Non-24-hour sleep-wake syndrome, also called free-running type or non-24-hour circadian rhythm disorder, is one of many circadian rhythm disorders and probably the rarest and most difficult to correct of all of them. Most people have an internal biological clock, or circadian rhythm, that roughly adheres to a 24 hour schedule. There may be slight daily variances in waking and sleeping onset times, but these all generally even out over a longer stretch of time. Even those with advanced or delayed circadian rhythm disorders function within this 24 hour schedule.

What is Non 24 Sleep Wake Disorder?

Those with non-24-hour sleep-wake syndrome do not have internal clocks that reset and stay balanced within a 24 hour schedule. In most cases, their circadian rhythms are set on longer loops, usually resulting in 25 or 26 hour cycles, or even more in some cases. There have documented cases of people having as dramatic as 72 hour cycles, in which they would stay awake for 48 straight hours, and then sleep for 24 straight hours as a regular sleeping pattern. There are only a few known dramatic cases such as that though, and most cases fall within the 25 or 26 hour range.

What this means for these individuals is that their sleep and wake times are pushed back by 1 or 2 hours every day. This leads to a constant cycle between sleep times that are considered unconventional by society’s standards, with occasional short stops in conventional time frames before progressing on again into unconventional. This extremely unbalanced sleeping schedule makes it all but impossible for the subject to hold a traditional job, or attend regularly scheduled school classes unless they fight the disorder, which is not easy without the proper treatment. individuals living with this have often found their ‘calling’ working in a self employed capacity, or in a number of other fields of work where they can effectively set their own work schedule. Those still attending school may find it necessary to take home schooling through the internet or other avenues.

Apart from the social stress or depression that living with non-24 hour disorder may cause, the disorder itself is not considered harmful. The actual quality of sleep, and more importantly deep sleep, is equal or in many cases better, than those without the disorder.

Who gets Non 24 Sleep Wake Disorder?

Non-24-hour sleep wake disorder is very common among blind people, with more than 50% of blind people having it. Though they have fully functioning biological clocks, without the light cues to balance and reset it on, the circadian rhythm often becomes unbalanced. This condition is quite rare in those with sight, but can occur. Having unstructured or irregular daily routines, bad sleeping habits, and poor exposure to sunlight on a consistent basis can all be factors in the development of this disorder.

There are also studies showing a link between delayed sleep phase disorder and non-24-hour sleep-wake syndrome, in that those with delayed sleep phase are at a higher risk of developing free-running type.
In most cases, a doctor should be consulted regarding this disorder. Even if it is not causing conflict with work or other activities, it may be that it is affecting your relationships with family or friends, which could lead to stress and depression, and other sleeping problems or mental health issues as a result.

How is Non-24 Disorder Diagnosed?

A doctor will need to have a history of your past sleeping routines, as well as your medical history and be informed of any recent changes in your life that may be contributing to the disorder. Any drug or medication use will also need to be documented. You may be subjected to a neurological test as well. Additionally, you may need to have your body temperature and melatonin levels examined.

Treatments for Non-24  Disorder

Once the disorder has been diagnosed, which will not require an overnight sleep study, the treatment plans can begin. The first area will target changes you can make in your routine in an attempt to reset and balance your circadian rhythm. This will include incorporating fixed events into your schedule at set times no matter when you wake up, to try and root your internal clock to a 24 hour rhythm.

Melatonin is the most widely used treatment, and is typically ingested within a few hours of the desired bedtime. This can be helpful in rooting your bedtime. Light treatment for sighted people, chronotherapy and acupuncture have all been used as well with varying results.

It is common of all treatment methods that they take a long process before showing any results, and some subjects have shown extreme resistance to all therapies. Like many sleeping disorders there is no cure in a traditional sense, and the disorder must be constantly monitored and effective treatments for the patient actively continued. Maintaining a sleep diary after starting on any treatment plan will help a doctor in determining the success rate of the plan, and whether it should be maintained, abandoned in favor of another treatment option, or merged with another plan.

13 thoughts on “Non-24 Hour Sleep Wake Syndrome

  1. Veronica Reply

    I stay up for 48 hours then sleep for 3 days and it’s getting worse the older I get. This has been going on since my 20’s I am now 48. Makes me mad because I can’t commit to anything.

  2. Nick Reply

    I’m in the. Same boat but have few responsibilities. I need you all to take a look. At what you are responsible for and evaluate if you are lazy like myself or neglecting your problems if you suffer from neglect get up and handle your business and if your lazy motivate yourself because you hopefully just realized your lazy… Set goals force yourself to be up to meet those those goals you will be amazed

  3. Josiah Brooks Reply

    I usually stay awake for 25 to 30 hours sometimes 40 hours, and I sleep for 15 to 20 hours. Last time I slept really long was 25 hours, then one time I think I slept like 35 after being awake for 3 days. Idk wtf is wrong with me.

    • Christine Ryan Reply

      This is new for me and it’s been stressful. I’m afraid to go to sleep bc I know I’ll sleep over 20 hours then I’ll be awake over 24 hours or more. I am otherwise sick too waiting for doctors without s good schedule or much sun. I have a lot of symptoms but this is happening to me and now I have sleep anxiety.

