Talk:Non-24-hour sleep–wake disorder/Archive 1

Sleep disorder ?

From Circadian rhythm sleep disorders:

Researchers have placed volunteers in caves or special apartments for several weeks without clocks or other time cues. Without time cues, the volunteers tended to go to bed an hour later and to get up about an hour later each day. These experiments demonstrate that the "free-running" circadian rhythm in humans is about 25 hours long. To maintain a 24 hour day/night cycle, the biological clock needs regular environmental time cues, e.g. sunrise, sunset, and daily routine. Time cues keep the human circadian clock aligned with the rest of the world.

So sleep cycle longer than 24h is a natural state and it is really silly to call it "a sleep disorder" (and social norms cannot determine whether something is a disease or not). Taw 01:34, 15 August 2006 (UTC)

But under normal environmental conditions, a human's rhythm will synch to the light cues. Some people, however, cannot, and they continue to exhibit the "locked in cave" pattern, no matter what they do-- making it impossible to do things like hold down a regularly scheduled job, etc. --Alecmconroy 08:44, 15 August 2006 (UTC)

Doesn't that make society the source of the disorder, not the person? - G3, 15:44, 22 August 2006 (UTC)

No, because only a very low percentage of the population lack the ability to sync their sleep cycle to the daylight cycle. Someone with this disorder would do well to find a job that doesn't require them to work specific hours, because they're going to have a lot of trouble holding down a 'normal' 9-5 job. On the other hand, I do wish people would believe me when I tell them I can't maintain a 24hr cycle.— db48x | Talk 21:30, 1 October 2006 (UTC)

Society is the source of most non-heredetary disorders, and it is perfectly valid to define something as a disorder because is incompatible with commonl views, opinions, mores and practices. This is because "disorder" is increasingly becoming synonymous with "abnormality", which is just what it says: a deviation from the norm.

Comorbidities in AS and ADD tend to arise from friction with neurotypical society, just ask any aspie or a person with adult ADD. Rape trauma is demonstrably exacerbated by feedback from society, although of course there is an initial trauma to begin with; if the initial trauma is insufficient, according to the expectations of society, feedback is applied until the trauma grows to the point where it is sufficient and the cognitive dissonance in society disappears. Many other examples abound. Note, though, that most people are not aware of their participation in this mechanism, and should not be blamed for the harm they are causing. Do not attribute to malice, etc..

That said, circadian rythm disorders appear to be biological in nature. Figures of up to 26 hours have been cited for the zero-feedback circadian rythm, but light sets the rythm for most people. Presumably, the "slack" is there for a reason that has to do with compensation for seasonal variation in daylight, etc., although that's pure speculation on my part.

Db48x, making most people believe any "mental problem" is "real" is virtually impossible, unless they have experienced some first-hand. I have lost count of how many times I've heard people start off their sentences with "Yes, I realize you're depressed, but..." and then progressing to clearly demonstrate that they realize no such thing. Society is the problem, in their inability to accept anything outside their set frame of reference, but there's really no way to do anything about that.

Zuiram 12:47, 21 November 2006 (UTC)

Asked above: "Doesn't that make society the source of the disorder, not the person?" Certainly not. Virtually all plants and animals, including us, normally are able to adjust circadian rhythms daily to the length of time it takes the earth to turn 'round once. No matter what we've decided to call that period of time, it is defined by the earth's turning and not by society.

As to the quote at the very top of this section, that was long the belief, but it is in error. Researchers now agree that the average (for adult humans) is 24.18 hours. What those old experiments actually showed was that low level indoor (electric) lighting, extended at will into the evening, delays our circadian rhythms. --Hordaland (talk) 00:56, 18 October 2008 (UTC)

I don't mind it being called a disorder; it is a social label, for we are "out of order" with the world around us. What I mind is words like "disease" and the implications that it's some kind of brain damage that needs to be "cured". It is simply a natural rhythm, one of many, and while only a relatively small group lives this way, it doesn't make it comparable to an illness. As the sleep doctor told me, "if it doesn't interrupt your life, I don't suggest a treatment. It isn't a problem or a disease". He also said many more people would live a non-24 cycle if they didn't have the confines of their jobs and social norm (although they wouldn't suffer the effects we do when we try it). —Preceding unsigned comment added by 79.91.245.235 (talk) 19:02, 9 May 2009 (UTC)

Well said! Syndrome, disorder, not normal, abnormal -- all that is OK. But illness, disease -- NOT OK. Maybe it will be curable some day when the genetic engineering becomes possible and safe. That would be fixing an unhandy condition, not a sickness. - Hordaland (talk) 20:55, 9 May 2009 (UTC)

