Drugs
 2017
DOI: 10.1007/s40265-017-0707-3
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Diagnosis and Treatment of Non-24-h Sleep–Wake Disorder in the Blind

Jonathan S. Emens
1
,
Charmane I. Eastman
2

Abstract: Non-24-h sleep-wake disorder (non-24) is a circadian rhythm disorder occurring in 55-70% of totally blind individuals (those lacking conscious light perception) in which the 24-h biological clock (central, hypothalamic, circadian pacemaker) is no longer synchronized, or entrained, to the 24-h day. Instead, the overt rhythms controlled by the biological clock gradually shift progressively earlier or later (free run) in accordance with the clock's near-24-h period, resulting in a recurrent pattern of daytime hyp… Show more

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Cited by 45 publications

(25 citation statements)
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“…We suspect that this finding is related to the fact that the lack of light perception leads to disruption of the normal circadian entrainment that happens in sighted individuals, leading to more frequent nighttime awakenings and disrupted sleep. These findings are congruent with prior studies in children with visual impairment,4,5 as well as literature on non-24 sleep disorders in adults 21. Free response data from the current study also highlighted sleep maintenance as the most frequently encountered sleep challenge.…”
Section: Discussionsupporting
confidence: 92%
“…These findings are congruent with prior studies in children with visual impairment, 4,5 as well as literature on non-24 sleep disorders in adults. 21 Free response data from the current study also highlighted sleep maintenance as the most frequently encountered sleep challenge. Importantly, children with intact light perception still had a high prevalence of sleep problems, so clinicians should not assume normal sleep with normal light response.…”
Section: Discussionmentioning
confidence: 60%
See 1 more Smart Citation
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
“…We suspect that this finding is related to the fact that the lack of light perception leads to disruption of the normal circadian entrainment that happens in sighted individuals, leading to more frequent nighttime awakenings and disrupted sleep. These findings are congruent with prior studies in children with visual impairment,4,5 as well as literature on non-24 sleep disorders in adults 21. Free response data from the current study also highlighted sleep maintenance as the most frequently encountered sleep challenge.…”
Section: Discussionsupporting
confidence: 92%
“…These findings are congruent with prior studies in children with visual impairment, 4,5 as well as literature on non-24 sleep disorders in adults. 21 Free response data from the current study also highlighted sleep maintenance as the most frequently encountered sleep challenge. Importantly, children with intact light perception still had a high prevalence of sleep problems, so clinicians should not assume normal sleep with normal light response.…”
Section: Discussionmentioning
confidence: 60%
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
“…The high prevalence of sleep issues was also reflected in responses related to medication usage, where melatonin was reported with the highest frequency (39.5%) among all medications. While sleep issues are known sequela of both blindness and dementia and have been previously reported in CLN3 disease, the very high prevalence reported here suggests that it may be a characteristic aspect of the disease that potentially contributes to other cognitive and behavioral problems [ 22 – 24 ].…”
Section: Discussionmentioning
confidence: 73%
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
“…Certain demographic groups may experience different lifestyle-related behaviors in different ways or may be more or less willing to disclose symptoms of depression. For example, non-24-hour sleep-wake disorder is a circadian rhythm disorder that is experienced by approximately 55–70% of totally blind individuals (Emens & Eastman, 2017), which may affect the ability of a large percentage of this particular sample in meeting sleep guideline rates. In addition, according to Call and Shafer (2018), women appear to be more likely to endorse symptoms of depression than men, which could influence self-reported results.…”
Section: Discussionmentioning
confidence: 99%
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
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