday life. “A night person may tend to [go to] sleep later at night, but they can still sleep at their preferred time, wake up without issues when they are required to, and obtain adequate sleep,” says Abhay Sharma, MD, director of the Division of Interventional Sleep Surgery and co-director of the USF ENT Sleep and Snoring Center, in partnership with Tampa General Hospital.

In other words, if you make the choice to stay up late, but you get enough sleep and can function normally the next day, there’s not a lot of evidence to show there’s anything wrong with that (i.e., you don’t likely have a diagnosable disorder).

If you can’t fall asleep at a normal time, though, and that makes it difficult to wake up in time for daily obligations and then stay awake and alert throughout the day, it could mean you have delayed sleep phase syndrome or another sleep issue, per the Mayo Clinic.

What it’s like living with this sleep disorder

Living with this disorder can really put you at odds with the rest of society. It has always been challenging for me to get the rest I need while trying to conform to other people’s needs and schedules.

Graduating high school was a relief because I could take charge of my own schedule. I chose afternoon and night classes in college and eventually became self-employed, which allowed me to create my own hours—a privilege I know not everyone has. I would often work with clients on the West Coast (I live in New York) and schedule calls during the afternoon or evening, which was still a reasonable hour in their time zone.

These changes worked well for my career, but they haven’t always been helpful in day-to-day life with things like doctors’ appointments, service calls from plumbers or electricians, visiting friends overnight, or other obligations like (yikes) early-morning jury duty. Even when I’d go on vacation, I’d either miss the hotel breakfast altogether because I overslept or wander down to grab waffles in a pajamaed stupor at the last possible minute. Dating and relationships were also challenging—most partners aren’t exactly happy with mismatched bedtimes or the inability to spend mornings together.

I knew some people would see me as lazy for sleeping later, even though I was working all night and getting less sleep than most. I eventually learned to tell people I work overnights so they’d understand why morning appointments were so tough for me.

My sleep schedule was the most problematic in the first few years after my daughter was born. I fought my body’s urges to stay up all night until I saw the sun and forced myself into a more acceptable routine. (She couldn’t have a mom who woke up at 11 a.m. every day.) Once she was old enough to go to school, I came up with a plan to break my sleep into two parts: I’d go to bed between 3 and 5 a.m., wake up to get her ready and off to school, and then return home for “part two” of my sleep.

Most of my symptoms throughout the years have been pretty typical of delayed sleep phase syndrome. But I’ve also dealt with related health complications, including severely low levels of vitamin D because I missed so much daylight while I was asleep. Not only can this deficiency weaken your immune system and cause symptoms like pain, fatigue, and weakness, but it can also further contribute to poor sleep in both children and adults, according to a study in the Journal of Clinical Sleep Medicine.

How to manage delayed sleep phase syndrome

Turns out, delayed sleep phase syndrome can typically be cured, especially if it’s situational. Here are a few methods that can help, some of which I’ve tried:

1. Take melatonin

Supplemental melatonin is one of the most common and easily accessible treatments for delayed sleep phase syndrome. In fact, in a small June 2018 randomized controlled trial in PLOS Medicine, people with delayed sleep phase syndrome who took 0.5 mg of melatonin one hour before their bedtime for four weeks fell asleep 34 minutes earlier, on average. Other studies³ have found the optimal time to take melatonin is not right before, but two to four hours before bed.

There’s no one-size-fits-all approach to dosage and timing; you may have to experiment to figure out what’s best for you. And more melatonin isn’t always better.

Dr. Sharma says at recommended doses (i.e., up to 5 mg per day), there’s little evidence that melatonin causes adverse health effects long term—save for the occasional (and harmless) vivid dreams. But as with any sleep aid, he says it’s best to only use it for a short time, to reduce the risk of your body developing a tolerance.

Of course, talk to your doctor about melatonin for delayed sleep phase syndrome (or other sleep disorders) before trying it.

2. Avoid bright or blue light near bedtime

Whether you have delayed sleep phase syndrome or not, exposure to bright light at or near bedtime can disrupt your circadian rhythm. This includes the light from phones and computers because it tricks the brain into thinking it’s still daytime, delaying the body’s natural release of melatonin. (In other words, staying up working on a screen til dawn was the opposite of what I should’ve done to fix my schedule.)

“This effect is also commonly seen during daylight saving time every year in most states,” says Dr. Sharma. “Shifting the clock forward results in more sunlight during the evening and less sunlight during the morning hours, delaying circadian rhythm. This frequently causes significant disruption in the sleep/wake cycles for at least one to two weeks.”

The best thing to do? Dim the lights and turn off screens altogether for a couple of hours before your desired bedtime, or at least minimize their use. If the light is from outside, getting some blackout curtains can be helpful, too.

Personally, I’ve also learned to read paper books and magazines and write in my journal before bed rather than staring at a computer.

3. Try bright light therapy in the morning

On the other hand, bright light in the morning can help people with delayed sleep phase syndrome wake up, per Stanford Medicine. That’s because bright light “resets” our circadian rhythm and tells our brains it’s morning. Getting daylight (or simulated daylight) when you first wake up is essential for people with circadian rhythm issues.

You can do this by sitting outside or taking an early morning walk, or using things like light boxes, sun lamps, or light visors if you live in a darker place or it’s wintertime. I have worn a light visor in the morning while going about my regular routine and have found it helps me wake up.

Interestingly, research has found it’s not so much about the intensity of the light that’s beneficial, but the amount of time you’re exposed. A small May 2011 randomized controlled trial in Sleep found the longer participants used the lights (up to three hours per day), the more effective they were at moving into the sleep phase earlier.

4. Keep a regular routine

Erratic nighttime (and morning) routines can contribute to an irregular circadian rhythm. Even though it can be difficult, do your best to go to sleep and wake up around the same time each day. This can be a tough one to follow on the weekends, but if you want to train your body to go to sleep around your desired bedtime, Dr. Sharma says consistency is important. (I’ll admit, this is still my biggest challenge.)

What to do if you think you have delayed sleep phase syndrome

It’s not common to get diagnosed with a circadian rhythm disorder because primary care doctors don’t normally ask about them. You may have to bring it up if you want an official diagnosis and advice. (I never received a formal diagnosis, though the doctor who I worked with years ago unofficially diagnosed me based on my symptoms.)

From there, your doctor might refer you to a board-certified sleep medicine specialist (sometimes affiliated with ENT doctors), who more commonly diagnoses and treats sleep and circadian rhythm-related disorders.

One test they might order is called dim light melatonin onset (DLMO), which can be done at home or in a sleep clinic. The test involves collecting several saliva samples throughout the night to check your melatonin levels at different hours, per a February 2023 paper in Sleep. This can help you figure out the best time to take melatonin before bed.

A specialist might also suggest you try at-home treatments like low-dose melatonin, bright light therapy, and lifestyle changes.

Most importantly, remember to be patient with yourself and don’t expect to go from an obscene sleep schedule to an early bedtime overnight. It can take time for your body to adjust to a new routine, and even then, you may go through bouts or stretches of time where your sleep gets thrown off again, making it hard to fall asleep and wake up at a “normal” time.

Also, don’t be afraid to make some minor life changes to help make things easier—like seeking assistance at work or school, or adjusting dates and times of other appointments or social gatherings to make sure you’re still getting the rest you need.

While I know I still have the natural tendency to drift into an “abnormal” sleep schedule, I also know I can find ways to rein things in. Which is why I’m writing this at 2 a.m. rather than 4 a.m.—progress!