Talk:Delayed sleep phase disorder/Archive 2

Niteowl mailing list
Here are some reasons I think the Niteowl mailing list is worth mentioning in the article:


 * Articles should cover all aspects of a topic. Peer support an important aspect of many chronic medical conditions, including this one. I'd like the article to discuss peer support more extensively. For now, Niteowl is the only peer support group I know of.


 * It's a link to a non-commercial site for a non-profit community group. It's not spam.


 * Niteowl has been around for over a decade. That should count for something.

If you have reasons it's not worth mentioning, please let's discuss. Cheers! Kla'quot 05:32, 2 August 2006 (UTC)
 * Okay, but I still think it would be much better to list it under "External Links". &mdash;ptk✰fgs 05:41, 2 August 2006 (UTC)


 * I'm OK with that. I've moved it to External Links. If we do cover peer support more extensively in future then maybe it will fit into that discussion. Kla'quot 05:51, 4 August 2006 (UTC)


 * Good deal. &mdash;ptk✰fgs 05:52, 4 August 2006 (UTC)

Evolutionary History
Can someone please provide reliable sources for the Evolutionary History section? Perhaps it should be reworded to discuss morningness-eveningness instead? Note that ASPS is extremely rare. Kla'quot 16:38, 26 October 2006 (UTC)

I've deleted this for now Kla'quot 07:12, 10 November 2006 (UTC) : There is a theory that in an evolutionary context, people with DSPS were the ones who could look after the tribe at night and stand guard against predators or invaders.

''A small percentage of the tribe who had with DSPS could help the survival rate of the tribe or clan, and hence this behavior would be beneficial to propagation and be selected for. The ones with DSPS would no doubt have their shift taken over by the ones with ASPS (advanced sleep phase syndrome). See also: Evolutionary Psychology''

What a load of BS
So if I go sleep at 4:00 and wake up at 12:00 I have a "disorder" and I need "treatment" ? Wouldn't it be far more effective and simple if I simply moved to another time zone? Cuzandor 18:00, 1 November 2006 (UTC)
 * That doesn't really work. A delayed sleep phase appears to be caused by a time offset in the brain's production of melatonin in response to environmental cues from exposure to sunlight. In another time zone, the sun rises and sets at a different time and the sleep phase would shift accordingly.
 * Also, the reason people generally seek treatment for DSPS is because life in industrialized societies enforces rather strict scheduling requirements. The primary complaint is usually not the sleep schedule itself, but of its interference with work, school, etc. For a lot of people it is much easier to change one's own schedule than it is to persuade others to adjust.
 * Is there a change you are proposing to the article here, or did you just want to stop by to issue some invective toward circadian rhythm sleep disorder research? &mdash;ptk✰fgs 21:20, 1 November 2006 (UTC)
 * Well I agree with you to some extent about the use of the word 'disorder'.  It's probably more accurate to call it a less common state, but I suppose it really depends on your perspective.  --Animus9 11:30, 20 November 2006 (UTC)
 * A "disorder" label is always controversial. It assumes that the given state is "wrong" and needs to be "fixed." It's a debate that could go on forever, for nearly every "disorder" you can think of. However, that does not invalidate the underlying condition. The fact is that there are people whose bodies do not run on the same light/dark cycles as most. I am one of them, and I can assure you it is not an easy condition to live with. The revelation that my trouble maintaining the schedule expected of me was a consequence of my biology and not some kind of moral failing under my own control was profound. Now, whether I ought to adapt to fit society or whether society ought to adapt to fit me is a hard question. But there is no doubt in my mind that some kind of adaptation must happen, because my body and my obligations are not compatible. Personally, if I can find a pill that will help me sleep and wake on the kind of schedule my job expects and my friends share, I will jump at it. There may be long-term negative consequences, but I can't imagine they are worse than the long-term consequences of chronic sleep deprivation and the anxiety and distress my condition has caused me. As a side note, moving west a time zone or two always helps for a couple of days, but my body always readjusts. Going east again is simply painful. Lamanteuse 08:35, 18 February 2007 (UTC)

Your're right: it may seem easier to adjust yourself than to try to persuade others to accept you as you are. But it normally doesn't really work, does it? I had to live against my own biological needs all the years in school, but I was constantly getting headache and becoming ill. After school I discovered the first time how much more efficient my work could be, how good it felt to be less tired, how much better my bodily condition became. After that, I didn't want to get back to the bad stage of school time. And during school I was able to sleep one hour in the afternoon. A whole working day doesn't allow this (also a bad feature of our civilization). So, I decided to think it over, and by now I hold two opinions: 1) there is nothing wrong with me and I have a right to live a life which doesn't harm my health, 2) we are permanently ignoring our biological and psychological needs as human beings just to fit into the pattern of a society which needs to be corrected in the interest of all individuals living in it. It is not even economically efficient to live this way! So, I decided to fight for my rights and for a better social environment for all of us, especially the next generations. —Preceding unsigned comment added by 87.183.222.81 (talk) 22:30, 4 September 2008 (UTC)


