References

"Alcohol Use Disorder." Psychiatry.org, American Psychiatric Association, www.psychiatry.org/patients-families/alcohol-use-disorder. Accessed 3 Aug. 2026.

"Antisocial Personality Disorder: Often Overlooked and Untreated." Psychiatry.org, American Psychiatric Association, 29 Dec. 2022, www.psychiatry.org/News-room/APA-Blogs/Antisocial-Personality-Disorder-Often-Overlooked. Accessed 29 July 2026.

"Avoidant Personality Disorder." Cleveland Clinic, 28 Sept. 2023, my.clevelandclinic.org/health/diseases/9761-avoidant-personality-disorder. Accessed 29 July 2026.

"Body Scan Meditation." Emotiv, www.emotiv.com/neuroscience/body-scan-meditation?srsltid=AfmBOopghR7gjHobzPhJe3Z3M86E2uRmaxNLAESliYO5g2jPk4PqyHw8. Accessed 30 June 2026.

"Cannabis Use Disorder." Cleveland Clinic, 4 Oct. 2024, my.clevelandclinic.org/health/diseases/cannabis-use-disorder. Accessed 3 Aug. 2026.

"Conduct Disorder." Yale Medicine, www.yalemedicine.org/conditions/conduct-disorder. Accessed 4 Aug. 2026.

"Delayed Sleep Phase Syndrome." Cleveland Clinic, 13 Oct. 2023, my.clevelandclinic.org/health/diseases/14295-delayed-sleep-phase-syndrome-dsps. Accessed 3 Aug. 2026.

"Diaphragmatic Breathing." Cleveland Clinic, 30 Mar. 2022, my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing. Accessed 29 June 2026.

"Exercise and stress: Get moving to manage stress." Mayo Clinic, 19 Sept. 2025, www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469. Accessed 2 July 2026.

"5-4-3-2-1 Coping Technique for Anxiety." Behavioral Health Partners, University of Rochester Medicine, www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/april-2018/5-4-3-2-1-coping-technique-for-anxiety. Accessed 30 June 2026.

Gorica Micic, Amy C. Reynolds, Andrew J.K. Phillips, Phyllis Zee, Cele Richardson, Helen J. Burgess, Leon Lack, Peter Catcheside, Cathy A. Goldstein, Hannah Scott, Sean Cain, Robert Adams, Nicole Lovato, Understanding delayed sleep-wake phase disorder (DSWPD): Mechanisms, comorbidities, and evolving approaches to diagnosis and treatment, Sleep Medicine Reviews, Volume 86, 2026, 102240, ISSN 1087-0792, https://doi.org/10.1016/j.smrv.2026.102240. (https://www.sciencedirect.com/science/article/pii/S1087079226000122)
Abstract: Background Delayed Sleep-Wake Phase Disorder (DSWPD) is a circadian rhythm disorder marked by a consistent and distressing delay in sleep timing relative to societal norms. While traditionally viewed as a circadian phase disorder, growing evidence shows psychological, behavioural, and physical health factors interact with circadian biology to influence onset, maintenance, and outcomes.
Purpose of review: This review synthesises recent literature on DSWPD's multifactorial nature, focusing on aetiology, nosology, comorbidities, and treatment. It highlights emerging evidence supporting a multidimensional diagnostic approach and personalised, multimodal management.
Recent findings: Some individuals with DSWPD exhibit a significantly delayed circadian phase, while others show normal circadian timing but persistently delayed sleep behaviour. A spectrum approach or subtyping into circadian and behavioural variants has been proposed. Comorbidities with psychiatric conditions including depression, anxiety, ADHD and autism are common and may affect treatment response. Chronobiotic treatments remain core, but cognitive-behavioural and psychotherapeutic interventions are increasingly essential, especially in non-circadian or comorbid cases. Advances in wearable technology and circadian modelling offer promising tools for diagnosis, monitoring, intervention.
Summary:DSWPD is heterogeneous and requires an integrative, individualised approach considering circadian biology, behaviour and psychiatric comorbidities. A multidimensional diagnostic and treatment model could improve outcomes and functioning.
Keywords: Delayed sleep-wake phase disorder; Circadian rhythm sleep-wake disorders; Mental health; Circadian modelling; Circadian subtypes; Clinical management

"How Box Breathing Can Help You Destress." Cleveland Clinic, 17 Aug. 2021, health.clevelandclinic.org/box-breathing-benefits. Accessed 30 Aug. 2026.

