Elizabeth Saenger, PhD
Counting sheep to go to sleep has a long history, beginning at least in the twelfth century in the Islamic world. But does it work? Two Oxford scientists tested the idea by comparing how long it took people to get to sleep if they:
- Counted sheep
- Imagined a beach or a waterfall
- Did not do either
The people who imagined a beach or waterfall fell asleep first, twenty minutes earlier than usual. The people who counted sleep actually took longer than usual to fall asleep. The experimenters concluded that counting sheep was too boring to work.
But what if imaging a beach, or a waterfall, or fireworks, does not work for you?
DSPD (Delayed Sleep Phase Disorder)
If you go to bed by midnight, but find it impossible to fall asleep until 3 a.m., you may have Delayed Sleep Phase Disorder (DSPD). DSPD is a circadian rhythm disorder. It occurs when:
- Your internal body clock is running several time zones behind actual local time
- The discrepancy between inner and outer time makes it virtually impossible to fall asleep at a conventional hour
- You may have a genetic predisposition which runs in families
Alternatively, DSPD can occur when a person purposely:
- Stays up unusually late
- Sleeps in a darkened bedroom
- Avoids early morning exposure to bright light
Sleeping pills do not solve the problem. Careful use of bright light therapy can be effective. Here is what the Center for Environmental Therapeutics recommends.
Treating Mild DSPD
For those without extreme delayed phase (for example, with sleep onset between 1 a.m. and 2 a.m.), a good strategy is to:
- Estimate current circadian rhythm phase using the Automated Morningness-Eveningness Questionnaire, or MEQ, a free and confidential survey.
- Use the results to identify a time in late morning when light exposure should be used to begin resetting the internal clock.
- Begin treatment with exposure to light at that time, and then move exposure earlier every few days, in roughly 30-minute steps, until sleep onset normalizes.
Treating Extreme DSPD
The MEQ is not designed for people with extreme delayed phase. If you have extreme delayed phase:
- Consider supervision by a specialist
- Start light therapy around the time of spontaneous waking (for example, noon)
- Move exposure earlier as described above
- think about the possibility of taking a low dose of melatonin 12 hours before the scheduled light therapy for a synergistic effect. Doses this small are not available now, but you can find out when they will be available.