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Steve2
#1 Posted : 25 February 2010 00:28:17(UTC)
Steve2

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Joined: 25/02/2010(UTC)
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I am currently providing Acceptance & Commitment Therapy (ACT) for a man who has been diagnosed has having a major depressive episode (severe, recurrent) and Delayed Sleep Phase Syndrome with hypersomnia. For about 10 years, he does not get to sleep, on average, until 2.00am to 3.00am and sometimes later. Once asleep, he often sleeps heavily for up to 10 to 12 hours, not even hearing the alarm clock which he has set for approximately 8 hours (e.g., 11.00am). Most of my therapy with him has been to help him take a more mindfulness-based approach to his depressed mood - an approach that has had a significantly positive impact on him. However, his DSPS with hypersomnia remains virtually unchanged. I would be appreciative of any information on any treatment that could address both his DSPS and hypersomnia.
Hope
#2 Posted : 03 March 2010 21:48:54(UTC)
Hope

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Have you tried a light box? I know it helps with SAD and might help his DSPS. I also have DSPS and insomnia which I am struggling with, but thankfully not major depression. I can't use a light box, because I have migraine and epilepsy and it affects that. I use the lumie elite 300 and often sleep right through it, even though I have made my room darker with blackout curtains so the 'dawn' is very obvious. Sigh.

Has he been to the doctor to rule out any underlying reason for the hypersomnia? I might just be that he has to accept that he has DSPS and maybe he just needs that much sleep. Not everybody needs 8 hours and some people need a lot more. Unfortunately sleep isn't a simple thing.

Depending on where you are, he might be able to try melatonin, but this isn't a cure-all and can have side-effects. It can be quite complicated to find the right dose and doesn't necessarily work for long.

There is also chronotherapy, where the person goes to bed later each night until the desired wake time is reached. But this isn't simple either, and usually isn't effective for very long. Only weeks or maybe a couple of months before the person's natural sleep pattern assert themselves.

I do recommend that both you and he join a yahoo group called Niteowl. http://lists.circadiandisorders...l-circadiandisorders.org I belong and they are a very interesting, intelligent and supportive group. They turn up very interesting research documents and have a lot of advice about dealing with doctors. It is also a place for people to vent in a space where people understand and sympathise rather than have judgemental attitudes which so many of us with DSPS come across.

If you ask there for advice about treating your patient you will get lots of answers from people who are patients themselves and what's been helpful (or not) for them.

Hope this helps. I hope he can find a way of dealing with his sleep problems, it can make life very difficult, but in the end it could be that you and he have to accept that that is who he is.

I'd be very interested to know how you both get on. (I don't mean breaking patient confidentiallity or anything like that, just generally)

wwcrites
#3 Posted : 28 March 2010 12:57:31(UTC)
wwcrites

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I was diagnosed with DSPS w/hypsomnia in 1999. The doctor recommended light therapy, it didn't seem to do me much good. I found working working cateye much more helpful.
Ann
#4 Posted : 17 July 2011 16:51:31(UTC)
Ann

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I have DSPS. I have had it all my life and it has been a real struggle physically and socially. There is very little understanding of the condition out there. I have succeeded in managing it better recently by using a variety of techniques. Sleep phase chronotherapy was particularly useful. To stop this from leading to Non-24-hour sleep-wake syndrome I have to use light therapy to stabilise my sleep pattern at the desired point. I have used one of the bodyclock products on here to do this and that has helped. I have also tried to get maximum natural light exposure before 12:00pm and minimum natural light exposure after this. I avoid stimulants like caffeine completely including even the small amounts in tea. I stick to 12:00 bed time and try and wind down and go to bed before this if I can. My natural pattern is something like 4am-12pm. Though it is worse if I am under any kind of stress. However using all these techniques together consitently I have been able to shift it to 12:30am-8:30am. I am planning to buy a SAD light box from here for morning use during the winter. I am also thinking about trying a Melatonin supplement in the future. Of all the techniques I have tried so far I found the sleep phase chronotherapy to be the most vital in creating change. Though it is really the combination of techniques above that has been most effective for me.
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