Non-24 hour sleep phase syndrome
Non 24-hour sleep phase syndrome, also termed non 24-hour circadian rhythm disorder, is a sleep disorder in which a person's internal clock runs longer than 24 hours. The person's body essentially insists that the day is longer than 24 hours, which may disrupt socially accepted sleeping patterns and make it difficult for the sufferer to sleep at "normal times." Left untreated, non 24-hour sleep phase syndrome causes a person's sleep-wake cycle to change every day, the degree determined by how much over 24 hours their cycle lasts. The cycle may go around the clock, eventually returning to "normal" for one or two days before going "off" again. This is known as "free-run" sleep. People with the disorder often have a hard time "resetting" their internal clocks along socially accepted sleep-wake patterns. They may also have an especially hard time adjusting to changes in "regular" sleep-wake cycles, such as vacations, stress, evening activities, time changes like Daylight Savings Time, travel to different time zones, illness, medications (especially stimulants or sedatives), changes in daylight hours in different seasons, and growth spurts, which are typically known to cause fatigue. Outside treatment may be sought. Common treatments for non 24-hour sleep phase syndrome are similar to those for delayed sleep phase syndrome, as the two often show up together, and include light therapy with a full spectrum lamp set on a timer and chronotherapy. For other patients, acupuncture may be a solution. However, it often takes several treatments before any progress is noticed, and for many the treatments may only be marginally effective or not effective at all. In addition, the treatment is not a cure, and the condition can only be managed. Treatment with melatonin taken 30 minutes to an hour before the desired bedtime may be helpful in establishing a pattern "gone awry", but has limited effect on a pattern that is healthy, albeit out-of-sync. 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.
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