Delayed Sleep Phase Syndrome: A Melatonin Onset Disorder
Delayed sleep phase syndrome (DSPS) is a common but little reported cause of severe insomnia. Characteristic symptoms of this poorly defined circadian rhythm disorder are sleep onset insomnia and trouble to awake at conventional hours. Generally DSPS patients feel more alert at night than in the morning. Many suffer from hypersomnia and fatigue during the day. The prevalence of depression and personality disorders in DSPS is high. Delayed melatonin onset plays a key role in the pathophysiology of this circadian rhythm disorder. The possibility to assess melatonin onset relatively easy in saliva resulted in the finding that melatonin onset is delayed in several patients with poorly understood disorders such as chronic fatigue syndrome, chronic whiplash syndrome and children with idiopathic chronic sleep onset insomnia.
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