Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study

Figures & data

Figure 1 Participant selection.

Notes: After applying the inclusion and exclusion criteria, a total of 66 patients admitted for inpatient phase-advance therapy for DSWPD were included. The rate of remission was 100%. Among the 66 included patients, 59 underwent outpatient examination following discharge, 27 of whom experienced relapse. Thus, the relapse rate was 45.8%.
Abbreviation: DSWPD, delayed sleep–wake phase disorder.

Table 1 Participant characteristics (n=66)

Sex	32 males, 34 females
Median age	16 years (IQR: 14–21 years)
Median age at DSWPD onset	15 years (IQR: 13–17.75 years)
Median duration of DSWPD	12 months (IQR: 5.25–28.5 months)
Sleep data 1 week prior to hospitalization
Sleep time	2:15±0:33
Wake time	12:21±0:31
Median duration between admission and remission (regardless of being awakened by physician)	1 day (IQR: 1–2 days)
Median duration between admission and remission (waking up on one’s own)	1 day (IQR: 1–3 days)
Median length of hospital stay	14 days (IQR: 9.25–19 days)
Living with others at home	64
Coexisting mental disorders (DSM-5)
ID	1
ASD	4
ADHD	3
ASD and ADHD	1
BPD	1
DD	3
AD	1
SSDs	1

Note: Values are presented as numbers with IQRs.

Abbreviations: AD, anxiety disorders; ADHD, attention-deficit/hyperactivity disorder; ASD, autism spectrum disorder; BPD, bipolar and related disorders; DD, depressive disorders; DSM-5, Diagnostic and Statistical Manual of Mental Disorders, 5th edition; DSWPD, delayed sleep–wake phase disorder; ID, intellectual disabilities; SSDs, somatic symptoms and related disorders.

Table 2 Medication details for patients with DSWPD

Drug therapy during hospitalization	Drug added during hospitalization
None (N=40)	Ramelteon (N=13)
	Melatonin and B12 (N=3)
	Ramelteon and AP (N=2)
	Melatonin (N=1)
	B12 (N=1)
	AP (N=1)
	B12 and Bz (N=1)
	None (N=18)
Bz (N=6)	Ramelteon (N=1)
	B12 (N=1)
	None (N=4)
Ramelteon (N=4)	None (N=4)
Ramelteon and B12 (N=4)	Bz (N=1)
	None (N=3)
B12 (N=3)	None (N=3)
B12 and Bz (N=3)	Melatonin (N=1)
	None (N=2)
Ramelteon, Bz, and AP (N=3)	None (N=3)
AP (N=2)	None (N=2)
Ramelteon and Bz (N=1)	None (N=1)

Note: Values are presented as numbers.

Abbreviations: AP, antipsychotic; B12, vitamin B12; Bz, benzodiazepine hypnotic; DSWPD, delayed sleep–wake phase disorder.

Table 3 Clinical and demographic characteristics of patients with and without relapse

	Relapse (N=27)	Nonrelapse (N=32)	P-value
Age (years)a			0.0339*
<18	23	18
≥18	4	14
Sexa			0.653
Male	11	16
Female	16	16
Age at DSWPD onset (years)a			0.0136*
<16	22	15
≥16	5	17
DSWPD duration (months)a			0.905
<12	13	17
≥12	14	15
Motivation for the occupationb			<0.001*
Absent	10	0
Present	17	32
Family living togetherb			1
Absent	0	1
Present	27	31
Bright light therapya			0.0737
Absent	19	14
Present	8	18

Notes: Values are presented as numbers.

* P-values with significant results.

a Chi-squared test.

b Fisher’s exact test.

Abbreviation: DSWPD, delayed sleep–wake phase disorder.