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Delayed Sleep Phase Syndrome in Adolescents

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Book cover Sleep Disorders in Women

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Delayed sleep phase syndrome (DSPS) is encountered more frequently in teen and young adults than in the general population. The hormones of puberty play a triggering role in the onset of the syndrome. The pertinent neuroanatomy is reviewed in this article, including the role of the retinal ganglion cells, suprachiasmatic nucleus, and hypothalamus. The physiology underpinning the disorder is described, including the role of melanopsin and melatonin. The genetic predispositition is managed by the interaction of the genes per, tim, and clock ultimately manifesting as the circadian rhythm. Understanding the interplay of the circadian rhythm and homeostatic drive in Borbely’s two-process model helps to create the foundation for clinical evaluation of persons with this syndrome. Details for careful clinical evaluation are described. Identifying DSPS reduces the stigma associated with issues such as school truancy and informs the clinician so that recommendations in accord with the circadian rhythm can be provided. Successful treatment can prevent sequelae including difficulties with mood regulation, accidents, substance abuse, and poor academic performance. Currently used diagnostic evaluation tools including the sleep log, the “morningness/eveningness” scale, and actigraphy are described. Future tools including salivary melatonin assays are reviewed. Therapeutic interventions including phototherapy, chronotherapy, and pharmacotherapy are also reviewed.

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Authors and Affiliations

  1. Department of Neurology and Sleep Medicine, Gillette Children’s Hospital, St. Paul, MN, 55101, USA

    John Garcia

  2. Department of Neurology and Pediatrics, Fletcher Allen Health Care, University of Vermont, Burlington, VT, 05401, USA

    Garrick Applebee

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  1. John Garcia
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  2. Garrick Applebee
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Correspondence to John Garcia .

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Editors and Affiliations

  1. Department of Neurology, Sleep Medicine, Northwestern University, N. Lake Shore Drive 710, Chicago, 60611, Illinois, USA

    Hrayr P. Attarian

  2. , Department of Neurology, NorthShore Univ. HealthSystem, Ridge Avenue 2650, Evanston, 60201, Illinois, USA

    Mari Viola-Saltzman

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Garcia, J., Applebee, G. (2013). Delayed Sleep Phase Syndrome in Adolescents. In: Attarian, H., Viola-Saltzman, M. (eds) Sleep Disorders in Women. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-324-4_6

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  • DOI: https://doi.org/10.1007/978-1-62703-324-4_6

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-323-7

  • Online ISBN: 978-1-62703-324-4

  • eBook Packages: MedicineMedicine (R0)

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