One of the rarer sleep disorders Australians suffer from, Non-24-hour sleep-wake Disorder, is a type of circadian rhythm sleep problem that can disrupt daily life. It is more common among those with total blindness. In fact, over half of these patients show symptoms. However, sighted patients can also develop symptoms on rare occasions.
The exact number of sighted patients with 24-hour sleep-wake Disorder, also known as N24SWD, is not fully understood. One reason is that it is a condition that few are aware of and can go undiagnosed for extended periods. However, taking case studies around the world as a guide, they refer to around 100 sighted patients. Also, one of the few help groups for the problem has around 100 members. As such, it is fair to view this as one of the rarest types of sleep disorder for sighted people. But because it can be so destructive to your quality of life, it is important to understand it and know what to look for if you think it may be affecting yourself or a loved one.
What is Non-24-hour sleep-wake Disorder?
N24SWD is a type of circadian rhythm disorder that affects sleep patterns, putting you out of sync with your social and work life. The circadian rhythm is our inner body clock that regulates sleep to occur overnight. It prepares the body for sleep in the evening and then compels the body to wake again the next morning. It is this natural cycle that almost all our daily lives are built around, from work to social activity.
When that is disrupted, as it is with non-24-hour sleep-wake disorder, you fall out of sync with your life. There are several types of circadian rhythm disorder, but with N24SWD in particular, the sleep cycle slips out of phase. So, instead of a 24-hour cycle, it becomes 25 hours or, in the worst cases, as much as 30 hours.
The result of that is you don’t feel like you need sleep until later in the night. Then, you want to stay asleep later the next morning, too, as your entire sleep period moves. But because it is a cumulative effect, the next night you will be going to sleep and waking up even later. If you have non-24-hour sleep-wake disorder symptoms, this carries on until treated. Eventually, you want to sleep during the day instead of the night. Then it rolls around, coming back to sleeping at normal times until the whole cycle starts again.
As with most sleep disorders, we have little understanding of the cause of non-24-hour sleep-wake disorder. However, research does allow us to note some things that could influence the condition. Because this is an ailment closely associated with blindness, specialists believe that disrupting your exposure to the light and dark cycles that we naturally experience can be a factor. This could be light sensitivity, reducing the amount of time you spend in natural light. Another option is an environmental issue, such as working in a darker room for extended times.
Whatever the cause, having your internal clock out of sync with your life can be very debilitating. It can leave you unable to function in your career or with your friends, family, and loved ones.
How does one diagnose this sleep disorder?
N24SWD is a sleep disorder that can affect you for the rest of your life. If you believe that you may have it or another type of circadian rhythm disorder, seek medical help.
Diagnosis is challenging because symptoms often match other similar sleep disorders. Additionally, there are so few reference patients from whom to build an understanding. Your Sleep physician will ask you to keep a sleep diary for several weeks. This will allow the exact changes in your sleep patterns to be recorded and analysed.
In addition, your doctor may request additional testing such as actigraphy. This monitors active and inactive sleep patterns over a couple of weeks. You may also need a blood test, CT scan, or MRI to rule out neurological issues and narrow down the possibilities before a diagnosis is made.
What are some of the symptoms that someone with Non-24-hour sleep-wake Disorder is likely to display?
The first sign you might have an issue with non-24-hour sleep-wake disorder could be difficulty sleeping at normal times. This is then accompanied by a desire for sleep during the day. It can often be confused with insomnia, but both together can also be a symptom of a shifting sleep cycle.
There is a key difference between N24SWD and other sleep issues, including other circadian rhythm disorders. It has a very visible cycle. As the sleep period is pushed back each day, your sleep will eventually return to normal for a short period. But then the cycle begins again.
This is the tell-tale sign of non-24-hour sleep-wake disorder.
How do you treat a circadian rhythm sleep disorder like this?
If you suffer from N24SWD, it is likely to become a lifetime issue. However, there are ways to mitigate the problem as much as possible. Melatonin supplements are one of the main options, helping to synchronise your internal clock with the rest of the world. While light therapy can be an additional option to prevent daytime drowsiness.
Good sleep hygiene can also help. Maximising the quality of sleep you get when struggling can significantly impact your quality of life.
The main issue with treating non-24-hour sleep-wake disorder is that once you stop these therapies, your body clock can become detached from the standard 24-hour cycle once again.
Conclusion
Every sleep disorder causes problems far beyond the symptoms themselves. However, N24SWD is a particularly disruptive type of circadian rhythm disorder. It is important to seek medical help if you display any symptoms similar to those described.
Treatment can be effective in stabilising your sleep pattern, but it is not permanent. Once diagnosed though, ongoing treatment provides effective management. This is why seeking medical help is so important if you think you may be affected by non-24-hour sleep-wake disorder.
Featured post image by Med Ahabchane from Pixabay