 * It's a "disorder relative to societal norms", in other words, the same type of disorder as left-handedness and homosexuality. We all know how attempts to cure those "disorders" end. —Preceding unsigned comment added by 82.224.148.118 (talk) 11:20, 2 November 2009 (UTC)

Recognition in the Medical Community
Research into DSPS, and its opposite, ASPS, is only a couple of decades old and by no means conclusive. Many doctors reject its status as "incurable", while others see it as "shifted phase", i.e. that a normal pattern exists but has been suppressed. These beliefs are highly contentious, especially among sufferers.

As I mentioned earlier, this paragraph sounds alarming but I don't understand what it's saying. Can anyone clarify what this paragraph means? Kla'quot 08:54, 5 May 2006 (UTC)

It means that there is division in the medical community over whether or not DSPS can be "cured" as such -- a percentage of doctors see DSPS as little more than shifted phase (think persistent jetlag) and do not acknowledge the possibility of a permanently shifted schedule. I can't provide cites right now.Darkaddress 19:04, 26 October 2006 (UTC)

This is no B.S. as I see some may put it. I made myself wake up as 9 this morning and although i am sleepy i can not go to sleep, even though it is 2:30 in the morning. I do hope that u post some cites soon though, because this 'disorder' is keeping me from moveing on to bigger and better things. 2:39, 11 December 2006

DSPS and Depression
I suffer from DSPS myself (though I didn't know it was called that), and have a suggestion for the depression section. I have suffered from depression in the past, so I do know what it's like. When I first came to my doctor about my DSPS he wrote it off as depression, against my objections, and medicated me thusly for 3 months until I convinced him that it wasn't a problem with depression. How much could this 50% link between depression and DSPS be people like me, who were misdiagnosed as depressed simply because DSPS shares some symptoms with depression? Is there a place for stating something like this in the article without it being original research? And for those that suffer with me, my doctor has me on Modafinil. It's not the best solution (don't want to be medicated forever), but it's working for me rather well. Only problem is I have to wake up 2 hours early to take my dosage so that it will wake me up on time. Adam Weeden 14:59, 21 December 2006 (UTC)
 * Is there a place for stating something like this in the article without it being original research? 
 * Nope, not unless you have a citation to a reliable source. &mdash;ptk✰fgs 20:18, 21 December 2006 (UTC)
 * There are many reliable sources on this. I've been meaning to expand this section for a long time. I'll try to expand it soon. Kla'quot 20:33, 21 December 2006 (UTC)

Teenage sleeping patterns
Isn't this similar to what's considered normal teenage sleeping behaviour? Njál 01:17, 24 December 2006 (UTC)


 * What is normal teenage behaviour? More to the point, what is a normal teenager? --MushroomCloud 00:23, 24 January 2007 (UTC)


 * I think it has to do with military intelligence. Adam Weeden 03:17, 24 January 2007 (UTC)


 * Giggle ;) Kla'quot 21:26, 25 January 2007 (UTC)


 * There's a spectrum. The article should mention that most teenagers, at least in the West, don't get enough sleep, and teenagers do tend to sleep at late times. But most teenagers (93% if you believe the statistics) have these tendencies to a mild enough degree that it isn't a major health problem. Kla'quot 21:24, 25 January 2007 (UTC)


 * While Western teenagers may not get enough sleep, this is probably more of a concious decision (staying up to party/study/whatever) and really early wake-up times due to early school hours and/or increasing distance to school. --MushroomCloud 22:56, 9 February 2007 (UTC)


 * I think the important difference is that DSPS tends to begin early in life, and persists beyond adolescence. I have had DSPS since I was a very young child. It became worse when I was a teenager, mostly through a combination of need to wake up much earlier for high school, and having more bad habits about my sleep, but it has always been a similar tendency, and I have had more trouble controlling it than my peers. Most people I know, for instance, stay up late more or less by choice, and if they go to bed at an unusually early time, they fall asleep at an unusually early time. This is not something I have ever been able to do. Going to bed earlier simply means spending more time staring at my ceiling. The question of whether or not "normal" sleeping patterns for teenagers conflict with the social expectations for their behavior is a separate one from whether or not there is a percentage of people who have significantly more trouble following a typical diurnal pattern than most. Lamanteuse 08:20, 18 February 2007 (UTC)

