title: Physical symptoms under forced-phase advance treatment in a patient with delayed sleep phase syndrome: a case report.
abstract: The physical symptoms that are observed with forced waking in patients with delayed sleep phase syndrome (DSPS) often prevent the successful treatment of patients. Better understanding of these symptoms will assist in providing appropriate treatment in such patients. Herein, a 19-year-old female patient with DSPS is described, in whom headache, fatigue, and dizziness were observed under forced-phase advance treatment. Statistical analysis showed that her headache was dependent on the therapeutic week, and her fatigue was dependent on the period of the day. There was no association between dizziness and either factor. Experience with this patient indicates that the fatigue observed with forced waking is related to the circadian system. This relationship should be explored for other physical symptoms as well.
authors.affiliation: National Center Hospital for Mental, Nervous, and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan. hynag-tky@umin.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yanagida
authors.forename: Toru
authors.initials: T
authors.lastname: Nakajima
authors.forename: Naofumi
authors.initials: N
authors.lastname: Kajimura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Toru
authors.initials: T
authors.lastname: Hori
authors.forename: Kiyohisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001831:Body Temperature; D004244:Dizziness / Q000628:therapy; D005221:Fatigue / Q000628:therapy; D005260:Female; D006261:Headache / Q000628:therapy; D006801:Humans; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy