My Son Is a Night Owl. Can You Help?

This case is that of a 14-year-old male who presented to the sleep clinic with daytime somnolence and sleep-onset insomnia which were hindering the child’s day-to-day functioning and performance. Further studies delineated the problem to be delayed sleep phase, after sleep apnea was ruled out. Actigraphy confirmed the diagnosis. Treatment strategies and differential diagnoses are discussed. Namely, treatment involves behavioral modification and keeping consistent schedules, and low-dose melatonin can also be tried. Additionally, the role of light therapy has been discussed. The challenges in correctly identifying and treating this disorder because it is present in adolescents are also touched upon. In summary, this care highlights the common clinical components present in a case of delayed sleep phase. Sleep study helps rule out sleep apnea, an important overlapping disorder which should not be overlooked. Actigraphy objectively confirms the delayed sleep schedule. The treatment which is a combination of behavioral and medical interventions improves adolescent functioning. Delayed sleep phase is mostly prevalent in the adolescent population.