17/02/2026
In adolescents and young adults, delayed sleep-wake phase disorder (DSWPD) may be associated with attention-deficit/hyperactivity disorder (ADHD) and restless legs syndrome (RLS), which can make falling asleep difficult and worsen insomnia.
DSWPD, RLS, and ADHD share common neurobiological, genetic, and clinical mechanisms and exacerbate one another.
Delayed sleep-wake phase disorder leads to sleep deprivation, which can contribute to the development of depression. This can worsen restless legs syndrome or even trigger it if treatment with antidepressants is initiated. All of these factors affect ADHD. Together, these factors contribute to sleepiness, fatigue, and poorer academic performance.
DSWPD is defined as a chronic shift in sleep onset and wake times, delayed by several hours. When constrained by early morning wake times, individuals with this circadian rhythm disorder accumulate sleep debt, leading to sleepiness, learning difficulties, and affective disorders.
During adolescence, pubertal hormonal changes and increased sensitivity to nighttime light are cited as potential causes of the slowing of the biological clock associated with DSWPD. The condition may also be favoured by changes in behavioural habits, such as increased screen exposure and social outings. Nearly 1 in 5 adolescents are affected.
ADHD affects about 5% of adolescents. It is also present in 26% of adolescents and young adults with DSWPD.
Treatment:
Iron deficiency is the main cause of RLS.
For DSWPD management, a chronobiological approach using synchronizers is recommended, particularly for exposure to morning daylight. Light therapy involves exposure to white light that simulates daylight for a set duration to correct phase delay.
Daily physical activity is also recommended to avoid exercising in the evening before bedtime.
For most adolescents with DSWPD, the optimal window is between 1 PM and 3 PM, which is favourable for falling asleep in the evening.