Sunday, September 27, 2009


Synopsis

From my teenage years until recently, I was not able to follow a 24 hour wake-sleep cycle without becoming chronically exhausted and sick. By following the steps that I outline below, I am now able to rise every morning at 7:30 A.M. after sleeping soundly for 8 hrs every night, without the use of drugs or dietary supplements like melatonin (whose long-term effects are not known). I feel great almost every day, usually all day long. (Updated on 3 March 2012: I have been diurnal with no relapses for more than 2.5 years, and still thriving.  Thank you for all of your e-mails and comments!  I'm now working at my [diurnal] dream job, which was formerly unthinkable.)

Background

For many years I suffered from the Non-24-hour Sleep-Wake Syndrome, also known as Free-running disorder (FRD), Hypernychthemeral syndrome, or the Non-24-hour Circadian Rhythm Disorder. I often used to tell people that I was from a planet where the days are longer than 24 hours (e.g., a day on Mars is 24 hours and 40 min long). My college years were made extremely difficult by chronic fatigue: e.g., falling asleep in class and failing to sleep at night. I felt heavy and exhausted nearly all of the time, as if my body were fundamentally "confused". When I reached graduate school, I had the luxury of following a rhythm that was comfortable (25h50m) and I thrived in this way for many years. Up to that time, I had not a clue how it felt to be in "good health". Nonetheless, during vacations and on other occasions when I was forced to follow a daytime schedule, I quickly spiraled into exhaustion. Very often, my immune defenses were undermined and I became sick as well. Recovery was normally slow unless I reverted to the biological rhythm (25h50m). My health insurance plan refused to pay for expensive consultations with sleep doctors, and there seemed not to be any clearly-defined remedies described and freely-accessible "on-line". My own doctors were of no use. I kept an eye on new sleep research and I tried many experiments in graduate school to solve the problem, all of which failed, sometimes with severe undermining of health. After graduating, I was lucky to get a [non-permanent] job that did not require me to follow the diurnal schedule, and I tried one more set of experiments. (This was my last chance before starting employment that would probably require diurnal living.) Happily, these experiments have worked wonders. I now sleep eight hours per night very soundly, waking each day at the same time, and with extraordinary amounts of strength. I feel better now than I have ever felt before -- even while following the biological rhythm of 25h50m. This was achieved by learning to control when my body produces melatonin, as well as controlling and preventing perturbations (e.g., caused by stress or ambient noise, which can result in missing hours of sleep) which can send the rhythm temporarily off the rails.  (Thankfully, I have found that I am able to recover from major perturbations (missing up to 3 hours of sleep) within a couple of days.)

Disclaimer

I am not a physician or a medical expert, and the purpose of this text is not to give medical advice. I have published this page to explain how I overcame a very severe and debilitating circadian rhythm disorder. I disavow responsibility for what any person does with this information. I do not claim that I have conducted original or formal scientific research. If you are a sleep researcher and would like to add something (including references), you may add a comment below. (Any person is welcome to add comments by clicking here.)

The Rules of a New Way of Life

What follows are 15 rules that I currently follow to maintain the 24hr rhythm, rising at the same time every day and sleeping 8 hours per night. After describing these rules, I discuss how I made the transition from a ~26 hr schedule to the 24hr schedule. If these rules seem draconian, the alternative (in my case) is to live like a zombie or else a vampire (i.e., constantly tired, or living at night half the time). I am glad to exchange misery for the modest discipline of a few constraints. The rules are listed in what I suspect is the approximate order of decreasing importance: i.e., Rule 1 is the most important, Rule 15 is the least important.  Some rules are necessary for diurnal living (near the top of the list), and others are mainly intended to maximize vigor and strength.


Rule 1: Evening restriction of blue light: yellow glasses and yellow/red lamps.

Blue light suppresses the production of melatonin, which the body uses to regulate sleep [1]. Accordingly, I have restricted my exposure to blue light in the evenings. During the three hours before bedtime, I wear special glasses that filter-out most blue light. I found these on the internet using a google search, and I ordered my pair for $80.

I have one set of lamps with normal incandescent bulbs, which emit white light (containing blue light). I have a second set with incandescent yellow bulbs (these are "bug lights", now available at grocery stores and general stores, which emit lower quantities of blue light (N.B., if you subtract all the blue from light that spans the visible spectrum, you are left with something that looks yellow to human eyes)). I have a third set of lamps with red bulbs (slightly more expensive "party lights", also available in stores) which emit no blue light. Three hours before bed-time, I switch to the low-wattage (60W) yellow bulbs. One hour before bedtime, I switch to the very low-wattage red bulbs (25W). I also dim the intensity of my computer LCD to the lowest level at one hour before bedtime. (Computer LCDs emit large quantities of blue light.) During the last hour of the day, I avoid blue light as if it were poisonous, even in tiny amounts.

(Update 2010.09.25: I suspect the yellow glasses (for 3 hrs before bedtime) and the daily transitions to yellow and especially red lights (a dimming environment) are the most important elements of Rule 1.  Eliminating the blue light is crucial, but the regular cues given by steadily dimming the ambient light are also important for retraining the body's clock, and "conditioning" the body to grow tired on schedule.)

