Delayed sleep-wake phase disorder

Bradley V Vaughn MD (Dr. Vaughn of UNC Hospital Chapel Hill and University of North Carolina School of Medicine has no relevant financial relationships to disclose.)
Sujay Kansagra MD (

Dr. Kansagra of Duke University has no relevant financial relationships to disclose.

Antonio Culebras MD, editor. (

Dr. Culebras of SUNY Upstate Medical University at Syracuse received an honorariums from Jazz Pharmaceuticals for a speaking engagements.

Originally released November 22, 1993; last updated November 5, 2020; expires: November 5, 2023


Circadian rhythm issues are common and can impact health and quality of life. Delayed sleep-wake phase disorder (DSWPD) is characterized by late bedtime and an inherent delay of biological rhythms compared to the natural daylight. This pattern is frequently observed in adolescents and young adults and may cause chronic sleep deprivation, leading to compromise in school and work performance. Some investigators have considered delayed sleep-wake phase disorder as a marker or precursor for psychiatric and possibly neurologic issues. Delayed sleep-wake phase disorder may disguise itself as insomnia, attention deficit disorder, emotional or affective disorder, or maladjustment, and it can be somewhat similar to the schedule seen in restless legs syndrome. The delay in the body clock can be treated with a combination of lifestyle modifications, appropriately timed exposure to light, and melatonin.

Key points


• Delayed sleep-wake phase disorder is a relatively common circadian rhythm sleep disorder; it usually begins in adolescence and is manifested as habitually delayed time of sleep onset and waking.


• Delayed sleep-wake phase disorder may significantly impede academic and occupational achievements.


• Delayed sleep-wake phase disorder must be distinguished from other sleep disorders as the treatment approach is different.


• Treatment with appropriately timed melatonin and bright light, augmented with behavior and lifestyle modifications, may be effective.


• Relapses after cessation of treatment are common.

Historical note and terminology

Delayed sleep-wake phase disorder was first described in 1979 by a group of researchers and clinicians from Montefiore Medical Center in New York and Stanford University School of Medicine (Weitzman et al 1979). The current formal name established in the third edition of the International Classification of Sleep Disorders (ICSD-3) is delayed sleep-wake phase disorder (American Academy of Sleep Medicine 2014). Prior names include delayed sleep phase syndrome and circadian rhythm sleep disorder, delayed sleep phase type.

The content you are trying to view is available only to logged in, current MedLink Neurology subscribers.

If you are a subscriber, please log in.

If you are a former subscriber or have registered before, please log in first and then click select a Service Plan or contact Subscriber Services. Site license users, click the Site License Acces link on the Homepage at an authorized computer.

If you have never registered before, click Learn More about MedLink Neurology  or view available Service Plans.

Find out how you can join MedLink Neurology