How Delayed Sleep Phase Syndrome Affects Teenagers

Circadian Rhythm Disorder May Cause Insomnia and School Problems

Teenage night owls can have delayed sleep phase syndrome that causes insomnia at night and morning sleepiness
Teenage night owls can have delayed sleep phase syndrome that causes insomnia at night and morning sleepiness. Getty Images

If you struggle to get your teenager to bed at a reasonable hour and fight to get them out of bed in the morning, you may be dealing with delayed sleep phase syndrome (DSPS). This relatively common condition can be accentuated during adolescence when the pressures of school schedule restraints conflict with changes in the body’s circadian rhythm among teens who are naturally night owls. Learn how delayed sleep phase affects the sleep of teenagers and how this can lead to both insomnia and morning sleepiness.

The Circadian Rhythm and Adolescence

As children get older and enter the teenage years, the timing of their desire to sleep changes. Many teens develop delays in desired sleep onset and offset, resulting in a shift to later bedtimes and sleep periods. As such, it is not uncommon for teenagers to stay up past 11 p.m. and to want to sleep in until 9 or 10 a.m. (or even later).

This occurs because of a shift in their circadian rhythms. The circadian rhythm is the synchronization of the body’s functions to the natural light-dark cycle. It helps to coordinate our periods of sleep to the nighttime. When this becomes delayed, it may result in DSPS.

What Causes Delayed Sleep Phases in Teenage Night Owls?

Teens who experience DSPS will often begin having difficulties with the onset of puberty. There may be underlying genetic factors involved that affect the suprachiasmatic nucleus, which is in part of the brain called the hypothalamus.

It is thought that between 5% and 10% of teens have DSPS. It can persist into adulthood in some people.

Symptoms of Delayed Sleep Phase Syndrome in Teenagers

It is important to recognize the symptoms that may suggest DSPS. Some of these symptoms that a teenager may experience include:

  • Feeling at their best in the evening

Other Conditions Resembling Delayed Sleep Phase Syndrome

Overlap occurs in the symptoms of DSPS and other medical and psychiatric conditions. As the treatments will differ, it is necessary to recognize the distinctions. Many teens simply do not get the sleep that they need and may benefit from tips to improve teen sleep. Some have an underlying sleep disorder that is contributing to their difficulties, such as insomnia, restless legs syndrome, or even sleep apnea. In addition, psychiatric illnesses, such as anxiety and depression, may masquerade as a sleep disorder.

Diagnosis and Treatment of Teens with a Night Owl Tendency

Aside from answering a few questions, it can be helpful to do some basic investigative testing. One option is to look at the patterns of sleep and wakefulness with actigraphy. This small device records movement, and with the information collected, a doctor can determine whether DSPS is likely to be present.

As a complement to this, the use of a sleep-wake diary may be useful in accounting for the patterns over several weeks.

Depending on the particular symptoms associated with the sleep disturbance, additional testing may be indicated. The treatment will depend on the cause, but teens with DSPS may respond to behavioral therapy, phototherapy with a light box or simply by getting natural morning sunlight for 15 to 30 minutes upon awakening, and even medications such as melatonin. Melatonin typically must be taken several hours before bedtime in order to be effective.

As there can be significant consequences from DSPS, including disruption of school performance and activities, it is important to get affected teenagers the help that they need. Keeping a regular sleep schedule (including on weekends), getting morning sunlight upon awakening, and going to bed when feeling sleepy can be highly effective. The condition usually improves in adulthood, but it may return if a regular sleep schedule is not required, such as in retirement.


Durmer, JS et al. "Pediatric Sleep Medicine." Continuum Neurol. 2007;13(3):182-184.

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