Rule 2: Using the "Relaxation Response" to relax and fall asleep (to shut down the cortex and avoid anxious thoughts).

This is one of the most important ingredients of the regimen, and which has made the difference between the current success and past failures. The key was to learn how to elicit what Dr. Herbert Benson (of Harvard University) calls "the Relaxation Response" (RR) : this is a natural physiological response that occurs in a state of very slow breathing and low cortical activity. To learn about this, I read "The Relaxation Response" by Dr. Benson [2]. I use the RR to fall asleep every night. Basically, this turns off higher mental functions, so that my mind isn't racing after senseless anxious thoughts that would otherwise keep me awake for hours. It also greatly reduces stress that would otherwise also tend to keep me awake. The perturbations caused by stress can wreck efforts to make the transition to diurnal living, which is why the RR is so important. (Early on, I used the RR also for 15 min, 1 hour before going to bed, but found this to be unnecessary except on high-stress days.)

A traditional word for the RR is "meditation," but I did not receive this news with the skepticism that I normally reserve for new-age esoterica (i.e., I read the book by the Harvard professor). I elicit RR by concentrating on my breathing, and simply counting the breaths (when I reach 100, I usually start over). I maintain a passive attitude throughout. If a thought arises, I casually put it aside and return my focus to the breathing and counting. Eventually my breathing slows to an extraordinarily slow rate. I often lose some sensation in my limbs (which returns on the slightest motion), or I simply lose track of where they are. Once again: I use this every night to fall asleep, usually within minutes. (N.B. On those rare occasions when it takes a long time to fall asleep, I can listen to an audio-book for a few minutes, which finishes the job.)

Rule 3: Rising at the same time every day.

I waken at 7:30 A.M. every day using an alarm clock.  I am usually wide awake (i.e,. alert and feeling refreshed) within five minutes of rising.  Sometimes I waken between 5 to 30 min before the alarm goes off and have a period of light sleep before rising at 7:30 A.M.  (During the transition from a free-running schedule to a diurnal schedule, it was often extremely difficult to wake up at the same time each morning, and I used more extreme methods to get myself out of bed -- see below.)

Rule 4: Going to bed at the same time every night.

I climb into bed at exactly the same time every night.

Rule 5: Sleeping in a light-proof room.

I covered the windows of my bedroom with cardboard and duct tape, to prevent any light from entering during the early morning when I am still trying to sleep. With the lights off, it is pitch black in my bedroom at mid-day. I have found that blindfolds sometimes come off during the night, or their position shifts slightly. In any case, they tend to allow some light to leak-in from around the edges, even when worn correctly.

Rule 6: No arousing activities within an hour of bedtime.

I avoid doing anything that is very stimulating or which can arouse passions or excitement within one hour of going to bed. I use this hour to listen to audio books or quiet music. Physical exertion is completely off limits. (I know what you're thinking, and this is all I can say: nights are for sleeping, and some activities are just as fun in the morning, when feeling vigorous.)

Rule 7: Exposure to bright blue light upon waking.

I purchased a blue light box (an array of blue LEDs), which can be obtained from a few different vendors (i.e., I found this using a google search). I place it in the field-of-view at roughly one arm's length away from my head for 30 minutes while eating breakfast and preparing myself for the day. As mentioned, blue light suppresses the production of melatonin, which causes drowsiness, and which the body uses to regulate sleep [1]. People with Seasonal Affective Disorder (SAD) use light-boxes to effectively treat their condition (i.e., to combat the low-light conditions during winter months and the drowsiness that results). Studies have suggested that exposure to blue light may accelerate a degenerative illness of the eyes, while other studies have shown otherwise. I receive a greater dose of blue light from the sky on a sunny day while walking to work than I do from this light box for 30 min in the early morning. (Update 2010.09.25: Eventually, the light box became unnecessary.)

Rule 8: Using white-noise generators to screen-out abrupt sounds.

I tend to waken in response to abrupt noises and not in response to constant or monotonous sounds or white noise (i.e., sound that occurs at equal magnitude at all not-highly-unpleasant frequencies). I leave a loud fan turned on during the night so that I am not wakened by noises from the street or neighboring apartments.

Rule 9: No caffeine or alcohol after noon.

I have one small cup of coffee almost every morning, and no caffeine at all after noon each day. Caffeine has a half-life in the body of about 5 hours, and I am taking no chances. (I am always alert and wide-awake before I drink the single cup of coffee -- I do not depend on this cup of coffee to wake up!  I sometimes skip it -- it is not necessary. I just like the taste.) Sometimes I consume a glass of wine at lunchtime. In the past, I have noted that a glass of wine for dinner has a huge and negative impact on the quality of sleep. I suspect that the odd glass of wine or a beer for lunch will not affect sleep at all. I enjoy chocolate, coffee, and wine, and so this rule is "a real bummer".

Rule 10: Vigorous daily exercise.

I exercise every day for between 45 minutes and one hour on a bicycle. I exercise before dinner. In the past, I have noticed that exercising within three hours of going to bed can interfere with sleep. (And exercising right after eating can cause cramps.)

Rule 11: Eating a healthy balanced diet (natural foods).