Changed "some studies" to "at least one study" wrt the 7% estimate of DSPS among adolescents and added that boys outnumber girls in adolescence while distribution is even among men and women (adults). All this after reading the referenced PDF. Hordaland 20:37, 4 November 2007 (UTC)

Cold showers
I just removed this as I suspect it's a hoax: "Local remedies and treatments for DSPS have been largely fabricated and often suffer from negative public sentiment that DSPS victims are self diagnosing with hypochondriac tendencies. One of the most successful treatments for DSPS remains the Schniedorf Shower method pioneered in Germany during the late 1980s.  The Schniedorf method takes advantage of physiological triggers in circadian rhythms by use of irregularly frequented cold showers during normal sleeping hours.  Taking between 1 and 3 ice-cold showers between the hours of midnight and 4 AM for a period of one week can reduce DSPS symptoms by up to 37% in males and 42% in females." Does anyone have a source for this? Kla'quot 06:38, 7 March 2007 (UTC)
 * A researcher by the name of J.G. Schnedorf produced a study in 1938 on something called the "hypnotoxin theory of sleep", but his studies had something to do with injecting something into dogs... nothing about showers. That's the closest I can find. We would certainly need a citation for the paragraph you removed. &mdash;ptk✰fgs 06:54, 7 March 2007 (UTC)

Name of the syndrome: DSPS vs DSPD
I know there was discussion on the niteowl mailing list about DSPS being officially renamed "Delayed sleep phase disorder" in the new ICSD. However, the new ICSD isn't out yet, and the syndrome is still called DSPS much more often than DSPD. Until that situation changes, the article shoudl reflect the fact that "DSPS" is the most common usage. Kla'quot (talk | contribs) 08:02, 16 June 2007 (UTC)
 * OK, I've made these changes. I suppose the new edition of the ICSD is coming out very soon. I've looked for it on Amazon and the web but the most recent version I can find is from 2005. When the new version becomes available, we should re-evaluate whether to call it DSPS or DSPD; there is a tension between using the "correct" name and using the name that is most commonly used. Best wishes everyone, Kla'quot (talk | contribs) 08:22, 16 June 2007 (UTC)
 * I hope we can avoid using DSPD, as it is being used in UK-officialdom to refer to Dangerous people with Severe Personality Disorder. As if people with DSPS didn't already have enough trouble explaining themselves... Hordaland 11:14, 30 June 2007 (UTC)

Sleep-phase related to other rhythms
Newbie here, and DSPS-sufferer. I don't know how to work my concerns into an existing article, either the one on DSPS or the more general one on circadian rhythms. "If treated successfully", it says under treatment. There is more to successful treatment than just moving the sleep-phase to an earlier hour. I've been treated for 3+ years by a knowledgable specialist (Prof. of Psychiatry Fred Holsten, MD, PhD, in Bergen, Norway). Using daily light therapy and melatonin we have moved my sleep-phase more or less successfully. However, it is obvious that my other rhythms, at least appetite and the creative "really awake" hours, have not followed suit. I've not been tested for core body temperature rhythm, cortisol and all the rest, but we're quite sure that sleep-phase is the only thing that's been moved. So I can keep my job until retirement, then hopefully(!) go back to sleeping at natural hours: 4 a.m. to 12:30 p.m.

I'd appreciate feedback on these thoughts! Thanks, Hordaland 11:39, 30 June 2007 (UTC)

I feel the same way, for what it's worth. I know i could give 150% or more of what i do now, if i could just come into work around 1pm!! I don't know of any way to incorporate this into the article, other then the below discusson on what "if treated successfully" means. Other then a support group, i suppose. —Preceding unsigned comment added by 12.148.206.70 (talk) 16:41, 16 October 2008 (UTC)

Treatment
As a DSPS sufferer for the last 30 years (age 7 to age 37), I believe the following needs a citation:

>If treated successfully, a person with DSPS can sleep and function as well with the early sleep schedule as with a late one. >Stimulant drugs (including caffeine) to keep the person awake during the day should not be necessary. The chief difficulty of >treating DSPS is in maintaining the earlier schedule after it has been established. Inevitable events of normal life, such as >staying up late for a celebration or having to stay in bed with an illness, tend to reset the person's sleeping schedule to >late times again.

