How to Manage Non-24 Sleep Patterns for People in the Blind Community

Non-24 hour sleep-wake disorder is a serious condition that primarily affects blind people, although some sighted people may suffer. It’s a condition marked by irregular sleep patterns that can seem impossible to correct. Often times, children and adults are misdiagnosed with alternate sleep disorders, when they are actually suffering from severe and chronic circadian rhythm disorders.

Unfortunately, most circadian rhythm disorders can’t be treated with an FDA approved pill and many people struggle to achieve positive results through therapy and alternative medicines. While no approved cure exists for Non-24 sleep patterns, there are some treatment options available. Here, I’d like to discuss the symptoms of Non-24 hour sleep-wake disorder and what treatment options are available to potentially turn you or a loved one’s life around.

What are Non-24 Sleep Patterns?

Non-24 hour sleep-wake disorder is prevalent among the blind community because our internal hormones are triggered by environmental stimuli, primarily light. This disorder does not affect most blind people, mainly those without light perception. While this is good news for those suffering from glaucoma or macular degeneration, who have preventative supplements, almost two-thirds of blind people without light perception suffer from Non-24 Hour Sleep/Wake Disorder and have few options for treatment.

This disorder is often misdiagnosed as another sleeping disorder as the symptoms mimic those of insomnia and excessive drowsiness. It’s essentially a chronic and more severe form of jet-lag.

Causes of Non-24 hour sleep-wake disorder could include a failure of the pineal gland to process melatonin. Other causes also include the eye’s inability to perceive light, which facilitates the pace of melatonin production. Non-24 hour sleep-wake disorder can affect people of all ages, which makes it especially hard to diagnose in children who already thrive on irregular sleep patterns.

This disorder may also impact the body’s ability to produce cortisol, TSH, and other hormones leading to metabolic disturbances and other serious conditions. People who suffer from this disorder will typically have trouble falling asleep at night and difficulty staying awake during the day. This will affect the subject’s ability to concentrate and focus on everyday tasks, affecting their personal and professional life profoundly.

There are actually two ways that people may be affected by Non-24 hour sleep-wake disorder. First, a patient may have a free-running bodyclock where their ~8 hour sleep cycle slowly gets delayed a few minutes or hours each night. The other form occurs when a patient’s bodyclock becomes completely misaligned, leading to frequent episodes of insomnia and intense drowsiness.

As Rütger Wever and Jürgen Aschoff of the Max Planck Institute for Behavioral Physiology showed with their extensive study on individuals cut off from temporal cues, including clocks, daylight, and even electromagnetic fields, most people tend to have a natural 25-hour cycle when the natural and sociological signals that we generally pick up are taken away, so it does follow that when that photosensitivity is gone, it is more difficult for the body to fall in line with a 24-hour day.

What we call a healthy sleep cycle may be a biased view of what fits best into cultural norms rather than what is natural for any given person, but that does not make the real-life struggles of working around a world that is following different patterns any easier. This is why treatment is often necessary for individuals suffering from Non-24.

Treatment

Generally, treatment options are far and few between. The most popular treatment includes melatonin therapy or administering .5 mg to 1mg of melatonin one or two hours before sleep. This can also be aided by delta wave therapy through a pair of sleep headphones that won’t interrupt the patient’s sleep. Certain diets can also aid in the production of melatonin.

The main idea behind these treatment options is to build a repetitive schedule for the person’s bodyclock.

There are currently no FDA approved medications on the market and success of these treatments isn’t guaranteed. For now, the best thing people can do is donate to research and spread awareness about this serious condition.