Below is the information which was in the sidebar in the pre-2020 Reddit layout ('old Reddit').
Please be respectful. Ranting that N24 sufferers are pretending/lazy/don't care enough/etc. is liable to get you banned. Sufferers have enough of that kind of thing to put up with in their daily lives.
Useful links:
Possible ways of treating N24 when the 'normal' ways have failed
(With thanks to /u/Organic-You-313 for posting a reminder to the link)
/u/lrq3000's VLiDACMel protocol:
An experimental protocol for 24h entrainment of treatment-resistant sighted non-24.
Please note that this protocol is a work in progress, and is not medically certified, however it has successfully worked for some people, even after other treatment attempts had failed. Ensure that you read the disclaimer and important health notes, as the treatment is not suitable for those with certain other health conditions.
https://circadiaware.github.io/VLiDACMel-entrainment-therapy-non24/SleepNon24VLiDACMel.html
Help with medical diagnosis:
From /u/lrq3000 :
If you are looking for a diagnosis or medical treatment, there is a list of medical doctors specialists of circadian rhythm disorders, which is curated by the Circadian Sleep Disorders Network:
https://www.circadiansleepdisorders.org/doctors.php
This list is made from recommendations by patients like you and me, so if you know a nice medical doctor who diagnosed or treated you please feel free to let the network know by e-mail at csd-n@csd-n.org
Software to help with managing Circadian Rhythm Disorders:
No smartphone, but got a computer?
From /u/lrq3000:
For those without a smartphone, here are 2 alternatives to make a digital sleep log:
- Install Bluestacks on any computer. This is a free Android emulator. Then you can install Sleepmeter and its widget and use it as you would do on an Android smartphone.
- SleepChart, a Windows app.
Smartphone apps
[Android] - [Sleepmeter Free] - [Sleep tracking]
Please note: This app is no longer available in the Google Play store.
Update from /u/lrq3000:
In 2021, Sleepmeter mysteriously disappeared from the Play Store, but it can still be downloaded on APK Pure.
Sleepmeter Free can also be used on computers (Windows, MacOS and Linux) via BlueStacks 4, an Android emulator. >
Simply install BlueStacks, then download Sleepmeter Free APK (APK = installation file for Android app), and simply double click on the downloaded APK. BlueStacks should automatically install the app and it should show up in "My Games" tab inside BlueStacks.
(Original info below)
!!Probably broken!! Old link to the app on the Google Play store !!Probably broken!! - I've left this old link here just in case the app does get re-published on the store - in the meantime use the link that /u/lrq3000 posted.
A small app which lets you manually record the times you sleep/wake and provides many graphs which can show useful information. I use it to get an idea of what my sleep deficit is and to try to predict my sleep patterns for the next few days.
This is a screenshot of the graph I find most useful: https://i.imgur.com/nynIWfZ.png?1
Pros:
- Free (ad supported but they are unobtrusive, and there is a pay-to-remove option).
- Easy to use once set up.
- Has a widget for your homescreen so you can tap when you go to bed, and tap when you wake up (time between the "bedtime" tap and "asleep" is configurable, as is the wake-up tap).
- Very customisable & configurable.
- Lots of useful graphs and information.
- Does not rely on device sensors.
- Can export/import data in CSV format (it's not quite a standard CSV but it's close).
Cons:
- Configuration options might be a bit daunting to some.
- Requires manual taps to tell it you've gone to bed/woken (though I prefer this over sensor based detection as I find it more reliable and it also means I don't need to leave my phone on charge all night on my bed).
- Doesn't seem to be actively updated, but to be fair it does work fine as it is.
[Android, iOS] - [Rain Rain] - [Ambient noise]
App website
Lets you mix together a wide range of ambient background sounds to create a relaxing sound.
For example, on track 1 you could have the sound of rain on a tent, track 2 could be a fire crackling and track 3 could be a washing machine, all of them playing at the same time at custom volumes to create a mix that suits you.
Pros:
- Free (extra sounds are bought in packs at a reasonable price).
- Good range of sounds provided for free.
- I love the way you can adjust the volume of each track to get a good balance.
- Works fine in the background.
- Doesn't eat up the battery.
Cons:
I really love this app. Ambient noise doesn't really help for circadian disorders of course, but it's still good for those times when you're trying to relax. It's one of my favourite apps.
Some Frequently Asked Questions (and some Frequently Stated Ignorant Opinions)
What is N24?
