61. Questions and answers about Non-2417 February 2011 at 13:56 | Posted in Circadian rhythm | 17 Comments
Tags: Body clock, Circadian rhythm, Disability, Japanese study, Non-24, Prevalence, Sleep disorder
About 50% of the totally blind have Non-24-hour Sleep-Wake Cycle Disorder while it is very rare among sighted people. People with Non-24 cannot adjust to the environmental 24-hour cycle.
If Hayakawa et al. are to be believed, there have been only 96 cases of N24 in sighted people reported in studies, worldwide, ever. The first 39 were reported in 26 separate studies dated 1970-2003. Hayakawa’s group reported on 57 cases in a report in 2005*. These 57 were diagnosed in Japan in 1991-2001. So what have I learned from that paper?
Are there equally many men and women? No, there are more than two and a half times as many men.
Is Non-24 about as common as the other Circadian Rhythm Disorders (CRDs)? No, the other CRDs together, primarily DSPS, are six times as common.
Do people with Non-24 have anything else in common physically? No. Eye examinations, blood counts, serum biochemistry, electrocardiography, electroencephalography and brain MRIs show nothing special.
Socially? 89% were unmarried and 39% were unemployed.
Had they any health problems in common before the onset of free-running? 28% had psychiatric problems (obsessive-compulsive, adjustment, schizoprenia, anxiety or depression and often associated social withdrawal), not remarkably higher than the general population. But more than a fourth had DSPS before developing Non-24.
How old were they at the onset of Non-24? 86% were ten to twenty-nine years old, none younger than ten. Sex had no effect on the age of onset. (None of the subjects was over 50.)
Do the hours of sleep correlate to the length of the endogenous circadian cycle? Most of the subjects’ cycles were between 24.5 and 25.5 hours, with only one having a cycle longer than 26.5 hours. Subjects slept between less than 7 hours to more than 12, with the majority sleeping 9-11 hours. But there was no correlation between the period of the sleep-wake cycle and sleep length, and neither was affected by sex nor employment status.
How debilitating is the disorder? “98% had a history of disturbed social functioning due to inability to regularly attend school or work.”
Do people with Non-24 often develop psychiatric problems after the onset of the disorder. Yes, but depression only, not the other disorders. “It is possible that these patients had tried to adapt themselves to their social life and failed, leading to psychological stresses that could have precipitated their depression.”
How does Non-24 in sighted people differ from that of people who are blind? The blind generally have a shorter circadian period, and it doesn’t fluctuate over time. In sighted people, the period tends to be longer when sleep onset is in the daytime than when a person falls asleep during nighttime.
*Tatsuro Hayakawa, Makoto Uchiyama, Yuichi Kamei et al. Clinical Analyses of Sighted Patients with Non-24-Hour Sleep-Wake Syndrome: A Study of 57 Consecutively Diagnosed Cases. SLEEP 2005;28(8):945-952
Next post: 62. Psychiatric misdiagnosis of N24