1018 A Case of Non-24-Hour Sleep-Wake Disorder in a sighted 29yo male. (12th April 2019) - Petrous, Jeremy
Abstract: Introduction: The prevalence of Non-24-Hour Sleep-Wake Disorder (N24SWD) is estimated to occur in 50–80% of totally blind individuals but reports of the disorder in sighted individuals is relatively rare. 1 This poster presentation aims to describe a case of N24SWD in a 29yo sighted male. A 29yo sighted male with Borlin Syndrome, chronic pain, and anxiety, received care at an outpatient sleep medicine clinic for chief complaint of difficulty with sleep onset and sleep maintenance. As a compensatory mechanism for pain, he developed the habit of staying in bed for extended hours "waiting for the pain to improve." Upon completion of sleep logs, a pattern of successively delayed sleep and wake times were observed consistent with N24SWD. CONCLUSION: Even though N24SWD is a disorder that most commonly afflicts the blind, it should always remain in the differential diagnosis for any patient who presents with insomnia. The pathophysiology of N24SWD is thought to be the result of lack of photic entrainment, decreased sensitivity of the circadian clock to light, or an alteration in entrainment pathways that result in weakened or lack of entrainment of the endogenous circadian clock.2 In sighted individuals, however, the etiology is less clear, but thought to be induced by certain environmental conditions such as limited exposure to light.1 This case report is one such example, and it demonstrates how essential sleep logs can be in aiding with the diagnosis. None