Delayed Sleep Phase Disorder(DSPD)[719].pptx

Delayed Sleep Phase Disorder(DSPD)

1. Presented by: Ajita Duwadi (B2) Archana Thapa (B6) Delayed Sleep Phase Disorder (DSPD)

2. Table Of Contents Introduction Factors associated with DSPD. Symptoms of DSPD Causes of DSPD Diagnosis of DSPD Consequences of untreated DSPD Treatment of DSPD 2

3. 1. Introduction Delayed Sleep Phase Disorder (DSPD) is a sleep disorder that affects the timing of an individual's sleep-wake cycle. DSPD is a circadian rhythm disorder. People with DSPD tend to have difficulty falling asleep at a conventional bedtime and struggle to wake up in the morning , leading to chronic sleep deprivation. This disorder is most common in adolescents and adults which is approximately 15%. 3

4. Circadian Rhythm Circadian rhythm is a body’s biological clock. It regulates the timing of sleep and other physiological processes. The circadian rhythm is driven by an internal biological clock located in the hypothalamus of the brain. This clock is synchronized with the 24-hour light-dark cycle of the environment through a variety of cues, including light exposure, temperature changes, meal times and activity patterns. 4

5. Melatonin Melatonin is a hormone that is naturally produced by the pineal gland in the brain. Melatonin regulates the sleep-wake cycle . Melatonin levels typically increase in the evening and decrease in the morning. Figure1.Melatonin production-24 hour cycle 1 5 Figure1:Melatonin production 24 hour cycle 1

6. Figure3: Melatonin production normal vs DSPD 3

7. 7 How does circadian rhythm work? Fig:Circadian Rhythm 2

8. Group of nerve cells is present within hypothalamus called suprachiasmatic nucleus(SCN). SCN is connected to optic nerves allowing SCN cell to respond to light and dark. In morning, when optic nerve sense light SCN sends signal to raise our physiological variables and inhibits release of melatonin and activates release of cortisol or serotonin (onset of wake cycle). In evening, exact opposite happens i.e as sun disappears SCN does not get any signal from optic nerve that decreases physiological variable and activates melatonin (onset of sleep cycle). 8

9. 3. Symptoms of DSPD Difficulty falling asleep at a conventional bedtime. Excessive sleepiness in the morning. Difficulty waking up at the desired time. Daytime sleepiness and fatigue. Impaired performance during the day. Note: DSPD isn’t accompanied by other disorders like insomnia and apnea. 9

10. 4. Cause of DSPD The main cause of DSPD is disruption of the body's natural circadian rhythm which may be caused by different factors: Genetic factors Environmental factors; exposure to light Lifestyle habits; Irregular sleep schedules, Caffeine and alcohol consumption, Lack of exercise 10

11. Other causes Changes after puberty Physiological and neurological disorder Depression Anxiety Attention deficit hyperactivity disorder(ADHD) Obsessive compulsive disorder Poor sleeping habit A medical condition Medication use Mental health disorder Substance abuse 11

12. 5 . Diagnosis of DSPD Diagnosis of DSPD involves combination of subjective and objective measures. Subjective Measures: To assess sleep patterns and symptoms. Sleep logs Questionnaires Objective Measures: To monitor sleep-wake patterns. Actigraphy Polysomnography . A healthcare professional can use this data to determine whether an individual's sleep patterns are consistent with DSPD. 12

13. Subjective Measures 1. Sleep Logs Sleep log is self-report tool which individuals use to record their sleep pattern, including the time they go to bed, the time they wake up, and time it takes them to fall asleep. 2. Questionnaires These questionnaires include questions about sleep habits, such as the time the individual goes to bed and wakes up, and the quality of their sleep 13

14. Objective Measures 1. Actigraphy It uses a device worn on the wrist which measures movement and can provide information about sleep onset, sleep duration, and wake time. 2. Polysomnography Polysomnography is a diagnostic test that monitors brain waves, heart rate, and breathing during sleep. 14

15. Figure4: Polysomnogram 4

16. 6. Consequences of Untreated DSPD Negative impacts on: Individual's physical and mental health. Work and school performance, Social relationships and Overall quality of life. Chronic sleep deprivation can lead to fatigue, mood disturbances, decreased cognitive function, and impaired immune function. 16

17. 7. Treatment Options for DSPD Treatment for DSPD typically involves a combination of behavioral and pharmacological interventions. Behavioral Intervention Establishing a consistent sleep schedule, Avoiding sleep-disruptive behaviors, and Using light therapy or chronotherapy to reset the circadian rhythm. Pharmaceutical Intervention Melatonin supplements Other sleep aids to promote sleep. 17

18. Behavioral Intervention Establishing a consistent sleep schedule involves going to bed and waking up at the same time every day, even on weekends, to help regulate the body's internal clock. Avoiding sleep-disruptive behaviors includes avoiding caffeine, alcohol, and nicotine, particularly in the evening, as well as avoiding stimulating activities, such as exercise or screen time, close to bedtime. Light therapy and chronotherapy involve using exposure to bright light at specific times of the day to help reset the circadian rhythm. Light therapy typically involves exposure to bright light in the morning. Chronotherapy involves gradually shifting the sleep schedule by delaying the bedtime and wake time each day until the desired schedule is achieved. 18

19. Figure5: Phototherapy 5

20. Pharmaceutical Intervention Melatonin supplements can help regulate the sleep-wake cycle in individuals with DSPD by providing a boost of melatonin in the evening promoting sleep onset. It should be taken a few hours before the desired bedtime to help shift the sleep schedule. However, these medications should be used with caution, as they can be habit forming and may have side effects. 20

21. 8.Lifestyle Changes to Manage DSPD Developing healthy sleep habits, such as maintaining a consistent sleep schedule and avoiding screens before bedtime, can help promote better sleep. Avoiding caffeine and alcohol and getting regular exercise can also promote better sleep and help regulate the circadian rhythm. Figure6: Sleep Hygiene Practces 6 21

22. References https://recharge.energy/wp-content/uploads/2020/12/melatonin-production-24-hour-cycle.jpg https://d2jx2rerrg6sh3.cloudfront.net/imagehandler/ts/20220707062422/ri/750/src/images/Article_Images/ImageForArticle_22787_16571894581487358.jpg https://neupsykey.com/wpcontent/uploads/2016/08/B9781437703269000269_f026-005-9781437703269.jpg https://www.verywellhealth.com/thmb/WqvaqBfULdj7bTXFKVm0Mb3X4J4.png https://cdnfcaog.nitrocdn.com/tVGeWjeASIofMZivDKJFzFymllJTzWcR/assets/images/optimized/rev-4e7b59c/wp-content/uploads/2020/04/1899356.jpg https://www.dovepress.com/cr_data/cache/submission_images/s85000/85849/figure490.jpg https://images.squarespacecdn.com/content/v1/60c6dafaaf99a435b9e54dc1/1626165153445-I4VKMXIIFZFLFHR4DLA7/E15B86E4-CC5D-4A87-AE62-224BBA3D5B8A.jpeg?format=750w 22

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