I eat a balanced and healthy diet. I do not eat any junk food or sugary soft drinks. I avoid foods with preservatives and any significant amount of fat. I do not smoke. Eating well may not be essential for diurnal living, but it is a crucial part of good health and maintaining high levels of energy and strength.

Rule 12: No sugary foods within three hours of bedtime.

I have noticed that sugary foods consumed at night can affect sleep, and so I have banned these altogether from the hours before bedtime.

Rule 13: Finishing dinner at least 3 hours before bedtime.

I have found that digesting while sleeping can affect the quality of sleep as well as the way I feel on waking up. I finish eating dinner at least 3 hours before bedtime every day.

Rule 14: Eating a larger number of smaller meals rather than few large ones.

Nearly all of the fatigue that I experience now is associated with digestion -- and even this is now uncommon. I eat a light (but highly nutritious breakfast), and my lunch is spread-out over a few snacks through the day. Dinner is the largest meal, but also not huge.

Rule 15: Adequate hydration, ceasing well before bedtime.

I drink between 1.5 and 2 liters of water daily. I stop drinking fluids 3 hours before bedtime, to avoid being wakened by bathroom trips during the night.

Making the transition from ~26 hrs to 24 hrs

Step 1: Starting from a state of rest

I made the transition from a 25h50m schedule to 24h00m schedule starting from a well-rested state. Sleep experts use the word "chronotherapy" to refer to living with a biological night that shifts constantly to later times over a short period (i.e., bedtime shifting by some amount each day for a week or so, in order to "reset"). I lived according to this "natural" or biological rhythm (i.e., 25 hours and 50 min) for many years because it was the only way to lead a healthy and productive life. This meant waking sometimes at 3:00 AM and sometimes at 3:00 P.M. (i.e., since the waking time shifts by a small amount each day, I would commonly sleep and then waken at very odd hours). I determined the length of my biological rhythm by simply sleeping until I could not sleep anymore, and remaining awake until I could sleep again. After doing this for two weeks, my rhythm settled on a period of approximately 26 hours. I lived this way for six years. Therefore, I started the transition to the 24-hr rhythm from a well-rested state.

Step 2: Beginning with a long sleep period

I made the transition by going to bed every night at the same time for 40 days and 40 nights, waking 9 hours later (i.e., at 7:30 A.M.). I applied all of the rules mentioned above, except for Rule 1. Instead of using the blue light-restriction mentioned above (Rule 1), I took 0.75 mg of melatonin 3 hours before bedtime every day, and merely switched to low-wattage bulbs 1 hr before bedtime. (Please note that although I used melatonin to make the transition (and stopped using it later, as I will describe), it is very possible that by applying Rule 1, I could have made the transition without using melatonin at all. Rule 1 was applied later, to ween myself off of this substance.) Melatonin has been shown to be effective in treating sighted as well as blind people with the Non-24hr sleep-wake syndrome [3,4], however, the long-term consequences of taking melatonin every day are not known.

Over the first six days of the transition, I grew steadily more tired and eventually exhausted. On the seventh day, I felt much better. By the eighth day, I was markedly better, and my strength improved from that time forward. As mentioned, I continued with the 0.75 mg of melatonin each day (3 hrs before bedtime) for 40 days and nights. Then, I reduced the amount of time that I spent in bed from 9 hours to 8h30m (abruptly), in accordance with "gradual sleep restriction," first explored in the late 1970s [5,6]. Once again, on the 7th day I felt much better, and the situation improved from that time forward. I made one further transition in the same way, to spending just 8h15m in bed at night (i.e., about 8hrs of sleep). In previous studies [5,6] the transition to fewer hours of sleep required 11-13 days. I suspect that it might be possible to restrict sleep even further (without undercutting my strength or health), but the scientific community is divided on this question and most sleep doctors seem to recommend getting 8hrs/night.

During the transition stages, it was frequently extremely difficult to get myself out of bed at the same time every morning.  I used two very loud alarm clocks.  After rising, I would go immediately to the shower to put my head under cold water, which produced a kind of shock that was also helpful. Even on "good days" during the transition, it could take up to 20 or 30 min. to reach a state of moderate alertness.

Step 3: Going off the melatonin

After sustaining the 8h15m sleep period for 1 month with melatonin, I applied Rule 1 (see above) and stopped the daily melatonin supplements. In this case, I was very tired on the first day, and did not grow better until (wait-for-it) the seventh day once again. Over the following weeks, my sleep grew steadily more deep and sound. Infrequently, I had some difficulty falling asleep (i.e., for 1-2 hours), but these episodes grew steadily more uncommon as time went on.

Dealing with travel and nights out.

In the future, when I have to travel or when I do not have as much control over lighting conditions as I do at home (or if I wish to go out in the evening), I may attempt to use melatonin to maintain the diurnal rhythm on a short-term basis. What is very clear by now is that the 15 rules are sufficient to maintain excellent health and strength on the diurnal rhythm in my case.

