National Sleep Foundation

Chapter 5: Circadian Rhythm Sleep Disorders


How is Non-24 Hour Sleep Wake Disorder Treated?

Treatment is designed to stabilize the individual’s sleep-wake cycles.

Timed, exogenous melatonin administration has been shown to be effective in treating Non-24, and is emerging as a first-line treatment for the condition.65 66 Treatment of this disorder with low-dose melatonin (0.5 mg) may be more efficacious than with higher doses.67

In patients who have some remaining sensitivity to light, morning bright light therapy may be effective (2,500 lux for 2 hours daily upon awakening), but further studies are needed.68


65. Lewy AJ, Emens JS, Lefler BJ, Yuhas K, Jackman AR. Melatonin entrains free-running blind people according to a physiological dose-response curve. Chronobiol Int. 2005;22:1093-106.

66. Lewy A, Bauer V, Hasler B, Kendall A, Pires M, Sack R. Capturing the circadian rhythms of free-running blind people with 0.5 mg melatonin. Brain Res. 2001;918:96-100.

67.McArthur A, Lewy AJ, and Sack R, “Non-24-Hour Sleep-Wake Syndrome in a Sighted Man: Circadian Rhythm Studies and Efficacy of melatonin treatment,” Sleep 1996; 19(7):544-553.

68. Reid KJ and Zee PC. “Circadian disorders of the sleep-wake cycle,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 470-482.