Delayed sleep phase syndrome

Persistent shift of sleep onset and wake time to late hours (falling asleep after 02:00, waking after 10:00) with inability to adapt to social demands. Standard therapy includes morning bright-light therapy and evening melatonin 2–3 hours before the target sleep time.

ICD-10 G47.21 drug

Also known as: DSPS, Delayed sleep-wake phase disorder

Drugs used for this condition

BMelatoninFirst line · Hypnotics. Melatonin receptor agonistsMelatonin in low doses (0.3–0.5 mg) 5–7 hours before desired sleep time is the main pharmacological approach to delayed sleep phase syndrome. AASM 2015 recommends melatonin combined with morning bright-light therapy. Standard hypnotics (Z-drugs, benzodiazepines) do not help in DSPS – the problem is not sleep onset itself but a shifted internal clock. Therapy lasts weeks to months with gradual timing adjustment.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit