DSPS: Physiology and Treatment
DSPS is manifest by sleep onset and wake times,
which are delayed several hours relative to conventional
sleep-wake times. 31 The prevalence of
DSPS in one study of 217 Japanese high school
students was 0.4%. 32 In another study of youth in
Norway the prevalence was 0.17%. 33
Genetics and family history give credence to the
biological basis for DSPS. The frequency of the
HLA-DR1 is increased in patients with DSPS
suggesting there are genetic predispositions to
DSPS. 34"35 Furthermore, familial occurrence of
DSPS is much higher than in general population. 35
Treatment of DSPS begins with patient and
parent education of the physiology of the biologic
clock and also includes careful sleep/wake scheduling,
selective use of light therapy, and sometimes
medication--either melatonin or a benzodiazepine.