I don't know who needs to hear this BUT YOU ARE NOT LAZY IF YOU ARE WAKING UP AT NOON. I have spent hours with patients with delayed circadian sleep phase trying to destigmatize sleeping late and waking up late. 1/4

A young patient looked at me incredulously as I told him that waking up late was okay. I could see him process it in his mind and I saw a wave of relief pass over his face as he understood the concept of circadian rhythm. 2/4

From a young age he has been told that that waking up late was a sign of laziness and he was terrified of even thinking about sleeping in and would feel ashamed if he woke up late. 3/4

People at extremes of circadian rhythm either sleep really early and wake up early (advanced circadian sleep phase) or sleep really late and wake up late (delayed circadian sleep phase). Let your physician know if you need help. We are here for you. #sleepmed #circadianrhythm 4/4

To answer @drgsreddy. A good patient history eliciting an inability to fall asleep,preference to stay awake at night & wake up late during days off & difficulty waking up early morning is indicative of a delayed CRSWD.

Actigraphy and melatonin assays can be done to further assess. However these are available in limited locations. Treatment can be either aligning your social life with your circadian phase. Or trying to align your circadian phase, using light & melatonin, with your social life.