That's like saying that a physically disabled person can "function as well" with one leg as well as two. Yes, there are things they can do as well (like type on a computer). And they can "get by" in a non-accessible world. But the term "as well" is simply not accurate. I have had 9-5 jobs and I can function "well" because I'm blessed with intellegence, drive and a great education. But I function MUCH better on a night schedule. That statement is like saying that a day person can function "as well" working from midnight to 8 am. It's simply not true, and it's contradictory to the rest of the entire article, which describes DSPS as a disorder with real symptoms. DSPS sufferers are able to work 9-5, with the help of a variety of treatments, ranging from caffeine to light therapy. But that doesn't mean they can function "as well" as when they follow their natural schedule. —Preceding unsigned comment added by Dreslough (talk • contribs) 16:36, 5 September 2007 (UTC)


 * I agree, and I've changed "a person with DSPS can sleep and function as well with the early sleep schedule as with a late one. Stimulant drugs (including caffeine) to keep the person awake during the day should not be necessary. The chief difficulty of treating DSPS..." to


 * "some people with DSPS can sleep and function well with the early sleep schedule. Stimulant drugs (including caffeine) to keep the person awake during the day may not be necessary. A chief difficulty of treating DSPS..."


 * We're all so different, and none of the original claims (above) will apply to all. The rest of the paragraph is OK, IMO, as it suggests that no treatment is a final cure.Hordaland 20:52, 12 September 2007 (UTC)

To be fair, it does say "if treated successfully"... :-) &mdash;BurnDownBabylon 22:21, 12 September 2007 (UTC)


 * To me, "if treated successfully" suggests that it can be (if you find a good enough specialist, for example). That may not be a formally correct interpretation, but common enough.  So I've change it to "With treatment, some people...", which I find unambiguous.  —Preceding unsigned comment added by Hordaland (talk • contribs) 23:19, 12 September 2007 (UTC)

"Impact on Patients" Section & Nevsimalova quotation
the citation link for the quote in this ("impact on patients") section, described in the footnote as being from "WHO Technical meeting on sleep and health - meeting report, accessed August 12 2006," is broken. Further, it ought to be removed and/or qualified, as in its current state the citation is incorrect, the quotation's information is misleading & its authority misrepresented.

A friend did some research and found the following: "I think that attributing the quote [...] to "sleep experts" at a WHO meeting makes the quote sound *very* authoritative. It suggests that it is the consensus view of the World Health Organisation on DSPS. However, if you follow up the source (which actually requires a lot of digging), in reality it appears to be the opinion of one sleep expert, and his/her extracted quote is based on an old analysis of psychiatric disorders, not sleep disorders. Searching pubmed for "Benca" [the author] and "DSPS," or "Benca" and "delayed" does not return any matches at all, so I think s/he cannot be said to be an expert in DSPS and certainly can't be "sleep experts" (plural).

The full citation to Benca et al is: (31) Benca R., Obermeyer WH, Thisted RA, Gillin JC: Sleep and psychiatric disorders. A meta-analysis. Archives of Genuine Psychiatry 1992, 49:651.

This source (which is not attributed on the current wikipedia page) comes from 1992, so it's very out-of-date given all the far more recent research into DSPS, It isn't even about DSPS specifically; and this meta-analysis is only reviewing "sleep in psychiatric disorders". Examining the role of sleep in psychiatric disorders would seem to be quite different to examining the role of psychiatry in sleep disorders! " —Preceding unsigned comment added by 134.10.22.197 • contribs 20:36, 12 September 2007

The quotation, attributed to sleep experts at a WHO meeting, does not represent the published views of the sleep experts at that WHO meeting.

It is also not clear which of the claims made in the quotation, other than an association with depression, can be substantiated. In particular, the claim about criminal leanings is controversial, "some young subjects show" is vague, and it does not reflect significant published views about DSPS.

However, there is good evidence available that depression occurs in a significant number of people with DSPS, so a separate paragraph about this association, with reliable citation, would be justified.

The conclusions of the sleep experts at the 2004 WHO meeting on sleep and health are given in the document that was originally cited, albeit with a broken link. That document can be found here: http://www.euro.who.int/document/E84683_1.pdf. It does not make a single mention of DSPS.

The link in the footnotes has now been changed to point to a different document that contains the quoted paragraph; the quotation actually comes from a paper presented by a single author. There is no indication that that paper has been peer-reviewed, and it was not accepted in the conclusions of the WHO-assembled sleep experts.

Furthermore, although the quotation now makes reference to another source document, Benca et al 1992, it is not clear which of the assertions in the quotation are supported by Benca, and which are the opinions of the single, non-peer-reviewed author. In addition, the abstract of Benca indicates that their paper is about psychiatric disorders, and not sleep disorders. This is significant given that DSPS has frequently been misdiagnosed as a psychiatric disorder. This would not appear to be an authoritative source for claims about DSPS, and it is not a recent document.