Speculative hypotheses

(What follows are speculations and not scientific ideas based on rigorous experimentation and analysis.) I suspect that blue light suppresses melatonin in humans not mainly because "the sky is blue" but instead because "fire is yellow". Imagine the time after fire was discovered, tens of thousands of years ago. People who had trouble sleeping because yellow light suppressed the production of melatonin probably didn't get far in life. (The pressures of hunter-gatherer society possibly wrecked the prospects of any person who was chronically tired!  This hypothesis might be tested by determining whether other mammals have the same response to blue light.) If that was a selective pressure in prehistory, then consider what happens when artificial light was invented more than a century ago. People who are highly sensitive to blue light are suddenly in trouble, because the world is no longer lighted by fire alone (i.e., effectively, the sun is no longer setting when it should). Science has shown that every person has an endogenous (natural) rhythm that's pretty close to 24 hours (i.e., circa dia or "roughly a day"). This is the time-scale on which the body begins to produce melatonin and when it shuts off that production, if blue-light levels are kept constant around the clock. In the presence of regular diurnal modulation of blue light, the rhythm can be entrained to 24 hours for many people. For those of us with an abnormally long endogenous rhythm, it is crucially important to revert to conditions before artificial lighting emerged (i.e., no blue light in the evenings). That may be the whole story in my case. As for others, perhaps the problem is caused by a weak sensitivity to the blue light melatonin-suppression mechanism.

Delirious Rant

The attitude toward sleep and relaxation that prevails in our culture is categorically perverse.  The medical community and the insurance companies have failed us in a spectacular way. Sleep and relaxation are essential to good health, and there are scores of people suffering from sleep disorders, many of them needlessly, because sleep research and the treatment of sleep disorders are not generally regarded to be an essential part of good health. Ignorance about sleep hygiene and relaxation methods is widespread, and I suspect drug companies are delighted with the status quo. To give one of many examples of just what I mean: science has learned a couple of things about how biology responds to blue light. First is that insects are attracted to it, and second is that blue light in the evenings prevents human bodies from producing melatonin, which is needed to sleep well. And in general stores across the United States, they sell blue-free bulbs to keep bugs away. Here's what I would like to say in the parlance of today's young people: WTF?!


A sketch by the author when he was teen-aged.

How to Cite this Blog

Baphuacs, Oijo. The Sandman is from Mars: Defeating the Non-24-Hr Sleep-Wake Syndrome. http://non24.blogspot.com, Sept. 27, 2009.

N.B. Before 2011.07.24, this site was published using the pseudonym "O. Sarlo," and then briefly "Fain, Olox."   

Questions and Comments

Feel free to post comments on this blog: simply click here. You may also send questions and comments to obaphuacs---at---gmail---dot---com.

Bibliography

[1] Lockley, S.W., G.C. Brainard, C.A. Czeisler. J Clin Endocrinol Metab. 2003 Sep; 88(9):4502-5

[2] Benson, H. The Relaxation Response, Harper Paperbacks (Exp Upd edition, Feb 8, 2000)

[3] Lockley, S.W., D.J. Skene, K. James, K. Thapan, J. Wright, and J. Arendt. Melatonin administration can entrain the free-running circadian system of blind subjects. Journal of Endocrinology, Vol 164, Issue 1, R1-R6.

[4] Non-24-hour sleep-wake syndrome in a sighted man : Circadian rhythm studies and efficacy of melatonin treatment. Sleep, 19(7): 544-553, 1996.

[5] Friedmann J et al., Performance and Mood During and After Gradual Sleep Reduction. Psychophysiology 1977; 14: 245-250

[6] Mullaney DJ et al., Sleep During and After Gradual Sleep Reduction. Psychophysiology 1977; 14: 237-244

29 comments:

  1. Dear Phlegyas,

    I have the same disorder you do, though I like to call it Free-running Disorder instead of Non-24, If I have to be living with this debilitating condition, the least I can do for myself is to call it by the coolest-sounding of its many names :)

    A huge thanks are in order for you for taking the time to write all this down, your blog is as much as I can tell the very first actually helpful resource for our kind on the net. And also a success story at that!

    It's funny, halfway around the world you were running your "experiments" in the same period I started mine, but I have to say, so far I haven't been nearly as successful as you are...

    My phase is somewhat shorter then yours, 24 hours and 50 minutes. The method I read about is to skip a nights sleep on every second weekend. I named the Friday morning to Saturday evening period of the aforementioned second week "Slingshot Day", and Sunday after that "The Aftermath". The Slingshot Day, where you are supposed to stay awake for 36 hours basically resets the phase by severe sleep deprivation, so after its done you'll able to maintain a regular 8 AM to Midnight wakefulness schedule for 12 days.

    Or that's the theory at least, but as of right now I have very serious problems to stay awake during the slingshot period. I'm able to maintain the 8 to Midnight deal for the 12 days just fine, but then it all unravels and it takes 4 days of gradually pushing bedtime later and later to get back to a relatively normal wake up time. And even though these 4 days are much less drastic then the 36 hour slingshot, I am very-very tired through them, coupled with consistent headaches, vertigo and severely low mood.

    So as you can tell, the Slingshot Method is for me much less of a success so far, but its still better then living ALL OVER THE CLOCK like I did before I started all this. And I remain hopeful, that by implementing the RR and the blue light thing you described with such care and detail above, one day soon I will finally be able to gain control over my life.

    Thank you again for your dedication and advice!

