Non-24-hour sleep-wake syndrome in a sighted man

Circadian rhythm studies and efficacy of melatonin treatment

Angela J. McArthur, Alfred Lewy, Robert Sack

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

The case of a 41-year-old sighted man with non-24 hour sleep wake syndrome is presented. A 7-week baseline assessment confirmed thai the patient expressed endogenous melatonin and sleep-wake rhythms with a period of 25.1 hours. We sought to investigate the underlying pathology and to entrain the patient to a normal sleep-wake schedule. No deficiency in melatonin synthesis was found. Furthermore, normal coupling between the melatonin and sleep propensity rhythms was documented using an 'ultrashort' sleep-wake protocol. Environmental light exposure was monitored for 41 days, and the circadian timing was calculated. Sensitivity to photic input was determined with light induced melatonin-suppression tests. Three intensities (500, 1.000, and 2,500 lux) were examined during three separate trials. The 2,500-lux trial resulted in 78% suppression, but the lesser intensity exposures were without substantial effect. Thus, the patient appeared to be subsensitive to bright light. A 4-week trial of daily melatonin administration (0.5 mg at 2100 hours) stabilized the endogenous melatonin and sleep rhythms to a period of 24.1 hours, albeit at a somewhat delayed phase A 14 month follow-up interview revealed thai the patient continued to take melatonin daily, and his sleep-wake schedule was stable to a near 24-hour schedule.

Original languageEnglish (US)
Pages (from-to)544-553
Number of pages10
JournalSleep
Volume19
Issue number7
StatePublished - 1996

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Melatonin
Circadian Rhythm
Sleep
Appointments and Schedules
Light
Environmental Exposure
Interviews
Pathology

Keywords

  • Entrainment
  • Light suppression
  • Melatonin
  • Non-24-hour sleep-wake syndrome

ASJC Scopus subject areas

  • Physiology

Cite this

Non-24-hour sleep-wake syndrome in a sighted man : Circadian rhythm studies and efficacy of melatonin treatment. / McArthur, Angela J.; Lewy, Alfred; Sack, Robert.

In: Sleep, Vol. 19, No. 7, 1996, p. 544-553.

Research output: Contribution to journalArticle

McArthur, Angela J. ; Lewy, Alfred ; Sack, Robert. / Non-24-hour sleep-wake syndrome in a sighted man : Circadian rhythm studies and efficacy of melatonin treatment. In: Sleep. 1996 ; Vol. 19, No. 7. pp. 544-553.
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