  4. Woke Reply

    Yeah I been doing this for years off and on. I believe the record is up 3 whole days without any help(caffeine) then passed out for 24 hours. Had issues as a kid but in my twenties took a horrible night shift job and been messed up ever since. I’ve done sleep 2hrs up 8. Sleep 12 up 24. Sleep 16 up 30-36. Sometimes I stare at the ceiling for hours and sleep never comes. I’ve zombied through work. Pass out as soon as I get home wake up go to work up all night and all day again. I dont stress it anymore. I wouldn’t mind having that rythym though.

  5. Ben Reply

    I just woke up from a 14 hour sleep and was searching and saw all the other comments. Same here. Doctors have been of little help. I wish there was a place that we could collect these experiences and present them to some experts. It feels more extreme than the 2-3 hour clock getting pushed back.

  6. EmzyT0 Reply

    For the past couple of years I have found myself being awake for 36-48hours and depending on how long I’ve been up sleeping between 12-24hours (minus forcing myself up to let dogs out, feed them in zombie state)!
    Thankfully I’m unable to work due to disability, but trying to organise appointments is a complete pain when I can be awake all night and ready to go in morning one day, but the next passing out at dawn!
    Before disability I managed to switch from being up all night to being able to wake up at 5am when I was working with horses, but over the last 6years my sleep pattern has gone very wrong. I think the worst part is the complete unpredictability of when I will physically and mentally wake up, although regularly being wide awake for 2days straight and being completely incapable of sleeping, when I suffer from pretty horrid chronic fatigue is almost as bad! Granted having long manic episodes when I’m physically exhausted and I can’t go for a run/exercise like I did as a teen is part of the problem lol!

    Quite surprised to see I’m on a pretty extreme end of spectrum! Obviously 36-48hrs between sleeps is extreme, but just assumed there would be plenty of other people going through it lol! Hopefully I should get some sleep at some point in the next 6hours, as body is saying it’s knackered, just got to wait for brain to give in!!

  7. CJ Reply

    Recently, my body has decided that a day consists of 36 hours. I stay up for 24 hours straight and sleep for 10 to 12 hours. It’s ridiculous.

    • Naddy Reply

      CJ, I have experienced this exact thing. Stay up for 20-28, sleep from 10-16 hours, repeat. The bizarre thing is I feel great doing it, better than trying to force 24 hour days. But, obviously, it makes it nearly impossible to keep a regular schedule and have a job….

  8. Kim Reply

    I feel awful when I wake up and it takes Bout 8 hour before I feel ok. I feel great when I’ve been up for 24 hours and don’t want to go to sleep because I know how I’m going to feel when I wake up. This has been a problem for me since i was diagnosed with a traumatic brain injury from a head on collision. After I’ve been up for 24 to sometimes 3 days at a time I sleep for 24 to 30 hours and feel horrible when I get up. No one understands

  9. Anonymous Reply

    I’ve got self-proclaimed hypersomnia where I’ve slept for 20 hours and 14 minutes on may 6th last year and I can have anywhere from 1 hour and 49 minutes of sleep to the very common 14 hours and 48 minute and the slightly more rare 15 hours and 27 minutes and the 2nd most recorded sleep time I have is 19 hours and 14 minutes and my sleep ends on the 14th minute of a hour so often it’s like a pattern literally like 150 times a year or more its weird

    • Grace Reply

      Me too, exactly the same thing. Just woke up from about 12 hours of sleep and feel good. I thought I was the only one with this weird cycle. Yes it makes it hard to socialize or even make appointments or plans. When I was working, I took sleeping pills and was always sleepy. After I retired I discovered this was sleep pattern my body wanted.

  10. Amber Reply

    Ever since I have been little i have slept weird. i have had my tail tore up for not going to bed when i was supposed to it was so much it seemed to be a everyday thing… I’m an adult now and I am afraid of the way i sleep. I can be tired and not fall asleep. So tired I call them sleep tantrums, where out of no where my body would twitch and burn but i still won’t go to sleep at least until i have literally caught my head dropping 5x! Every month i experience a really long sleep episode i always looked at it as my body catching up to the 1 or 2 days i fit fight sleep! But its happening more i just woke up after 13 straight hours of sleep last night well today! And like always It took me a while to realize what day it is. I wake up after 3/4 hours of sleep normally when i do get sleep and stay up 2-3 hours then go back to bed another 4. I been working 12s lately and I be ready to drop dead at work from being so tired, but will get off and get home and stay up another 3/4 hours, mind you i usually get up 2 hours before having to be at work… but thats nothing back in March i slept for exactly 28 hours! not a single person thought to check on me or wake me up when i finally got up i couldn’t breath right my head hurt so bad my body felt like i was beaten i had to use the bathroom immediately both #1#2 and while in the midst of using the bathroom i became nauseous and began vomiting!!! I never want to sleep that long again! I can’t really say if i have a sleep problem or if its something else but as long as i can remember i have been waking up tired and have always been deemed the lazy black sheep of the family cause I’m always up when i should be asleep or always the last to get up! However i just want to sleep like normal people! Its weird and hard trying to explain to people how i didnt get sleep cause i couldn’t or that every day i have a few minutes where i wake up and i forget everything including who i am! I hate it! I wish i could get some real direction and help, no one around here is going to!

Leave a Reply

Your email address will not be published.