Assessment and treatment of Delayed Sleep Phase Disorder in adolescents: Recent innovations and cautions

Michael Gradisar, M Smits, Bjorn Bjorvatn

    Research output: Contribution to journalArticlepeer-review

    19 Citations (Scopus)

    Abstract

    DSPD is the most common condition with which adolescents present to sleep clinics. Recent innovations in phase-advancing the delayed circadian rhythm include: (1) commercial availability of home assessment of DLMO with sequential salivary melatonin assays, which allows for specific timing of evening melatonin administration based on markers of circadian biology; and (2) brightlight therapy with short-wavelength (green) LED glasses. There is also good evidence to support the use of broad-spectrum white light, as well as sunlight, to phase-advance adolescents sleep timing. The authors encourage clinicians to be cautious of long-acting melatonin preparations because they may inadvertently worsen the phase delay, and to be wary of chronotherapy because of the limited available evidence. Finally, although more evidence is needed to support its use, motivational interviewing may be a useful technique to supplement the aforementioned treatment strategies.

    Original languageEnglish
    Pages (from-to)199-210
    Number of pages12
    JournalSleep Medicine Clinics
    Volume9
    Issue number2
    DOIs
    Publication statusPublished - Jun 2014

    Keywords

    • Adolescence
    • Bright-light therapy
    • Daytime sleepiness
    • Delayed sleep phase disorder
    • Delayed sleep phase syndrome
    • Dim-light melatonin onset
    • Melatonin
    • Sleep-onset latency

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