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GETTING BETTER

A night owl resets his body clock

With day hours fast escaping him, he grabs on to light therapy.

June 16, 2003|Joshua Tompkins | Special to The Times

Millions of Americans are night owls, routinely staying up past 2 in the morning and sleeping until noon whenever possible. For clubgoers and some shift workers, such a schedule is a necessity. But for 9-to-5 people, stay-at-home parents or anyone else with daytime obligations, it can be an intractable, self-perpetuating cycle that disrupts one's career and personal life.

I'm a night owl. I've been one since childhood in Ohio, where on dim, freezing mornings, only the weakest trickle of light reached my tree-shaded bedroom windows, virtually negating the difference between day and darkness. At night, over my mother's protests, I'd stay up watching late-night talk shows or reading Isaac Asimov novels or just sitting quietly and relishing having the world to myself. Sometimes I'd be up so late on weekends that I'd hear my father, an irrepressible morning lark, stirring just as I finally drifted off to sleep.

In college I avoided classes that started before 10 a.m., and at work I was always the last editor to arrive every morning. "You've got to get here earlier," a boss once told me. "The rest of the staff are using you to gauge how late they can be."

Recently, left to set my own hours as a freelance writer, I watched my schedule drift later than ever. Efforts to turn in at a decent hour proved fruitless, even on days when I had managed to get up early. Around 11 p.m., an exasperating second wind would swirl up and keep me awake for hours. I'd wake up around noon, finish "breakfast" by 1 p.m. and curse yet another truncated, unproductive workday.

I wasn't alone in my frustration. Scientists consider an unwillingly postponed sleep schedule to be a medical condition called delayed sleep phase syndrome, or DSPS. Caused by an irregularity of the circadian rhythms that govern the body clock, this and other sleep rhythm disorders most probably result from a combination of environmental and genetic factors, says Dr. Michael Wincor, an associate professor at USC's schools of pharmacy and medicine. Because relatively few people seek treatment for it, estimates of the prevalence of DSPS are imprecise. Most researchers believe that 4% or fewer adults have the condition.

Experts agree that it is more widespread among adolescents than adults, with about 7% of teenagers having the condition, according to a 1989 report by the Journal of Sleep Research. Studies have shown that many teens possess slightly delayed body clocks, remaining energetic through the evening and typically requiring 8 1/2 to 9 1/2 hours of sleep.

DSPS is also common among college students, says Wincor. "On a daily basis, I see people with at least mild delayed sleep phase syndrome," he says. "They're accustomed to going to bed at 1 a.m. or 2 a.m. and being able to sleep until 10 a.m."

Sleeping pills can't remedy DSPS, so physicians sometimes prescribe chronotherapy, in which the patient goes to bed three hours later each night until he or she rounds the clock dial to the desired schedule. That is as laborious as it sounds, and those who complete it (usually missing a week of work to do so) must strictly adhere to the new routine or risk total relapse. Taking melatonin, the hormone normally secreted at night to help regulate sleep, can correct the problem in some cases.

The most effective therapy, however, is light therapy, according to sleep researchers. Used since the early 1980s to alleviate seasonal affective disorder, the depression experienced by many residents of upper latitudes during the bleak winter months, timed exposure to bright light has proved equally effective at resetting the errant body clocks of frustrated night people and others with sleep schedule problems. Yet few people are aware of the treatment. Unlike seasonal affective disorder, DSPS has not been widely publicized, and many night owls quietly resign themselves to their off-kilter cycles, believing them immutable. Some eventually outgrow the problem during middle age or in their later years.

The light regimen is simple and can be done under a doctor's supervision or on one's own at home. Patients are typically instructed to spend about 30 minutes outside, preferably without sunglasses, before going to work. With daily repetition, the person should be able to wake up a little sooner each morning and fall asleep earlier each evening; 15 minutes every day or two is a good pace. In about a week, a body-clock shift of two or three hours is possible. After that, one or two sessions a week will maintain the new schedule, say several practitioners.

There's no doubt that light therapy works, says USC's Wincor. But using natural light doesn't work for everyone. Die-hard night people, who dread the arrival of dawn, often lack the time, energy or wherewithal to go wincing out into the morning daylight even for a jog or stroll.

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