Delayed sleep-wake phase disorder and its related sleep behaviors in the young generation.

Delayed sleep-wake phase disorder (DSWPD) is a sleep disorder in which the habitual sleep-wake timing is delayed, resulting in difficulty in falling asleep and waking up at the desired time. Patients with DSWPD frequently experience fatigue, impaired concentration, sleep deprivation during weekdays, and problems of absenteeism, which may be further complicated by depressive symptoms. DSWPD is typically prevalent during adolescence and young adulthood. Although there are no studies comparing internationally, the prevalence of DSWPD is estimated to be approximately 3% with little racial differences between Caucasians and Asians. The presence of this disorder is associated with various physiological, genetic and psychological as well as behavioral factors. Furthermore, social factors are also involved in the mechanism of DSWPD. Recently, delayed sleep phase and prolonged sleep duration in the young generation have been reported during the period of COVID-19 pandemic-related behavioral restrictions. This phenomenon raises a concern about the risk of a mismatch between their sleep-wake phase and social life that may lead to the development of DSWPD after the removal of these restrictions. Although the typical feature of DSWPD is a delay in circadian rhythms, individuals with DSWPD without having misalignment of objectively measured circadian rhythm markers account for approximately 40% of the cases, wherein the psychological and behavioral characteristics of young people, such as truancy and academic or social troubles, are largely involved in the mechanism of this disorder. Recent studies have shown that DSWPD is frequently comorbid with psychiatric disorders, particularly mood and neurodevelopmental disorders, both of which have a bidirectional association with the pathophysiology of DSWPD. Additionally, patients with DSWPD have a strong tendency toward neuroticism and anxiety, which may result in the aggravation of insomnia symptoms. Therefore, future studies should address the effectiveness of cognitive-behavioral approaches in addition to chronobiological approaches in the treatment of DSWPD.

Informations de copyright

Copyright © 2023 Futenma, Takaesu, Komada, Shimura, Okajima, Matsui, Tanioka and Inoue.

Déclaration de conflit d'intérêts

KF reported personal fees from Eisai., Ltd. and MSD outside the submitted work. YT reported lecture fees from Takeda Pharmaceutical, Sumitomo Pharma, Otsuka Pharmaceutical, Meiji Seika Pharma, Kyowa Pharmaceutical, Eisai, MSD, and Yoshitomi Pharmaceutical outside the submitted work. KM reported personal fees from Eisai, Meiji Seika Pharma, MSD, Otsuka Pharmaceutical, Takeda Pharmaceutical, and Yoshitomi Pharmaceutical outside the submitted work. AS reported personal fees from Eisai and Sumitomo Pharma outside the submitted work. IO reported grants from NEC Solution Innovators Co., Ltd. and Infocom Co.; personal fees from Otsuka Pharmaceutical MSD, and Eisai.; and consultation fees from NEC Solution Innovators Co., Ltd. and Suntory Wellness Ltd. outside the submitted work. YK reported lecture fees from Eisai outside the submitted work. YI reported personal fees from Eisai, Otsuka Pharmaceutical, Takeda Pharmaceutical, Astellas Pharma Inc., and MED K.K. and grants from Philips Japan Co., Ltd., Koike Medical Co., Ltd., and Teijin Pharma Ltd. outside the submitted work. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.