    Andrew from Hungary, Eastern Europe

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  2. Hello! I have some unholy combination of Non-24 and DSPS, probably caused by being housebound due to severe ME/CFIDS, and I too have managed to defeat it using light therapy and darkness therapy. I've just put up a blog/site about it at http://insearchofmornings.wordpress.com, and I'd love to discuss this further with you. I'm really glad to hear that you've been as successful as I have.

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  3. My circadian rhythm is 28 hours long. When I was a child, my mother would have to physically lift me from bed. It still took 30 minutes to wake up, and many hours to be alert. I have never had a normal M-F, 8-5 job in my life. Well, I did once, I was fired after three weeks. I am 37 years old. Other people in my family have the same cycle -- about 26-28 hours. The sleep doctors tell us we do not exist, or we need psychiatric help. I have several friends with the same issue -- they are all freelancers of some sort or another.

    I always had a strong suspicion it had to do with light. When I moved to Seattle during the summer, my insomnia became out of control, and during the first winter, I would sleep for 15 hours. (I think Alaska would kill me!)

    During a long stretch of unemployment, with no motivation to wake up at any particular time, I nearly went insane. I would wake up in the middle of the night or the middle of the afternoon, I lost track of days, and at one point I got a memory and a dream mixed up. Not good. I fixed that with regular exercise at 6 am -- the first three days I stayed up all night, then exercised, then slept. A week later I was going to bed at 10 and getting up in time for my workout.

    I have already figured out the need for a very dark room to sleep, and intense blue light upon awakening, but I didn't know about screening out all blue light in the evening! I'm very exited about adding this extra step. Thank you very much!

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  4. I have also had problems with this. I have not got the special yellow glasses but would like to. I am having great success just with my sunglasses. Thanks for posting because your experience inspired me! I also joined a group on experience project where I blogged about my own experiences and findings. Come and see me there - upsidedowngirl experience project in the group delayed sleep phase syndrome. Thanks for sharing your information.

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  5. Thank you for your comments and e-mails. I'm happy to say that I have been diurnal now for well over one year without a single relapse. By this time, all those years of Non-24 are like a distant memory of living on another planet. My life has changed in many profound and positive ways.

    I wish you all the best of luck with overcoming your sleep disorders. Goodnight and pleasant dreams.

    - The Martian Sandman

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  6. Thank you for sharing this. I have the same disorder thatn you, and didn´t know about the effect of blue light on melatonin production. I have a question: What about contact lenses? Do you know if there are yellow contact lenses that can block blue light? It would be great, don´t you think? I mean, there are situations when we can´t avoid going out at night, and we can´t put yellow light bulbs everywhere.

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  7. It's a good idea. I've never heard of blue-filtering contact lenses. That would be far less obtrusive than having to wear the amber glasses in public. (Note that I don't know if the yellow anti-bug-lights would have worked for me on their own. I use amber glasses *and* the yellow and red lights.)

    I have some hopeful news about the effects of going out now and again. I've noticed that after > 1 year of being diurnal, since I've been carefully "retraining" my body to produce melatonin at the right times, this "training" may have a certain amount of inertia.

    That is, I've noticed these perturbations (going out once in a while) do not have the same devastating effect they used to have. Nowadays, I can sometimes fall asleep on-time even though I've been exposed to blue lights until shortly before bedtime.

    This was unthinkable last year, when I was just several months into the experiment. Back then, perturbations of this kind would have ruinous consequences (and so, I avoided them *completely*).

    But I should stress that this applies to going out only every now and then. Disturbing the routine many nights in a row may cause the sleep-onset time to start drifting again. I have not run the risk of doing irreversible damage to the new rhythm. Someday, I will test its limits and report back.

    I should also stress that the *cues* in the routine may be important in my case. For example, switching over to red lights 1 hour before bedtime (overall intensity is also dimmed a lot) and taking it easy for that last hour is a powerful *cue* (or even eating at the same time each day). Going out at night may interrupt these cues and upset the conditioning, which may have long-term effects if allowed to continue several nights in a row.

    Good luck.

    - The Martian Sandman

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  8. Dear Phlegyas,

    I would like to congratulate you on your success in concurring the invincible and thank you for sharing the strategy to do so with us.

    I have had this disorder for about 13 years now and my life has never been worse. Granted, it didn't stop me from becoming a doctor. But it will do so in the next couple of months when my orthopedic surgery residency starts.

    When I was in med school, I used to stay awake until all lectures are over and sleep after for 2 weeks or wake up and attend lectures after only 4-5 hours of sleep and become sleep deprived for the rest of the month.

    But I am afraid this will most definitely not work in the upcoming 6 years of residency with all the on-calls and night shifts. The same could be said about your strategy. Unfortunately, it won't work for me as sleeping and waking up at fixed times for more than 3 days is out of question as a surgical resident. But then, what kind of surgeon would operate on patients half asleep?

    Thanks again for your share. You have managed to achieve what we (doctors be it or patients suffering from this disorder) could not.


    R.K.

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  9. amazing! i just figured out i have non-24, and am thrilled to find your blog. it gives me hope that i may cure myself.

    RRG NYC

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  10. First of all, what a fantastic blog :) It's great to hear of someone else's experience with this sleeping disorder.

    Are the yellow/red bulbs really necessary? Surely if you are wearing yellow glasses already then no blue light can enter your eye regardless.

