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What to do about a couple’s mismatched circadian sleep-wake rhythm

One of the patients I saw today was having considerable conflict with his wife because their circadian rhythms don’t match at all. It bothers her tremendously that he is up at night long after she has gone to bed.

I have diagnosed him with circadian rhythm sleep-wake disorder, delayed sleep phase type, which I just call “delayed sleep phase disorder” for short. He is up till late at night—fully awake and energized—while she goes to bed much earlier. My patient’s circadian rhythm problem has led to his missing meetings at work many times, needing to take long naps during the day to compensate for not having slept adequately at night, and marital conflict.


In other articles on this website, we have discussed circadian rhythm sleep-wake disorders, especially the delayed sleep phase type. Please see:

Circadian rhythm sleep-wake disorders: An overview

What is Delayed Sleep Phase Disorder?

Delayed Sleep Phase Disorder: Management


In this article, we’ll discuss a different aspect of delayed sleep phase disorder, one that is important but greatly neglected—how to manage problems resulting specifically from a mismatch in the circadian rhythm in a couple. Yes, of course, we should work on improving the delayed sleep phase disorder in the affected partner—to the extent needed and possible. But I mean, what can be done to reduce the interpersonal conflict?

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