Treatment for DSPS is specific. It is different from treatment of other types of insomnia, and recognizes the patient's ability to sleep well while addressing the timing problem. Nightly use of sedative and hypnotic drugs is rarely useful in DSPS, and surgery is unheard of.
There is no permanent cure for DSPS. The treatment methods described here have all been reported in the scientific literature to relieve DSPS in some patients. This does not necessarily mean you should try them; it only means these methods are taken seriously as options for treating DSPS. No particular treatment will relieve DSPS in all cases, and you and your doctor may decide that some of the strategies listed below are too risky or too uncomfortable to be worthwhile. And please take note of the appropriate use disclaimer.
If your DSPS is properly diagnosed and treated, you should be able to sleep and to function just as well with the early sleep schedule as you do with a late one. Stimulant drugs (including caffeine) to keep you awake during the day should not be necessary.
The first part of DSPS treatment is stabilization of the sleep/wake schedule, for a week. That means sleeping regularly, without napping, at the time which is most comfortable for you. It is important to start treatment well-rested. Mild cases of DSPS can be controlled by waking up and going to bed 15 minutes earlier every day until the desired sleep schedule is reached, and then maintaining a strictly regular sleep/wake schedule seven days a week. If this doesn't work for you, see a doctor.
Treatment Methods:
Working the evening or night shift, or working at home, can make DSPS less of an obstacle. Some people nap, even taking four hours of sleep a day and four at night. Long daytime naps are discouraged by almost everyone because they're believed to promote nighttime sleeplessness, but you may decide that a regular nap to make up for lost sleep at night is an acceptable pattern for you. If you're a student, ask for an arrangement to take exams at times when your concentration is good.
Avoid alcohol at bedtime. It disrupts sleep.
Don't try to fall asleep if you're not sleepy. You could spend hours tossing and turning, making yourself miserable. If after twenty minutes, you don't feel any closer to falling asleep, get out of bed and do something else to occupy yourself until you start to feel sleepy.
Avoid excessive caffeine, especially within two hours of bedtime. Aside from melatonin, sleeping pills (e.g. barbiturates, benzodiazepines, antihistamines, and over-the-counter "sleep-aids") usually will not make you sleepy if you take them before your body is ready to sleep. If they do induce sleep, the DSPS symptoms usually return the next night anyway.
DSPS is a difficult sleep disorder to treat. Some people outgrow DSPS after a few months, years, or decades, as their circadian systems mature. Unless this happens to you, you will always have a tendency to drift to later sleeping times, and you will then have to reset your body clock one way or another if you want to sleep and wake up at "normal" hours. Treating DSPS can be a lifelong adventure.
The most important way to prevent drift is to maintain an outrageously regular sleeping schedule, going to bed and getting up at the same time seven days a week. That means having to deal with the alarm clock every day - but the alarm clock will become much less of an enemy if your biological rhythms have been properly entrained. The main problem is that things inevitably happen in life that temporarily disrupt your sleep schedule - e.g. taking care of small children, occasional anxiety, illness or pain, and accidentally sleeping in. You can try to minimize the disruptions, but they will happen.
If you have had DSPS for many years, starting to sleep at earlier times will also demand a major psychological adjustment for you. You may have adapted your lifestyle to your night owl tendencies, and giving up your time alone in the early morning hours can be a difficult sacrifice. Remember that although it is important for you to sleep regularly seven days a week, you don't have to do that twelve months a year. It might be possible and worthwhile for you to sleep early when you need to, e.g. when you have to work, and then choose to stay up late during vacations. You just have to be willing to go through sleep-rescheduling again at the end of your vacation. However, it would be easier on you and your body if you sleep as regularly as possible. Resetting the sleep phase to earlier times is difficult for people with DSPS!
'Tis a gift to be gentle, 'tis a gift to be fair
'Tis a gift to wake and breathe the morning air
And every day to walk in the path we choose
- 'Tis the gift that we pray we may ne'er come to lose.
-traditional Shaker hymn