In conclusion, the quotation given is in reality the opinion of a single author, and does not have the authority of the WHO. It did not feature anywhere in the conclusions of the sleep experts at the WHO meeting. It is not a peer-reviewed source, and it is unclear which of the claims it makes can be supported by evidence.

I believe this quotation is not a reliable source for the contentious claims it contains, and it should be removed as it does not meet Wikipedia's Verifiability policy.

Amruk 22:10, 13 September 2007 (UTC)


 * I think you are overreacting. The Benca paper was published in the AMA's Archives of General Psychiatry, one of the most significant medical journals in its field. The paper is widely cited and you may review Benca's research methods here: http://archpsyc.ama-assn.org/cgi/content/abstract/49/8/651.
 * I also do not see what is contentious about the claims. Much of what we call sleep occurs in the brain, and the psychiatric effects of sleep deprivation are well-documented. &mdash;BurnDownBabylon 23:06, 13 September 2007 (UTC)


 * The first contentious issue is that this quotation as been attributed to "sleep experts" at the WHO; this is not accurate, and it gives it undue weight which is not warranted. In fact, the quotation is contained in a paper by a single author, Nevsimalova, which has not been peer-reviewed, nor was it accepted by the sleep experts at the WHO meeting. The accuracy of the attribution is important.


 * The second contentious aspect, in particular, is the line claiming that, "some young subjects show criminal leanings". It is not clear whether this is the opinion of Nevsimalova (the author of the quoted text), or if it has any basis in Benca. This cannot be verified from the Benca abstract. The prestigiousness of the journal that published Benca is beside the point if it is the opinion of Nevsimalova alone.


 * The association with depression is not contentious, as I acknowledged, and there is already a separate 'DSPS and Depression' section. I do however question the accuracy of a link with Bipolar Disorder, as I'm not aware of such an association being supported by research. If it is, then sources to verify this should be given. Other psychiatric aspects of sleep deprivation in DSPS could be better documented by more reliable sources than this Nevsimalova paper.


 * I hope this helps to clarify the objections to this quotation. Amruk 02:28, 14 September 2007 (UTC)


 * I am working on getting a copy of the Benca article. It will take a few days at least; I need to visit the medical library. Once we have that it will be easy to replace the WHO summary with quotations from the Benca article. &mdash;BurnDownBabylon 15:53, 14 September 2007 (UTC)

DSPS was first formally described in 1981, 26 years ago. In a long background paper (not peer reviewed) prepared for the WHO meeting in January 2004 in Bonn, neurology professor S. Nevsimalova wrote about effects of sleep disturbance on the health of adults. She is an expert on narcolepsy and hypersomnia, specializing in sleep disorders in children (according to a check of the first 3 pages of results of a Google search for ‘Nevsimalova + sleep’).

In her very short section on “Circadian rhythmicity disorders” the only cite is to Dr. Benca’s article from 15 years ago, but that review is not directly quoted. Access to the full text of Dr. Benca’s review article will show which of the items listed by Professor Nevsimalova (alcohol abuse, criminal leanings, SAD, primary depression and bipolar disorder/s) was/were mentioned by Dr. Benca in 1992.

Much research has been done and many studies and review articles published these last 15 years. Dr. Benca is the associate chairman of the Department of Psychiatry at the University of Wisconsin-Madison. From her profile:  “Research studies in Dr. Benca’s laboratory use behavioral, neurophysiologic, and neuroanatomic techniques to elucidate mechanisms for sleep abnormalities in psychiatric disorders.”  As has been pointed out, her field is psychiatry. She is indeed a much-cited author, but pointing out her observations from 15 years ago might be a bit unfair to her, and certainly contradicts the Wikipedia article’s emphasis on the pitfalls of “misdiagnosis of circadian rhythm sleep disorders as psychiatric conditions.”

The Wikipedia article has otherwise an entire section on ‘DSPS and depression’, which should suffice. That section could be renamed ‘DSPS and mental health’ if newer (emphasis on newer) information about DSPS and mental health is to be added. Professor Nevsimalova’s 1/2 paragraph with the tenuous WHO association should be removed. Fifteen year old findings referred to in a single-author paper do not reflect the current state of affairs. Hordaland 16:53, 14 September 2007 (UTC)


 * I originally inserted the WHO quote, and as I recall it was faithful to the source at the time. It looks as if the WHO changed the text of the paper recently, which is weird but is the only explanation I have. In any case, as there is no available source for the quote now, I support its removal. More should be added to the article on the relationship between DSPS and mental health problems, because the relationship is so notable that the article is actually significantly incomplete without it. I have been working on an expanded section for a long time and have found it very difficult to write. There are multiple quality sources and they come to similar conclusions. I'll post them here later... Take care, Kla’quot (talk | contribs) 17:16, 14 September 2007 (UTC)
 * OK, I found the original source of the quote now... it was in this report annex, linked to from here: http://www.euro.who.int/Noise/Activities/20030925_1. If attributed to Sona Nevsimalova, it is a reliably sourced, notable point of view and is worthy of inclusion. However, it should be put into perspective and disagreeing points of view also should be included. Kla’quot (talk | contribs) 17:26, 14 September 2007 (UTC)

