ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2018
Diagnostic and Treatment Challenges of Sighted Non-24-Hour Sleep-Wake Disorder.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 47 citations in OpenAlex.
- The Pittendrigh-Aschoff Lecture 2024.Journal of biological rhythms · 2026Article
- Clinical Chronobiology: Circadian Rhythms in Health and Disease.Seminars in neurology · 2025Review
- Associations of self-reported sleep disturbances, sleep onset, and duration with gallstone disease risk.Frontiers in nutrition · 2025Article
- Registry and survey of circadian rhythm sleep-wake disorder patients.Sleep medicine: X · 2024Article
- Managing non-24-hour sleep-wake rhythm disorder with ramelteon in a 12-year-old girl with Pierre Robin sequence and developmental delay: a case report.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Current Considerations in the Diagnosis and Treatment of Circadian Rhythm Sleep-Wake Disorders in Children.Seminars in pediatric neurology · 2023Article
- The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in community mental health: Comorbidity and use of modules under the microscope.Cognitive and behavioral practice · 2023Article
- Case report: Diagnosis and intervention of a non-24-h sleep-wake disorder in a sighted child with a psychiatric disorder.Frontiers in psychiatry · 2023Article
- Behaviorally and environmentally induced non-24-hour sleep-wake rhythm disorder in sighted patients.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Sleep deprivation therapy to reset the circadian pacemaker in a non-24-hour sleep-wake disorder: a case report.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
- Article
- The Emerging Circadian Phenotype of Borderline Personality Disorder: Mechanisms, Opportunities and Future Directions.Current psychiatry reports · 2021Review
- Non-24-hour sleep-wake disorder successfully treated with the combination of ramelteon and suvorexant in a case of autism spectrum disorder.Neuropsychopharmacology reports · 2020Article
- Assessment of Circadian Rhythms.Neurologic clinics · 2019Review
- Habitual light exposure relative to circadian timing in delayed sleep-wake phase disorder.Sleep · 2018Article
- Non-24-Hour Sleep-Wake Disorder in Sighted Patients: Dealing With an Orphan Disease.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Article
- Adopting the Unentrained Orphan.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesTo report the diagnostic and treatment challenges of sighted non-24-hour sleep-wake disorder (N24SWD).
methodsWe report a series of seven sighted patients with N24SWD clinically evaluated by history and sleep diaries, and when available wrist actigraphy and salivary melatonin levels, and treated with timed melatonin and bright light therapy.
resultsMost patients had a history of a delayed sleep-wake pattern prior to developing N24SWD. The typical sleep-wake pattern of N24SWD was seen in the sleep diaries (and in actigraphy when available) in all patients with a daily delay in midpoint of sleep ranging 0.8 to 1.8 hours. Salivary dim light melatonin onset (DLMO) was evaluated in four patients but was missed in one. The estimated phase angle from DLMO to sleep onset ranged from 5.25 to 9 hours. All six patients who attempted timed melatonin and bright light therapy were able to entrain their sleep-wake schedules. Entrainment occurred at a late circadian phase, possibly related to the late timing of melatonin administration, though the patients often preferred late sleep times. Most did not continue treatment and continued to have a non-24-hour sleep-wake pattern.
conclusionsN24SWD is a chronic debilitating disorder that is often overlooked in sighted people and can be challenging to diagnose and treat. Tools to assess circadian pattern and timing can be effectively applied to aid the diagnosis. The progressive delay of the circadian rhythm poses a challenge for determining the most effective timing for melatonin and bright light therapies. Furthermore, once the circadian sleep-wake rhythm is entrained, long-term effectiveness is limited because of the behavioral and environmental structure that is required to maintain stable entrainment.
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