Jonathan S Emens1,2,3, Melissa A St Hilaire4,5, Elizabeth B Klerman5,6, Daniel J Brotman7, Amber L Lin8, Alfred J Lewy2, Charles A Czeisler4,5. 1. Veterans Affairs Portland Health Care System, Division of Mental Health and Clinical Neurosciences, Portland, Oregon. 2. Department of Psychiatry, Oregon Health & Science University, Portland, Oregon. 3. Oregon Institute of Occupational Health Sciences, Portland, Oregon. 4. Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 5. Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts. 6. Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts. 7. Department of Medicine, Johns Hopkins University, Baltimore, Maryland. 8. School of Public Health, Oregon Health & Science University, Portland, Oregon.
Abstract
STUDY OBJECTIVES: To determine whether there was evidence of circadian or sleep-regulatory dysfunction in sighted individuals with non-24-hour sleep-wake rhythm disorder. METHODS: Three sighted individuals with signs and/or symptoms of non-24-hour sleep-wake rhythm disorder were studied. Thirty-five- to 332-day laboratory and home-based assessments of sleep-wake and circadian timing, endogenous circadian period, photic input to the circadian pacemaker, and/or circadian and sleep-wake-dependent regulation of sleep were conducted. RESULTS: No evidence of circadian dysfunction was found in these individuals. Instead, sleep-wake timing appeared to dissociate from the circadian timing system, and/or self-selected sleep-wake and associated light/dark timing shifted the circadian pacemaker later, rather than the circadian pacemaker determining sleep-wake timing. CONCLUSIONS: These findings suggest that the etiology of this disorder may be light- and/or behaviorally induced in some sighted people, which has implications for the successful treatment of this disorder. CITATION: Emens JS, St Hilaire MA, Klerman EB, et al. Behaviorally and environmentally induced non-24-hour sleep-wake rhythm disorder in sighted patients. J Clin Sleep Med. 2022;18(2):453-459.
STUDY OBJECTIVES: To determine whether there was evidence of circadian or sleep-regulatory dysfunction in sighted individuals with non-24-hour sleep-wake rhythm disorder. METHODS: Three sighted individuals with signs and/or symptoms of non-24-hour sleep-wake rhythm disorder were studied. Thirty-five- to 332-day laboratory and home-based assessments of sleep-wake and circadian timing, endogenous circadian period, photic input to the circadian pacemaker, and/or circadian and sleep-wake-dependent regulation of sleep were conducted. RESULTS: No evidence of circadian dysfunction was found in these individuals. Instead, sleep-wake timing appeared to dissociate from the circadian timing system, and/or self-selected sleep-wake and associated light/dark timing shifted the circadian pacemaker later, rather than the circadian pacemaker determining sleep-wake timing. CONCLUSIONS: These findings suggest that the etiology of this disorder may be light- and/or behaviorally induced in some sighted people, which has implications for the successful treatment of this disorder. CITATION: Emens JS, St Hilaire MA, Klerman EB, et al. Behaviorally and environmentally induced non-24-hour sleep-wake rhythm disorder in sighted patients. J Clin Sleep Med. 2022;18(2):453-459.
Authors: Ellen R Stothard; Andrew W McHill; Christopher M Depner; Brian R Birks; Thomas M Moehlman; Hannah K Ritchie; Jacob R Guzzetti; Evan D Chinoy; Monique K LeBourgeois; John Axelsson; Kenneth P Wright Journal: Curr Biol Date: 2017-02-02 Impact factor: 10.834
Authors: C A Czeisler; T L Shanahan; E B Klerman; H Martens; D J Brotman; J S Emens; T Klein; J F Rizzo Journal: N Engl J Med Date: 1995-01-05 Impact factor: 91.245
Authors: Melissa A St Hilaire; Elizabeth B Klerman; Sat Bir S Khalsa; Kenneth P Wright; Charles A Czeisler; Richard E Kronauer Journal: J Theor Biol Date: 2007-04-04 Impact factor: 2.691