It seems that you strongly wish to exclude information from this article on the links between circadian rhythm disorders and psychiatric conditions. Why is this? Do you really want DSPS not to be seen as a legitimate psychiatric condition? &mdash;BurnDownBabylon 21:45, 14 September 2007 (UTC)


 * I imagine it is the line "There is increased abuse of alcohol and other substances, and some young subjects show criminal leanings" that is causing the problems. It is inflammatory, and I am not sure it is backed up by other research. Presenting the quotation as it was originally -- as "sleep experts at the WHO" -- made it seem as if it was some sort of scientific consensus that DSPS causes criminal activity. Can you not see why people would have an issue with that, and would want to make sure it had bulletproof reasons for being there? Also, the paragraph seems out of place where it is, and should perhaps be in the DSPS and Depression section anyway, which talks about the comorbid psychiatric conditions that are often seen in those with DSPS. I think the reasons people have given for removing the paragraph are strong enough that it should at least be removed for now until some consensus is reached here on the Talk page. ManekiNeko | Talk 23:06, 14 September 2007 (UTC)


 * I took the section out of the page for now -- here it is so we can discuss it and try to come to a consensus:


 * At a World Health Organization meeting on the effects of sleep on health in January 2004, neurology professor S. Nevsimalova noted that:


 * The medium and long term effects ... are known especially in DSPS. Affected individuals suffer from chronic sleep deprivation and from behavioral and cognitive consequences of sleep debt. There is increased abuse of alcohol and other substances, and some young subjects show criminal leanings. A striking relationship has been found between circadian rhythms and psychiatric disorders, particularly seasonal affective disorder, primary depression, and bipolar affective disorder (Benca et al., 1992).


 * ManekiNeko | Talk 23:12, 14 September 2007 (UTC)


 * It seems totally reasonable to me. Someone who has trouble synchronizing to a 9-5 schedule will be more likely to have money problems, and will be more likely to be wandering around a sleeping town at 4:00 in the morning. As we have a reliable peer-reviewed study noting a statistical correlation, I don't see what the problem is here. Demonstrating the impact of the condition on the people who have it is totally appropriate. Noting a correlation with crime merely underscores the impact this condition can have on its sufferers. This is only "inflammatory" to a reader who holds a one-dimensional view of crime or subscribes to negative stereotypes about psychiatric conditions. For most adults this passage is highly unlikely to read as a smear, and I am kind of concerned that anyone would even see it that way. &mdash;BurnDownBabylon 00:51, 15 September 2007 (UTC)


 * " Someone who has trouble synchronizing to a 9-5 schedule will be more likely to have money problems, and will be more likely to be wandering around a sleeping town at 4:00 in the morning." And this means they will become criminals? This kind of thing is what causes prejudice against those with DSPS. I am concerned that you don't see why those with DSPS could find this disturbing. ManekiNeko | Talk 01:15, 15 September 2007 (UTC)


 * I think you are making a logical leap from "DSPS can lead some toward crime" to "DSPS sufferers are all criminals" where the quotation does not support that leap. The source doesn't say that, and no one appears to be arguing that. I think excising this statement from the article -- a statement which comes from widely cited peer-reviewed research -- is doing a disservice by concealing from readers the depth and breadth of the impact of a DSPS-style sleep schedule. This article refers numerous times to the lack of public awareness of what DSPS even is. The quotation disputed here is a very good summary of clinically verifiable effects of DSPS, and failing to include this or another very similar summary of those effects makes the article fundamentally incomplete. &mdash;BurnDownBabylon 01:24, 15 September 2007 (UTC)


 * Adding further... there are several people who seem to have concerns about this text (and have backed it up with strong reasons), and one person who is strongly in favor of it. This indicates to me that it needs to be discussed and should probably be removed during that process, while it's being hashed out here on the Talk page. The fact that the text is somewhat inflammatory, and the study is relatively old anyway, makes this even more appropriate, I think.


