4.4 Article

Behaviorally and environmentally induced non-24-hour sleep-wake rhythm disorder in sighted patients

Journal

JOURNAL OF CLINICAL SLEEP MEDICINE
Volume 18, Issue 2, Pages 453-459

Publisher

AMER ACAD SLEEP MEDICINE
DOI: 10.5664/jcsm.9612

Keywords

circadian rhythm; circadian rhythm sleep disorders; non-24-hour sleep-wake rhythm disorder; light; melatonin

Funding

  1. Oregon Clinical and Translational Research Institute at Oregon Health & Science University

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This study found no evidence of circadian dysfunction in sighted individuals with non-24-hour sleep-wake rhythm disorder. Instead, sleep-wake timing appeared to dissociate from the circadian timing system, and the disorder may be light- and/or behaviorally induced.
Study Objectives: To determine whether there was evidence of circadian or sleep-regulatory dysfunction in sighted individuals with non-24-hour sleep-wake rhythm disorder. Methods: Three sighted individuals with signs and/or symptoms of non-24-hour sleep-wake rhythm disorder were studied. Thirty-five- to 332-day laboratory and home-based assessments of sleep-wake and circadian timing, endogenous circadian period, photic input to the circadian pacemaker, and/or circadian and sleep- wake-dependent regulation of sleep were conducted. Results: No evidence of circadian dysfunction was found in these individuals. Instead, sleep-wake timing appeared to dissociate from the circadian timing system, and/or self-selected sleep-wake and associated light/dark timing shifted the circadian pacemaker later, rather than the circadian pacemaker determining sleep- wake timing. Conclusions: These findings suggest that the etiology of this disorder may be light- and/or behaviorally induced in some sighted people, which has implications for the successful treatment of this disorder.

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