"How To Do the 4-7-8 Breathing Exercise." Cleveland Clinic, 6 Sept. 2022, health.clevelandclinic.org/4-7-8-breathing. Accessed 30 Aug. 2026.

"Hypersomnia." Cleveland Clinic, 26 Feb. 2025, my.clevelandclinic.org/health/diseases/21591-hypersomnia. Accessed 3 Aug. 2026.

"Insomnia." Cleveland Clinic, 6 Jan. 2026, my.clevelandclinic.org/health/diseases/12119-insomnia. Accessed 3 Aug. 2026.

"LGBTQ+ Communities and Mental Health." Mental Health America, mhanational.org/resources/lgbtq-communities-and-mental-health/. Accessed 4 Aug. 2026.

"Mental health." World Health Organization, 8 Oct. 2025, www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response. Accessed 8 Aug. 2026.

National Collaborating Centre for Mental Health (UK). Common Mental Health Disorders: Identification and Pathways to Care. Leicester (UK): British Psychological Society (UK); 2011. (NICE Clinical Guidelines, No. 123.) 2, COMMON MENTAL HEALTH DISORDERS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92254/

"Nicotine Dependence (Tobacco Use Disorder)." Cleveland Clinic, 30 Nov. 2022, my.clevelandclinic.org/health/diseases/24482-nicotine-dependence. Accessed 3 Aug. 2026.

"Nightmare Disorder." Mayo Clinic, www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515. Accessed 4 Aug. 2026.

"Obsessive-Compulsive Personality Disorder (OCPD)." Cleveland Clinic, 13 Dec. 2022, my.clevelandclinic.org/health/diseases/24526-obsessive-compulsive-personality-disorder-ocpd. Accessed 29 July 2026.

"Post-traumatic stress disorder (PTSD)." Mayo Clinic, www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967. Accessed 5 Aug. 2026.

Sappenfield O, Alberto C, Minnaert J, et al. Adolescent Mental and Behavioral Health, 2023. 2024 Oct. In: National Survey of Children's Health Data Briefs [Internet]. Rockville (MD): Health Resources and Services Administration; 2018-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK608531/

"Self-injury/cutting." Mayo Clinic, 21 Nov. 2024, www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950. Accessed 30 July 2026.

"6 Brain Exercises to Help Keep You Mentally Sharp." Bella Vista Health Center, www.bellavistahealth.com/blog/brain-exercises-to-help-keep-you-mentally-sharp. Accessed 30 June 2026.

"Sleep Paralysis." Cleveland Clinic, 3 July 2024, my.clevelandclinic.org/health/diseases/21974-sleep-paralysis. Accessed 4 Aug. 2026.

"Specific (isolated) phobias." ICD-10Data.com, www.icd10data.com/ICD10CM/Codes/F01-F99/F40-F48/F40-/F40.2. Accessed 20 July 2026.

"What are Anxiety Disorders?" American Psychiatric Association, www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders. Accessed 20 July 2026.

"What are Disruptive, Impulse Control and Conduct Disorders?" Psychiatry.org, American Psychiatric Association, www.psychiatry.org/patients-families/disruptive-impulse-control-and-conduct-disorders/what-are-disruptive-impulse-control-and-conduct. Accessed 29 July 2026.

"What is Borderline Personality Disorder?" American Psychiatric Association, 10 Dec. 2024, www.psychiatry.org/news-room/apa-blogs/what-is-borderline-personality-disorder. Accessed 20 July 2026.