 * Also, the summary doesn't strike me at all as "a very good summary of clinically verifiable effects of DSPS", which is why it caught my attention in the first place. And regarding my comment that it was in the wrong place -- surely you can see that it was odd to have that paragraph followed by one that says "Misdiagnosis of circadian rhythm sleep disorders as psychiatric conditions causes considerable distress to patients and their families, and leads to some patients being inappropriately prescribed psychoactive drugs"? ManekiNeko | Talk 01:28, 15 September 2007 (UTC)


 * What evidence is there that Nevsimalova is an authority or "field expert" on DSPS to be relevant to this article? Clearly she must be considered an expert on some aspect of sleep to have been invited to the WHO meeting. But her area of expertise appears to be narcolepsy and hypersomnia. An expert on these two conditions is not necessarily an expert on DSPS, and there is no evidence to demonstrate that Nevsimalova is an expert on DSPS. Even if she were, a peer-reviewed paper from the same author would be a more reliable source than this one, which has not been through the peer-review process. This paper does not appear to be a reliable source about DSPS.


 * The fact that Nevsimalova included a citation to Benca at the end of the paragraph does NOT mean that the "statement comes from" Benca. No quotations were used at all. And the fact that Benca's paper has been cited by other papers does not mean that it is relevant to DSPS. It has not been cited by articles about DSPS.


 * The disputed issue here is, very specifically, the use of this quotation from this paper by Nevsimalova, and in particular the line that has been quoted above about criminality, for which there is no statistical correlation given, nor any other supporting evidence. Perhaps the original poster's choice of subheading on this page in referring to psychiatry was unfortunate, and has caused some confusion. I have changed the subheading of this Talk section to make the objection clearer. The objection is not about psychiatry in general, as has already been explained above, and the fact that the section about 'DSPS and depression' is not disputed should also make this clear. No-one has said that possible associations to psychiatry are "a smear". The objection is specifically about the use of this quotation from Nevsimalova.


 * Wikipedia's fundamental Neutral Point of View policy states that, "If a viewpoint is held by an extremely small (or vastly limited) minority, it does not belong in Wikipedia (except perhaps in some ancillary article) regardless of whether it is true or not; and regardless of whether you can prove it or not." (Undue weight section). All articles must comply with Wikipedia's Neutral Point of View policies. Amruk 09:18, 15 September 2007 (UTC)

Hypocondria Prevention and Scientific method
The explanation of this article is wonderful, but after reading it, while suffering from a bout of insomnia, I am thorougly convinced I am suffering from DSPS. Why? Because like many psychological disorders that are diagnosed via DSM IV they are based on rather common and overlapping symptoms. Although the article does mention a several differences that are likely to be present and testable e.g. (actigraph reading, sleep log for 3 weeks, melotonin difference etc.) they are not quantified. In the diagnosis, or psychology section there needs to be quantifications of the tests and graphs of the differences between a normal insomniac, a normal sleeper, and a DSPS. There is also no mention of TSH (thyroid stimulating hormone) differences for those with DSPS. This should be explored since (if memory serves) TSH is present in higher amounts between sundown and sleep onset. Feel free to edit this comment for better understanding and move it to another more approriate section. Also please feel free to double check the TSH fact. (It's been years since psych 101 so may now be irrelevent) eximo 08:00, 25 October 2007 (UTC)
 * Many of those things are difficult or impossible to quantify, especially in relationship to one another, and impossible to find out about oneself outside of a lab. But you got me thinking, and working on a new article.  I wanted to know more about what falls within the "normal" range.  The field of study is not many decades old.  Terminology and "requirements" for valid studies are still all over the place.  I landed on the word Chronotype instead of morningness/eveningness, larks and owls, A- and B-people, circadian type, diurnal preference, diurnal variation, and the oldest term BRAC, basic rest-activity cycle.(!)  My article, Chronotype, tries to quantify, to a degree, what is normal.  It's my hope that a comparison between that and the DSPS article will answer some of your questions.
 * BTW I take exception to DSPS being called a "psychological disorder". The International Classification of Sleep Disorders does allow for diagnosing DSPS (extrinsic) as opposed to DSPS (intrinsic).  This article is about the intrinsic, physiological version.  Note that it is chronic and virtually never pops up after the age of 20. Hordaland 21:55, 4 November 2007 (UTC)

Translating this content
I'd like to translate the entire contents of this wiki to the Portuguese site but am unsure of how to do it keeping things synchronized. Can anyone provide assistance? (My idea would be to replicate the entire content in the PT site and translate it over a couple of days, keeping it hidden while it's not ready. Not sure how to do this). Thx —Preceding unsigned comment added by Beowulf pt (talk • contribs) 23:14, 11 November 2007 (UTC)
 * Here's one way to do it: 1) Create a subpage in your user space, using the instructions here. 2) Click the "Edit this Page" tab at the top of the article you want to translate, and copy the entire contents to your user subpage. 3) Translate the content in your user subpage. When it is ready, create a new article on the Portuguese Wikipedia and copy the contents there. Let me know if you need more details. Cheers! Kla’quot (talk | contribs) 00:22, 12 November 2007 (UTC)