    I have tried many of these techniques myself and I still suffer with a non 24hr sleeping pattern. However, I just used normal sunglasses at night to try and restrict the light intensity as much as possible. I'm going to try and pick up a pair that blocks all blue light and see how I get on.

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  11. Hi Andrew,

    Wearing the amber glasses blocks out most of the blue light, but there is a concern about stray rays getting through at the edges. (N.B. these are glasses, not goggles.)

    Also, switching to yellow lights and then red lights (quite dark) at the same time every night I suspect has a role in retraining the circadian rhythm. These are strong cues to the body that it's time to start getting tired. That is, to some extent, there may be a conditioned response. I suspect this pattern is now very important -- perhaps as important as the change in light color.

    I don't know for sure what is completely necessary any longer, because I haven't deviated from this routine for well over 2 yrs. I plan to do some experiments, eventually, to find out to what extent my rhythm is robust with respect to perturbations.

    When I do, I'll post the results here of course.

    Good luck,

    - The Martian Sandman

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  12. thank you so much for this. I still feel a bit excited when I realize that I'm not the only person struggling with this. I'm going to try your suggestions, thanks again!
    -James

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  13. Great blog and great experience. Very encouraging.

    I have fought this all my life, and the result has been insomnia, headaches, chronic tiredness, and more important, a feeling that I was constantly letting family down by not being on the same schedule. Either I missed important events, or I attended them feeling like death warmed over. If I gave in to my body's timing, I feel physically better, but guilty that i am being self indulgent. If I force myself to try to follow a diurnal schedule, I feel terrible, get resentful, and eventually always fail anyway. I've gotten so excited when the sleep schedule cycled to "normal" times, thinking I would just make it a point to stay on that schedule, but within a week I was bak out of sync.

    I am going to follow your rules, several of them I already do anyway. If I have any success I will report back.

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  14. I am someone who has had problems with a 'shifting sleep schedule' for many years. It appears as though I have managed to stop it in its tracks and this seems, above all other things, to be due to practicing the 'relaxation response' as soon as I prepare for sleep. I found this out via this blog posting!

    I suspect in my case that a dominant underlying cause was 'not switching off' at the end of the day- whether it be thoughts about work or other things. I believe that this could not only shift what time I got to sleep by large amounts, but even interfere with my quality of sleep when I got there. It appears to me that sleep patterns are not totally stable, and that it doesn't surprise me that if you subject one's sleep to frequent perturbations of the type described above, then you might find yourself locked into 'non24'.

    Just as an example: if I found myself awake at 4:30am and had to wake up at 9:00am, I would previously have been anxious about the ever decreasing amount of time that I had available to me to sleep, and even waking up frequently after initially managing to get to sleep, worried about the ticking clock. This reached its nadir when, in just such a situation, I had a prolonged nightmare about not being able to fall asleep!

    Now though, if in such a situation, I could guarantee that I'd fall asleep completely relaxed. I seldom now wake up feeling as terrible as I used to if 'forced' onto a schedule. It's difficult to emphasize enough what a fantastic thing it is to be able to consciously induce relaxation. It has done me so much good and I am extremely thankful to the author of this blog. I hope that the advice can help others who had similar troubles.

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  15. hey, this blog is great! very insightful to me. I would like to add my experiences and I have two questions, which I'll post at the end of this comment, I hope someone can answer them! thanks so much!

    well now, the original issue I had was that when I left school (thus no need to get up early anymore, which was good because that led to sleep deprivation!!), I noticed that over time my sleep cycle would get out of sync, it just simply wasn't totally consistent. if I managed to go to bed at 10PM, that would over a few days slowly shift to 4AM, then I would hang on to this 4 AM time the longest, up to a few weeks, then it eventually shifted to 6AM and then the shifting was again unstoppable, it would shift to 10AM within a few days. otherwise I was always a very good sleeper, falling asleep almost immediately after getting to bed, easily maintaining sleep, etc.

    anyway, at that point I would use a bastard form of chronotherapy, suffering through 2-3 days to reset the cycle. I did this because even though I had freelance work, it still bothered me that I couldn't easily get to shops, meetings with friends, etc. so I wanted to fix the whole thing!

    now this february I tried chronotherapy again, but I went to bed too late on the 2nd day of it, and got restless, couldn't fall asleep for 2 hours and then I got a second wind and wasn't even feeling sleepy anymore. I had a very annoying week afterwards, trying to reset my cycle but couldn't, I always ended up falling asleep only after 10AM in the morning or so. and even that would take 2 hours. and the sleep quality was of course crap.

    after 1 week I had enough, I got too nervous about the whole thing, I took a kind of sedating medication (not a sleeping pill) one evening and I was asleep in 5 minutes after going to bed, at 8 PM. woo hoo! I stopped taking the pill after a couple of days but I feel like it was needed to finally reset the cycle.

    since then I've been on a consistent sleep cycle. I go to bed around midnight, I do feel sleepy, yet I take a while to fall asleep, but I do eventually fall asleep, and then I get up between 9AM and 10AM. my trick seems to be that I made sure that all the window blinds are up after I get up, so all the sunlight can come in. the other part of the trick is making sure I do get up before 10AM. from those two, it seems to automatically follow that I get sleepy in the evening.

    this is great living this way finally. I can't believe it's stable now. no drifting yet at least.

    my only issue is that I often take a while to fall asleep, even though I'm definitely tired, sleepy and not even thinking about day issues after I go to bed. would this issue go away after a while of living with a stable cycle? I can also wake during sleep, which was always normal for me but sometimes I can get too awake now before drifting back to sleep. on the whole I can maintain sleep though. I do my exercises, four times a week, so it's not that. I'm annoyed at this a bit because I used to fall asleep so very quickly and easily. and due to this, I don't even know how much I actually sleep (because I purposefully don't check the clock while trying to fall asleep). I guess it is not less than 7,5-8 hours though. and not more than 9 hours.