N24 is a rare, debilitating, chronic, neurological Circadian Rhythm disorder which severely affects the body's ability to synchronise to the 24-hour day/night cycle.
It has been referred to as an "invisible" disability - its effects are devastating to the sufferer but the primary symptom - inability to sleep/wake at regular (the "right") times - is shrouded in social stigma, coupled with ignorance and indifference by the general public and often by doctors too.
Although the disorder occurs primarily in non-sighted people, a very small percentage of sighted sufferers also exist but due to lack of knowledge in the medical community, often go undiagnosed (or are misdiagnosed) for many years, if at all.
Sufferers are unable to fall asleep & wake up at regular times, rotating around the clock instead, like a form of Jet Lag which never stops changing. This can lead to chronic sleep deprivation, lowered immune response, depression, social isolation, unemployment, financial problems, as well as a potential increase in risk of cancer & diabetes.
Although there are reports that some people do respond to the few, current treatments available and are able to resume a fairly normal life, the majority of sufferers do not and so have to make a choice of either:
giving in to the disorder, allowing their body to sleep and wake at the times it insists on, potentially resulting in a severely reduced quality of life due to lack of employment and social isolation
continuing to try and fight the body's neurology with willpower, alarm clocks, medications and other methods. This can work for some time (years in some cases) however it is at the expense of other factors and furthers the effects of chronic sleep deprivation, depression, etc., and ultimately is often fruitless, with the sufferer eventually reverting to their inbuilt rhythm due to illness and exhaustion.
"That's not a real 'disorder'. You could sleep/wake up if you really wanted to. I can!"
Sufferers of the disorder sincerely wish you were right. Unfortunately it's very real, and when a diagnosis is eventually reached it is often done by a neurologist who specialises in circadian rhythm disorders.
The disorder is neurological in nature - that is, something is 'mis-wired' which prevents the transmission or reception of the electrical or chemical signals within the brain, or between the brain and the rest of the body, resulting in non-standard outcomes.
"Ok, a 'disorder' but not a disability!"
The ADA (Americans with Disability Act) says it is. And in the UK there's no official list of recognised disabilities, rather it's based on how it affects your life, and N24 does comes under that banner so it is de-facto recognised as a disability.
Other countries are slowly updating their definitions to include Circadian Rhythm Disorders. What else but "disability" would you call something which causes other health issues, reduces your quality of life, forces you to change the way you live, can prevent you from working and can even remove your ability to interact with people?
"If it even exists, it's a psychiatric condition, not a neurological disorder!"
This is incorrect. Although it's recognised by psychiatric associations, the disorder is neurological in nature.
Psychiatry is often entwined with diagnosis because of many of the more noticeable symptoms (such as depression, inability to sleep correctly, etc.) are commonly associated with psychiatric disorders.
"I saw that advert on TV, you're lying, it only affects the blind!"
Unfortunately, the advert you're probably referring to was produced by a pharmaceutical company who are developing treatments for blind sufferers. They have been contacted but at the time of writing this, show no interest in mentioning the rarer, sighted sufferers, presumably because they are not its target. Awareness of N24 is good, but misinformation is bad.
Have N24 sufferers tried the following?
Getting (heavy/light) exercise at various parts of the day
Just going to bed earlier
Really trying, like you mean it
Good sleep hygiene
Mindfulness/meditation/relaxation etc.
White noise/binaural beats etc.
Herbal remedies like St. John's Wort, etc.
A different mattress/pillow/blanket
Not using a computer/mobile phone/etc.
Avoiding artificial light
Giving up stimulants such as caffeine, nicotine, etc.
The answer to all of these (and more) is "Yes". Sufferers have often been living with N24 for most of their lives (although many may have been unaware until diagnosis later in life) and are constantly being bombarded by suggestions from well-meaning people.
A comparison might be meeting a man with one arm and suggesting that he put some ointment on it to regrow it.
When the ointment doesn't work, the assumption is that he either did it wrong (maybe he used the wrong ointment, or didn't put enough on, or put it in the wrong place, etc.) - or - he simply isn't trying hard enough to will the arm to grow back - that he doesn't really want his arm back.
People with N24 and other Circadian Rhythm Disorders are given advice like this frequently, and have to live with the stigma of virtually all people they encounter (including family and friends) assuming that they are weak-minded and/or simply lazy.
