[Norway]

I've had DSPS for decades, since early childnood, first learned its name 4 years ago and have had *some* success with melatonin as well as light therapy. I am not a doctor. This is my first post here.

It's sad to see that people who self-treat with melatonin often find that it has no effect at all or that it has unpleasant side-effects. They often decide once-and-for-all that melatonin is not for them.

My opinion, from reading, going to a sleep specialist regularly and my own experience, is that people take too high a dose and, most importantly, don't understand the importance of getting the timing right. We're all different and I'm not going to try to run through all the possibilities here (I'd necessarily miss some of them anyway). Here's what works, most of the time, for me:

1. The tiniest possible dose, I use liquid melatonin and an eye-dropper, about 8 hours after spontaneous wake time. This is supposed to act as a chronobiotic to advance the circadian phase, not to make one sleepy.

2. One-half mg an hour and a quarter before bedtime makes me sleepy by bedtime. The sleepiness window only lasts a half an hour or so. If I override it and stay up too long, I may well be up all night.

Maybe comparing this with your own mileage might be helpful?

The timing of light therapy is also very important, as using it too early has the opposite of the intended effect. It can be used some minutes before you'd spontaneously awaken anyway, but not much more. In other words, if you're spontaneously awakening at about noon and someone tells you to use bright light at 8 a.m., that is just as wrong as it can be.

Agree? Disagree? Discuss.

[Lin83]

Hello
I also went to a neurologist specialized in sleeping disorders, to get treatment for my dsps. I take 5 mg melatonine between 19:00 and 20:00. I go to bed at 23:00 and fall asleep 20 minutes later. In the beginning I got very sleepy 30 minutes after taking the melatonin, but that stopped after a week. Before I took melatonin I couldn't sleep before 2:00.

[Norway]

5 mg is waaay more than anyone needs, about ten times more! However, if you're lucky enough to have found a doctor who knows something (anything!) about circadian rhythm sleep disorders, you do have to listen to her or him. I'd suggest this:

1. Stabilize on the plan you're on for at least a couple of months (if you haven't already), keeping track of sleep times, daytime sleepiness etc.

2. Suggest to your specialist (carefully, as some doctors don't like patients coming with what they've read online) that you've heard that 3 mg or less often is recommended. Ask if she or he thinks such a dose would be as effective as the 5 mg.

3. Whether the doctor goes along with that or not, select a month you think you won't be particularly stressed and try using one half of the 5 mg dose. I'll wager it's just as good, and why take more than you need?

Good luck.

[ogress]

I'm curious about this melatonin treatment. What are the side effects, if there are any? Like most of the people here, I am glad that this condition has a name and is actually "universal" - other people have it too. I used to think that my condition is "psychological"..err, uninterested in the normal life pursuits. Ergo, laziness. But the symptoms all of you have been describing are so apt, I couldn't contain my excitement I registered to this forum right away.

Right now, I'm in a job that requires me to come to work at 7:30 am....imagine my predicament! Because I used to think that this is all just a "pattern" and is caused by "my laziness", I applied for a job that would challenge this condition. (hear the loud buzzer now) Wrong move!! Now, I am regretting every waking hour that I have to drag myself to work- always late and with co-workers always looking at me funny for being perpetually late. My competence in my job is being questioned because of this and I have to always prove to them that I deserve my position and that the "tardiness" is such a "minor" factor in my over-all performance. As much as I love my work, these new info made me realize that I may have to get a new job in a similar field but with a different work shift, if possible - but an output-based work would be a definite God-send.

So, thank you very much for sharing all these info. Also, can you recommend which kind of doctor can I go to to discuss this condition? Is a neurologist the best that could explain this syndrome?

[Norway]

Right. You write: "I used to think that my condition is "psychological"..err, uninterested in the normal life pursuits. Ergo, laziness." And constantly making up new excuses, right? And self-doubt -- everyone else can fix this, why not me?

You ask about melatonin treatment (which goes hand-in-hand with bright light treatment). And you ask what kind of doctor.

About treatment and the disorder itself, read up. Wikipedia: DSPS, Phase response curve, Circadian rhythm, etc. See also dspsinfo.org, which tries to be not-too-pessimistic and not-too-optimistic. All those pages also list further links to look at.

A trickier question: what kind of doctor. Even doctors calling themselves "sleep doctors" don't necessarily know anything about circadian rhythms. Some just do apnea , narcolepsy and restless legs. Same goes for "sleep clinics". Circadian rhythms is a relatively new field, only very recently -- if at all -- covered in medical education.

Some family doctors and even psychologists do happen to know something about circadian rhythms, but not many. Specialists who ought to, but may not, include neurologists, psychiatrists & pediatricians. You probably should ask them on the 'phone before making an appointment and wasting your time and theirs.

I'm so lucky that my family doctor *finally* found a specialist who immediately knew what's been wrong with me all these years. He happens to be a psychiatrist, but on his one day a week at the sleep clinic, he's just a sleep doctor. The disorder is not curable and sometimes not manageable either, but it's still life-changing to learn that it exists and has a name. Good luck!

[RIGGS]

I could not agree more, before there was actually a DSPS out there it was not unusual for people to just think I was some lazy bastard that didn't take my job seriously. I tried melatonin, sleeping pills, the only thing that seemed to work at all was alcohol but that has serious repercussions as you can imagine.

[Norway]

Since I became intensely interested in everything about circadian rhythms, I've made an interesting observation. People who are really, really early bird larks are more likely to understand us than those in the middle. My boss,for one, now that I've taught him about it. He'll often come in a couple of hours early (meaning before 6!) to get work done. But he's also been embarrassed by falling asleep in a theater or over a beer or even over coffee at mother-in-law's at 9:30 p.m. He understands better than most the our body clocks do sometimes rule. Maybe this is obvious and/or something everybody knows, but I found it to be an interesting discovery.