Do you suspect that you have non-24 hour sleep-wake disorder? Do you have trouble sleeping during the day, but constantly up at night? Even though this condition is one of the most uncommon sleep disorders, you can take comfort in knowing you’re not alone.
Luckily, the medical community is becoming more and more aware of non-24 hour sleep-wake disorder. As a result, there’s plenty of information regarding its causes, risk factors, potential treatments, and more.
Keep reading to learn about non-24 and what you can do to manage the condition.
What is a Circadian Rhythm?
To understand what non-24 hour sleep-wake disorder is, you must first understand the circadian rhythm and how it affects your ability to sleep. Circadian rhythms are 24-hour cycles that are part of the body’s internal clock, which is important for carrying out essential functions and processes.
These natural processes respond primarily to light and dark, which is why a well-balanced circadian rhythm is tied to the cycle of day and night.
The sleep-wake cycle is one of the most important circadian rhythms. The brain’s master clock coordinates all the biological clocks in a living thing, keeping the clocks in sync.
For example, daylight during the day triggers the master clock to send signals that make you alert. These signals are what help keep you awake and active.
At night, the master clock causes your body to produce melatonin, a hormone that promotes sleep. When the master clock fails to regulate the circadian rhythm, it becomes out of sync. This can disturb a healthy sleep pattern.
As a result, an individual may struggle to fall asleep, wake up during the night, or be unable to sleep as long as they want into the morning.
An out-of-sync circadian rhythm may also lead to shallower, fragmented, and lower-quality sleep. On the other hand, a properly aligned circadian rhythm can promote consistent and restorative sleep.
What is Non-24 Hour Sleep-Wake Disorder?
Non-24 hour sleep-wake disorder is a circadian rhythm disorder that occurs because the body’s internal clock is out of sync with daytime (light) and nighttime (dark) cycles.
People with non-24 have a circadian rhythm that’s shorter or slightly longer than 24 hours. This often pushes sleep and wake times progressively earlier or later, usually by one or two hours at a time.
For example, one night, you might fall asleep at 12am. But the next night, you may not be able to fall asleep until 3am. Over time, the delay gets worse, as you go to sleep later and later each night.
You might notice that you prefer going to sleep during the day and have trouble sleeping at night. Then, a few weeks later, you might not have symptoms at all because your body has naturally reset its internal clock, thus, restoring a normal sleep-wake cycle.
After a few days of this, your sleep-wake cycle may become out of sync once again. Unfortunately, in people with non-24, attempts to maintain a regular sleep-wake cycle are often unsuccessful.
Common signs and symptoms of non-24 include:
- Falling sleep during the day
- Irregular sleep patterns
- Attention and memory problems
- A sleep cycle that seems to get later and later every night
- Waking up later and later every day
What are the Causes of Non-24 Hour Sleep-Wake Disorder?
People develop non-24 because of a problem with their internal clock, which controls their ability to sleep at night and stay awake during the day.
There are many factors that play a role in the balance of the sleep-wake cycle. For example, environmental factors such as light can increase wakefulness when it reaches the internal clock.
This is why non-24 affects 55-70% of totally blind people. That’s because their eyes can’t perceive light, which means they don’t get signals to the brain that help regulate their sleep-wake cycle. Therefore, blindness may “throw off” a person’s internal clock.
However, people who aren’t blind can also have this disorder, but these cases are very rare. Certain risk factors that may contribute to the development of non-24 in sighted people include:
- Mental disability
- Mental health disorder
- Brain injury
- Lack of exposure to daylight
- Lack of melatonin production
- Weak circadian clock
- Genetic predisposition
How to Manage Non-24 Hour Sleep-Wake Disorder
Unfortunately, there’s no cure for non-24. Experts and specialists consider it to be a lifelong condition. However, there are certain steps you can take to help restore a 24-hour rhythm.
Below are a few practices to help you manage the symptoms of non-24:
- Take melatonin at least 2 hours before bedtime. Melatonin is a hormone that controls the sleep-wake cycle. Taking a melatonin supplement may help you fall asleep faster at night, allowing you to feel well-rested when waking up.
- Establish a regular bedtime routine with soothing activities. Setting a specific bedtime and participating in calming activities like taking a warm bath, reading, journaling, or meditating can help reset your body’s internal clock.
- Keep your bedroom cool, dark, and quiet. Lights and sounds coming from your TV, phone, and other electronic devices can make it more difficult to fall asleep. Also, keeping your room cool can play a role in the quality of your sleep.
- Get plenty of exercise outdoors. Exercising outside allows you to get natural light, which helps your body establish a good sleep-wake cycle
- Consider light treatment. Light treatment, or phototherapy, involves exposing yourself to bright light early in the morning from a lightbox. Later in the day, you wear special goggles to avoid light. This treatment helps your eyes send the right signal to your brain about light and dark.
If neither of these actions work to restore your circadian rhythm, your doctor may prescribe an orphan drug called tasimelteon (Hetlioz).
If you’ve been diagnosed with non-24, you may have trouble functioning during the day. And unfortunately, this could be affecting important commitments, such as work, school, and family. When you’re extremely tired during the day and wide awake at night, it can be difficult to lead a normal life.
However, by following the tips in this article, you may notice a much improved sleep-wake cycle that allows you to sleep and remain awake during normal hours.