    I have a second question too. I sleep normally for maybe 7 hours then for 1-2 hours drifting in and out of light sleep with dreams until I had enough and get up finally. I'm wondering if I'd be better off with skipping (some of) this and just get up after a minimal amount of this light dreaming? would it help with the falling asleep issue? I have not dared to experiment with this yet. I would love to know if anyone has any thoughts on this!

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  16. btw, I forgot to say, I have no idea if I really have one of the DSPS or Non-24 disorders but definitely something's out of whack with my cycle by default, perhaps less sensitive to the light upon waking (so that's why I needed more of it to make it stable?).

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  17. Hey my friend with all that good advices :-) Thanks so much for posting this!!!
    I'll keep experimenting - now with nights out!

    Do you get up the same time if you get home late from a party?

    Anyway, I think you helped me a lot, so for I had 4 good nights sleep out of 5, just started following your advices :-)

    Thanks so much
    Jonathan

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  18. Dear Ctrli & Anonymous,

    First, Ctrli: What I can say about your first question is already written in the blog post. When I was on a long-sleeping diurnal schedule, it did eventually become easier to fall asleep by following the rules I described above. As for skipping the 2 hrs of light sleep, I found that this was highly detrimental. I, too, after making the transition, was spending 9-10 hours in bed each night. By now, after sleep restriction according to reference [6] above, I spend just 8 hrs in bed each night, and I feel great each day.

    Second, Anonymous: During the several months that it took to make the initial transition, I did not go to parties (I had just moved somewhere, and had no friends in the area, so this was not very hard). The point is, I took no chances during the transition period. By now, I can go to parties and go to bed a bit late and even sleep in a bit late once in a while with no harmful effects. When I was retraining my body's rhythm, I simply made *no* *exceptions*.

    Cheers,

    - The Martian Sandman

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  19. I really wish I found this info years ago. Shortly after having my daughter, I realized I would have to force myself (no matter what) to be awake and productive in order to care for her. Eventually I turned to using (my own Rx) stimulants and downers to be able to keep up. Obviously, these only mask the problem for a little while. Now it seems nothing helps. After 2 yrs, I am completely drained. Lately, my memory has gotten extremely bad. Even if I sleep as long as I can once in a while, I still feel like I'm a zombie. But, sometimes in the middle of the night, I will have an hour or so where I feel normal. These times are awesome but sadly very rare. I'm missing out with my daughter, and have given up on just about everything else. I'm going to try to use as many of your rules as I can mix in. My family doesn't understand. Actually, I have never met anyone else like me. I've been this way since around middle school. This has definitely effected my life in every aspect. I'm so glad I found this site! Gives me some hope. Thank you!

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  20. I had the same problem since I was a child. I read that this problem sometimes correlates with a vitamin B-12 deficiency. I tried talking high-quality high-potency sub-lingual vitamin B-12 supplements for a little over a month, but it didn't help - so I wrote that off.

    A few years later I started showing more overt signs of B-12 deficiency and so I started taking B-12 injections (1/day for 1 week, then 1/week for 1 month, then 1/month forever). To my surprise, I have not had any problems with my circadian rhythm since starting the B-12 injections. Sure, I still stay up late occasionally, but my clock now snaps back to normal like other people's do.

    I just wanted to let you know, in case the cause of your (or others') Non-24-hour sleep-wake disorder happens to be the same as mine!

    Hope this helps.

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  21. Thank you so much for writing about this problem. I feel like nobody in my life understands my problem, and this includes the many doctors I've seen (psychiatrists, general practitioners, etc - all with different diagnoses that ranged from Mono, to depression, to possible thyroid problem and so on). Many of my friends, family and even my spouse have become angry with me time and again for my erratic sleep habits which I have always felt no control over. I have flunked out of school because of it, lost jobs because of it, missed out on important social functions, and, when I have managed to be awake according to the world's schedule, I have been sick, tired, suffering from a number of mysterious ailments such as chronic idiopathic nausea/digestive problems. In fact, I did suffer with depression on a number of occasions, but I always knew that the depression was a result of the sleep disorder and not the other way around. I was depressed because I could not function in the ways that came so easily to everyone else. I could not hold a job, I could not manage my life, I was in ill health - and I never saw an end to it. I was depressed because I thought that I would be a failure at life and I just "couldn't help it." I tried every imaginable stimulant and sedative - including melatonin - to no avail. I tried to go to bed and wake up daily at the same time, but I'd just end up lying in bed awake all night and feeling like crap all day (after maybe getting an hour of sleep) and then the next night, I would still be up all night even though I'd been tired all day. I have never heard anything about blue light. In fact, I haven't tried several of these things. I don't know how I will be able to work with all the different kinds of light and whatnot, when I am married and have children. I am curious if you have any suggestions that might make this more practical for someone who is not entirely in control of their surroundings. I would have to have my own bedroom and isolate myself for several hours a night to live the way you do. My spouse likes to watch television in bed at night. Also, I can't afford 80 dollar glasses. What might you suggest as a modification or are there any? Thanks

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    Replies

    1. Sadly, I can only report here about my own experience, which involved a radical change that was consistently applied over a long period of time. The good news is that my rhythm has been completely retrained, so that I don't have to follow the 15 rules religiously any longer. That is, it's not a "life sentence".