It is a disorder, although some here oddly are describing symptoms that don't line up with it, I can assure you it's a disorder, it is definitively the reason why I had to drop out of high school when I was younger. I was only recently diagnosed with it, and I've suffered with it for many years and it has prevented me from pursuing a career, and after discussing it with my sleep specialist and having his opinion in opposition to your own, I believe it's safe to say there is not a consensus on the condition among professionals. Revrant (talk) 01:26, 1 August 2009 (UTC)

Thank you. Personally (same person as before), I wouldn't want it fixed. I rather like being able to see all hours of the day and night with alertness, the beauty of all hours. I like having full nights to myself, and full days for the outside world. I wouldn't really want to miss it :) —Preceding unsigned comment added by 79.91.245.235 (talk) 22:29, 9 May 2009 (UTC)

Job affliction

I have free-running circadian rythm disorder. I've been having issues trying to find a job. With strange and sometimes unpredictable waking hours it's been difficult just getting through school. I've figured out that owning my own buisness would work the best, because I could hire people to open and close the shop when I'm asleep. Other than that I have no clue. Can I please have some suggestions?

p.s. I have tried sleep aids, but those are unreliable and sometimes produce an opposite effect.

Thank you —Preceding unsigned comment added by BanditmanEXE (talk • contribs)

You might want to consider a job in IT. There are some companies there that are willing to accomodate such issues; there are many jobs there that can be done without a fixed schedule, as well as many opportunities to telecommute. Programming springs to mind. Zuiram 12:51, 21 November 2006 (UTC)

Banditman, welcome to wikipedia. Sorry to hear you're having trouble. Here's my two cents, keeping in mind, I'm not a doctor and don't know what I'm doing.

The first thing would be to try to CURE your free-running sleep through the right combination of light therapy in the early morning and then doses of melatonin at night. Between the two of them, they almost always synch sleep schedules.

If that really can't work, there are a few things that can help. It is an actual medical disorder, and universities in the US at least are required to help accomodate you if possible, so discussing this with your university would be a start. Hopefully, they could provide you with lecture notes, alternate test times, and things like that. On-line classes, which are now being done by lots of reputable universities, is another option.

Regarding work possibilities-- telecommuting would be something to look at, as would any job that doesn't require you to be anywhere at a given time-- author comes to mind.

--Alecmconroy 08:19, 5 October 2006 (UTC)

I will consider your advice about being an author and I'll look into light therapy. As for melatonin, that was the unnamed "sleep aid".

Also, if there is such a thing as a support group for sleep disorders I would like to know. Google offered little help on the subject.

Thanks and please pardon my limited abilities for using Wikipedia's discussion. I'm afriad I don't know much about how to program things properly yet.—Preceding unsigned comment added by BanditmanEXE (talk • contribs)

No problem about being new-- everyone doesn't program things quite right when they first get here, so we've all been there. To sign your posts, add four '~' characters together in a row-- ~~~~.

I believe melatonin is the kind of thing that you need to take every night at a fixed time, as close as possible to the same exact time each day. Then, do the light therapy at the exact time each day, and between the two of them, that will get MOST people in synch, if you can get the discipline to do it consistently for like six weeks, even though your body doesn't want to adjust at first.

As to support groups-- I'd look around doing google searches for things like ' "Non-24 hour" Forum ' or ' "Non-24 hour" group'. So, I found one group that way. If you live in a major metropolitan area, you might be able to find an in-person group, but given the rarity of this disorder, I think it'd be hard to find a group of suffers in a smaller place.

Hope you find a solution! :)

--Alecmconroy 17:41, 6 October 2006 (UTC)

Support Group

The Niteowl listserv is a support group for people with delayed sleep phase syndrome, but many* people on it have non-24-hour tendencies as well. Good luck. :) Kla'quot 19:14, 7 October 2006 (UTC)

* if by many, you mean around 3! ; )

In its 12 year history, the group has had "many" more than three Non-24 members. Admittedly, Kla'quot could as well have used the word 'several' instead of 'many.' --Hordaland (talk) 23:09, 20 January 2008 (UTC)

No sources?

This article is marked: This article does not cite any references or sources. (October 2007) Please help improve this article by adding citations to reliable sources. Unverifiable material may be challenged and removed. But there are 4 obviously applicable sources. Can the above box, dated October 2007, be removed now? If not, what is required? Hordaland (talk) 15:48, 21 November 2007 (UTC)

• Done. Anyone can remove these tags from articles that have sources. However, it would be better if the article had inline footnotes to those sources; I think that's what the tagger was asking for. Cheers, Kla’quot (talk | contribs) 18:00, 21 November 2007 (UTC)

Done. §:c) Hordaland (talk) 01:18, 22 November 2007 (UTC)

Removed due to significant figure issue

In 2002 Uchiyama et al showed, among other things, that five sighted Non-24 patients had a longer sleep-wake cycle, averaging 25.12 hours, as compared with their normal controls, 24.02 hours.