Can't we just change society?
I think we're all about as sick of '9 to 5' as people were of the 60 hour work week before the labor revolution. Labor revolution II anyone? ... anyone? Please? :( —Preceding unsigned comment added by 64.122.63.142 (talk) 14:42, 28 December 2007 (UTC)

DSPS and SIESTA as similar patterns as a result of evolved responses to temperature extremes
I've had this most of my adult life and I have the following obsevations


 * 1) It is mostly for me a winter condition which I associate with SAD
 * 2) The pattern for me is starting sleep from 0300 (but sometimes as late as 0500) and mysteriously waking at 10.50 regardless (plus or minus 10 minutes) but stil feeling "slowed down" most of the day
 * 3) I also associate it with a desire to sleep 1-2 hours as the sun goes down (at about 16.00 - I live in a Northern latitude) but after this sleep I am "alive" and fully alert until 03.00 again.

To me there is an obvious theoretical explanations for all this, and it actually has a mirror effect in hot and sunny climates. Let me explain:-

In our genetic past, winter for homo sapiens in northern climates was extremely dangerous. We must remember that we evolved over millions of years and the lifestyle we lead to today is very different from that of our genetic ancestors. Winter was dangerous for two main reasons. First fresh food is in short supply compared to summer and spring. Secondly the nights were dangerous times. They are the coldest part of the day and hypothermia is dangerous. Therefore we evolved a natural (innate) behavioural strategy. We slowed down in the winter to save energy. If we did not slow down, we could use all our food supply and our body fat might not see us through to spring. Hence we tend to eat carbs in the autumn and put on weight, and then slow down mentally as well as physically to conserve energy. At night time, however, hypothermia was the biggest danger. Those of us that evolved a metabolism that speeded up at night had a better chance of survival. We generate more internal heat to protect our internal organs from the extreme cold. Also if we were awake at night we could keep the fire going and hope to protect ourselves for longer. The strange thing is that (optional) 2 hour sleep at sun down. It may be a natural response to normal sun-down in the summer. But the pattern is interesting...8 hours sleep plus 2 hours about 5 hours after waking up.

0300/0500 until 1100)    6-8 hours deep sleep (worse of cold is over.. now safe to sleep)

1100 until 1600          5 hours of low wakefulness (low metabolism..its day, but not much to do)

1600 until 1800          2 hours light but refreshing sleep (sometimes optional)

1800 until 0300          9 hours of increasing wakefulness (metabolism increases.. keep warm!)

Compare this winter sleep pattern in colder climates with the summer pattern in hotter climates such as Algeria or Spain. There, there have an opposite problem. The middle of the day is extremely hot. Too hot! If you are out in that heat you can die of hyperthermia. So in many of the African and Meditteranean countries there is a 2 hour sleep in the afternoon... siesta. And 6 or 7 hours sleep at night. Its the same pattern as the DSPS pattern I have in winter, but with more waking time. They have about 6 hours sleep at night and then a 2 hour siesta about 5 hours waking up. And it too is adaptive to environmental conditions. There they sleep the mostly during the dark which is natural because there is not much to do in the dark. For night owls like me in the winter, I am just living out the things my ancestors did. I am programmed to behave in this way.

2300/0000 until 0700/0800 6-8 hours deep sleep (its dark but generally safe to sleep)

0700 until 1200          5 hours of high wakefulness (day starts cool so metabolism high)

1200 until 1400          2 hours light but refreshing sleep (avoid hottest part of day)

1400 until 2300          9 hours of wakefulness taking it easy (day is still hot... slow down!)

So although the timing of sleep patterns is pretty much identical, the metabolic processes at the waking times are somewhat different. I appreciate that not everyone with DSPS has depression, but that may because the body clock shift process and the metabolic issues are related (perhaps co-triggered) but not always connected (i.e. they can be disconnected). Its interesting to note how many people with this condition are convinced that it is the rest of the world that is out of synch! I too feel like that because I am in my natural rhythm.

Now I know that this has no place yet in the article because it is not based on research. But the reason for stating it is that in all the stuff I have read about DSPS, nobody seems to have made the connection between this aleep pattern and the hot climate pattern and the fact that both seem to be natuarally evolved patterns of behaviour in response to climatic conditions. To me it seems obvious. Now I may be wrong. Does anyone here know of research along these lines? If there are researchers reading thus, this might trigger a useful line of further research. --Tom (talk) 21:32, 19 January 2008 (UTC)