      Good luck,

      - Martian Sandman

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  22. Hmm, obviously I have the same problem. I remember 2000 year, when I was on a holiday with my class. We were at rooms, at 3 people. All night we were making a jokes, and at one time I had asked one of my two roommates. "Do you want to sleep ?". He told me that he is taking a sleep-pills permanently. We decide to meet the sunrice. I have been like beaten all day.
    Now I am at state that I found the best for me is to go to bed when I feel sleepy, and to take up when I am slept. Firstly I noticed this syndrome, when I were at school vacations.
    I can't feel as good as normal people, if I live in 24 rhythm. But now when I'm a year period without a job, I found that many people complained of fatigue, but I don't. My rhythm is about 25 hours. For one month the cycle is reset. I had never imagined that there could be people with the same crazy problem.
    My e-mail slav4o_1 "monkey A" abv.bg

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  23. It's great to hear from others with this condition (even though it sucks for all of us trying to deal with this). I think I have had non-24 since around high school - I was tired every day, and missed a lot of days or arrived late since I wanted extra sleep. During school holidays my patterns would shift later and later, and I would have no sleep for the first day on going back to school.

    I'm now 27 and have only learnt about non-24 in the last year. I had symptoms more like DSPS most of the time, but it always took me a few hours to fall asleep and I always made an effort to get up by midday each day, despite feeling tired most days. Last year I was playing computer games all day every day and just let my patterns drift and went to bed when I was tired. Thats how my non-24 started. Initially it felt kind of nice, not being tired every day and actually feeling well-rested. But after a while it gets in the way of everything, you can't make plans or do very much at all.

    I have been trying the yellow light glasses after doing a bit of research, and they definitely made my circadian rhythms more normal - down from around 25 or 26 hour cycles to 24.2 or so. So it is still slowly shifting forward. If I was more diligent I think I could make the glasses work - by putting them on at exactly the same time each night and getting up at the same time each morning. I will have to try some of the other methods listed here too.

    Good luck everyone, and if you are unsure what to do, give the yellow glasses a try, just google "low blue lights". They have been very helpful for me, I think mainly because I spend so much time on the computer before bed and have a large 32" screen - it must be putting out a lot of blue light.

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  24. Thank you for this post. I believe I have non-24, since my sleep has always drifted during college and defied my attempts to make it regular. I just assumed that when I got a job, I'd have no choice but to make it regular and that I'd get used to it. But now I've started a promising career where I have to sleep on a 24 hour cycle, and I have been miserable for weeks! I usually feel great in the mornings when I wake, but by the time noon rolls around I feel a sort of mental fog overcome me. Then by 5 o'clock it's full-blown depression and anxiety which I've not experienced before! Maybe it's because my body wants to sleep in the day but isn't? I've been using drugs to deal with the symptoms but that's obviously no long-term solution. Just the other day the muscles in my back were sooo sore, tense, painful - whatever - that I felt like I had been lifting boxes all day even though I have a sendentary job. Extreme exaustion perhaps?

    Well I'm so glad that there's stuff I can actually try. You have no idea how miserable I've been - I've been thinking a lot about death and suicide which is not good. I'm going to try what you did and hope that it at least helps me feel better.

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    1. Hi Anonymous,

      Looking through these posts I was concerned to read that you've been experiencing thoughts of death and suicide. Even if you have non 24, you should seek help for these symptoms as depression that bad should not go untreated. I hope that you've experienced some success with trying the stuff suggested in the blog and are feeling a lot better now. Best wishes, from a fellow sufferer.

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  25. I'm so glad it worked for you!

    I can see how you will feel better adapting to a 24 hour schedule. When you sleep during the day, your sleep quality must have been poor. It doesn't take much light to shut off melatonin production. So if you need to go to the bathroom at night, use a dim red flashlight if it's too dark.

    Animals get depression when lights are on 24/7. Blind people have lower rates of breast cancer. Melatonin wise, you are better off with 24/7 darkness.

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    1. Hi Anon,

      I have been using a small red flashlight for some years now.

      As for daytime sleep on the N24 cycle: during those years, my sleep was quite profound, even in the daytime. The problem was not that I couldn't sleep deeply: it was that I couldn't sleep deeply **when I was supposed to**.

      Update: it's been 3.5 years now since I made the transition, and my 24 hr rhythm remains extremely robust.

      -The Martian Sandman

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  26. thank you so much for this webpage. your advice has been life changing.

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The Sandman is from Mars: Defeating the Non-24 hour sleep-wake syndrome by Oijo Baphuacs
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