Normal people, by definition, have, within the margin of error, a cycle of 24 hours. Two possibilities. 1) The numbers should read 25 and 24, or 25.1 and 24.0 depending on the margin of error. 2) The ref is wrong, in which case it cannot be used to back up this sentence and it should be removed. Shinobu (talk) 11:02, 8 December 2007 (UTC)

"Normal people, by definition, have, within the margin of error, a cycle of 24 hours. Two possibilities. "

That's definite assumption, but it's not necessarily. true. It's the most likely answer, but not the only possible one. The easiest way to talk about this is just to throw off examples of other conceivable possibilities: Perhaps normal people have a cycle of slightly >24hrs half the time, and slightly <24hours, the other half the time, so that it averages out to 24 hours, despite never having that exact value. OR, perhaps normals have a >24 hr cycle, but only minutely greater than 24, with discontinuous 'resyncing' events occurring every so often, not unlike a watch that is ever so slightly slow, but gets re-set to the correct time every few months. It's also possible that there's season variation in "normal" sleep cycle length. (these are just 'for examples' of why you can't automatically assume normal human beings actually have a sleep cycle of 24.00000 hrs.)

That said, I suspect your interpretation is correct, and the report of "normals had a cycle of 24.02" carries with it a +/- margin of error >.02.

In any case, listing the 24.02 number in the article text demand some sort of further explaination which is beyond the scope fo I'll reword it in a less detailed fashion to so it doesn't confuse the reader. :) Good catch, Shinobu. --Alecmconroy (talk) 12:02, 8 December 2007 (UTC)

The numbers 25.12 and 24.02 are the cycle lengths observed for 20 people during the specific duration of Uchiyama's study. The purpose of that study was to assess ways in which people with a non-24-hour syndrome differ from a control group. The study was not designed to measure the cycle length for the general population. Moreover, even for the particular 20 subjects, the study does not claim to precisely measure actual cycle lengths over the long term; what it claims is to measure cycle lengths during the timeframe of the study. Reporting Uchiyama's numbers is good as long as we state what they are reported to represent, which is an average of a particular number of readings taken over a particular timeframe for particular subjects. Anyway (long discussion over a small amount of text!) the article currently says, "In 2002 Uchiyama et al examined five sighted Non-24 patients who showed, during the study, a sleep-wake cycle averaging 25.12 hours." I think that's all that needs to be said about it. Does that work for everyone? Kla’quot (talk | contribs) 12:44, 9 December 2007 (UTC)

Uchiyama used only 15 normal controls, and it's quite impressive that their average innate cycle was so very close to 24 hours. The accepted average for adult humans (younger and older) is 24.18 hrs. But I agree with Alecmconroy that not just every reader has that figure at her/his fingertips! I'll try to squeeze it in, with a cite. I think the 25.12 figure is more meaningful when one can compare it to the normal. Hordaland (talk) 14:43, 9 December 2007 (UTC)

The "innate" normal cycle length of 24.18 hours was recorded under laboratory conditions designed to eliminate time cues. The numbers 25.12 and 24.02 are the cycle lengths recorded under home conditions, which reflects the subjects' behaviour when they were exposed to a typical day's time cues, so these numbers reflect non-innate rather than innate cycle lengths. If we are to compare the 25.12 number with anything, it should be the 24.02 number because it was recorded under similar conditions. Does this make sense? Kla’quot (talk | contribs) 07:02, 10 December 2007 (UTC)

Formatting

I made some edits to add info, but somehow messed up some of the formatting in the process. Certain paragraphs are refusing to be separate paragraphs and the line-spacing looks a little funny at some places. I'm sure one of you can easily fix it, but I dont know how. —Preceding unsigned comment added by 24.22.5.203 (talk) 09:36, 29 January 2008 (UTC)

Treatment

I removed the following: "treatment with melatonin taken 30 minutes to two hours before the desired bedtime may be helpful. Too high a dose of melatonin may have the unintended effect of disturbing the sleep or even causing nightmares, and uncontrollable yawning the next day." I did this because these particular difficulties of melatonin are not specific to n-24 patients. Also, why mention these specific difficulties but not the fact that it may cause depression, have long-term ill health effects, that it is not FDA approved or regulated, and that the correct dosage for any normal individual could be 200X different from another normal individual? It would be too much info for this article, yes, but that is just another reason why whoever wants to know how melatonin is used or what it's problems are should just be directed to the melatonin article. —Preceding unsigned comment added by 24.136.206.184 (talk) 09:40, 3 June 2008 (UTC)

Good call, especially as that section begins "Common treatments for non-24-hour sleep-wake syndrome are similar to those for delayed sleep phase syndrome." I think interested readers can find the info you removed several places. In general though, re melatonin dosage, less is better. (Within reason :-)) --Hordaland (talk) 10:36, 3 June 2008 (UTC)