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Would A Circadian Rhythm Disorder Mess Up A Sleep Study?


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#1 eightlegs

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Posted 26 May 2009 - 07:41 AM

One of the possible explanations the dr's gave me for my sleep issues is a Circadian Rhythm disorder. Having done some reading my natural sleep patterns, when left to do my own thing, very much fit the profile of Delayed Sleep Phase Syndrome. I function best between 9pm and 3am, and tend to wake up around noon if left to wake naturally. I still feel horrible when I wake up though, and and without adderal or some other med am usually a fumbling zombie until after the sun goes down. This however still doesn't explain my narc like symptoms including cataplexy, HH's, sleep paralysis, and all the other "fun" stuff... dry.gif

So I began to wonder... would my sleep studies be skewed because my internal clock is on a different schedule.. such as my usual bedtime isn't 11:00.. more like 3 am.

#2 sleepless sleeper

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Posted 26 May 2009 - 11:23 AM

maybe that is a symptom of the cause instead of the other way around.

Does a sleep study not show this, or at least help with this dx? I certainly don't know. I bet that someone on here will.

#3 Lais02

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Posted 27 May 2009 - 02:14 AM

eight I completely know what you're saying. I thought it was just the way I was to go to sleep super late every night. When I did my sleep study I got very lucky and somehow fell asleep when I was "supposed" to. I think that is a ridiculous thing to tell someone with N to do though. Going to sleep "on time" has been the impossible thing in my life. I can't stay awake when I need to, and I can't sleep when I need to do that either.

I think it would make tons more sense if when we went in to do a sleep study that we could do it on our own sleep schedules rather than what they tell us to do.

So were you dx'd with N or not?

What are you thinking would be different about your study?

#4 eightlegs

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Posted 27 May 2009 - 08:56 AM

I've had 2 studies with 2 different dr's. Both studies were inconclusive, but the first dr. Dx'd me with Narcolepsy based on my symptoms... the 2nd dr. "un" diagnosed me with N because the study was inconclusive.

I'm not sure another study would show anything different.. just trying to figure things out...

#5 Stacy D

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Posted 11 September 2009 - 12:26 AM

I've had 2 studies with 2 different dr's. Both studies were inconclusive, but the first dr. Dx'd me with Narcolepsy based on my symptoms... the 2nd dr. "un" diagnosed me with N because the study was inconclusive.

I'm not sure another study would show anything different.. just trying to figure things out...


I am a shift worker and primarily work mid-shift (10pm-6am) so they did my PSG during the day and MSLT at night. Maybe they should do yours the same way? It's best if the sleep study follows your "normal" sleep pattern.

#6 Nyx

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Posted 11 September 2009 - 03:18 AM

eight I completely know what you're saying. I thought it was just the way I was to go to sleep super late every night. When I did my sleep study I got very lucky and somehow fell asleep when I was "supposed" to. I think that is a ridiculous thing to tell someone with N to do though. Going to sleep "on time" has been the impossible thing in my life. I can't stay awake when I need to, and I can't sleep when I need to do that either.

I think it would make tons more sense if when we went in to do a sleep study that we could do it on our own sleep schedules rather than what they tell us to do.


I tried to convince my sister to go to a sleep doctor recently, suggesting that perhaps she has lower levels of hypocretin if not outright narcolepsy (which I don't really feel confident enough to go out on a limb and suggest she has anyway), but she insisted that because she has problems getting to sleep at night she couldn't possibly have narcolepsy. While I convinced her to go see the sleep doctor through other arguments (i.e, perhaps he could give her something so she could sleep through the night once she does fall asleep so she's not so tired all day), her argument got me thinking. Could it actually be common among narcoleptics to have problems falling asleep at night while be unable to stay awake during the day? They usually only talk about circadian changes in teenagers and the elderly, but what if it presents in a decent proportion of narcoleptics as well?

I was asking around for sleep medicine doctors to perhaps shadow in Chicago, and a sleep medicine doctor/neurologist here recommended a specialist in circadian rhythm disorders. If anyone is interested in looking her up or searching for her papers, her name is Dr. Phyllis Zee and she's at Northwestern, and I think I remember seeing some of her research on the circadian rhythm and the elderly. If I do get the chance to shadow her, I'll try to post back here if I get any good info from her on the connection or suspected mechanism. Sounds like another topic I should add to my ever-increasing list of things narcoleptic that I'd like to research and read more about. Speaking of which, I just did a quick search and found two promising papers that I don't have time to read right now (gonna try to get to sleep again), but thought I'd throw out there as food for thought and perhaps some validation that something's going on. First, there's a 2008 paper titled "Circadian rhythm in salivary melatonin in narcoleptic patients" that says, "The results suggest that in some narcoleptic patients the circadian rhythm might be disturbed."

The other article sounds great, but I just don't have time to read it right now. But in case someone else has access to pubmed or can find it online and wants to check it out first:

Sleep Med Rev. 2008 Apr;12(2):109-28. Epub 2008 Feb 20. "Nocturnal aspects of narcolepsy with cataplexy." Plazzi G, Serra L, Ferri R., Department of Neurological Sciences, University of Bologna, Bologna, Italy. Here's the abstract (summary):

Even though the most impressive manifestation of narcolepsy is excessive sleepiness, paradoxically a significant number of patients have trouble sleeping at night. A wide array of alterations can affect the night-time sleep of a narcoleptic patient, and the aim of this review is to increase awareness on this issue, thereby enhancing the care of narcoleptic patients by more specific approaches to their disturbed night sleep. This review covers a broad variety of nocturnal sleep features in narcolepsy. Starting from animal models and the clinical features of patients, the paper then discusses the many comorbid conditions found in narcolepsy at night, the most advanced methods of analysis and the few recent advances in the specific treatment of night sleep in narcoleptic patients.


Speaking of which, off to bed. AGAIN.

#7 Shambo

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Posted 08 January 2010 - 01:07 AM

I end up falling into two sets of cycles-

The first is similar- I will stay up until 1-2-3 or even later and sleep until after 12 and really be at my peak during the evening.

The second- I will sleep 10 hours and stay awake 16 hours. In just a few days I will go from falling asleep at 10 pm to being up until 4 am.

It is very inconvenient so I have to stop myself and force myself back into a regular schedule. The first is just as inconvenient so I have to force myself out of it as well. I had noticed the 10/16 thing right around the time I started showing symptoms- 5 years before I was diagnosed. I always wondered about it.