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CC BY-NC-ND 4.0 · Sleep Sci 2019; 12(03): 203-213
DOI: 10.5935/1984-0063.20190086
ORIGINAL ARTICLE

Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences

Authors

  • Cátia Reis

    1   Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Lisboa- Portugal.
    2   CENC - Sleep Medicine Center - Lisboa - Portugal.

  • Teresa Paiva

    2   CENC - Sleep Medicine Center - Lisboa - Portugal.
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Objective/Background Delayed sleep-wake phase disorder (DSWPD) is defined by a delay in the major sleep episode relative to desired or required sleep and wake times. The objectives of this study were to evaluate DSWPD in our population and to compare it with similar clinical data, to analyse gender differences, and to identify possible subpopulations based on circadian timing and alignment.

Patients/Methods 162 consecutive DSWPD patients from a sleep clinic with a median age of 35.5 (24.0) years, 85 (52.5%) males were studied. Patient data were obtained from a clinical interview composed of socio-demographic, life events, daily habits, consumptions, and comorbidities data; and from diaries, actimetry, melatonin and PSG T1. The Dim Light Melatonin Onset (DLMO) was used to define circadian alignment or misalignment.

Results In our DSWPD cohort, there were gender differences for different age groups (p=0.028). Men were more likely to be single and women more likely to be married (p=0.034). In students, school failure was higher for women (p<0.001); for workers, absenteeism was higher in women (p=0.001). In the circadian aligned (compared to misaligned group), DLMO was later (p<0.001), sleep onset time (p=0.046) was later, total sleep time (p=0.035), and number of sleep cycles (p=0.018) were lower, as measured using PSG T1.

Conclusions In this clinical population, DSWPD is more prevalent in young men and in middle age women, although with no overall significant differences between genders. There are two different phenotypes of DSWPD: circadian misaligned and circadian aligned. Depression is prevalent in both groups. Better definition, classification and diagnostic criteria for DSWPD are still needed, and targeted therapeutical intervention should be evaluated.

Gender differences - phase angle - circadian phase - circadian misalignment - phenotypes


Publication History

Received: 24 April 2019

Accepted: 04 September 2019

Article published online:
31 October 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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