Non-24-hour sleep-wake rhythm disorder (N24SWD) typically presents in patients with visual impairments that disrupt the ability to entrain to the 24 hour solar cycle. We discuss a 43 year old sighted man who presented with periodic daytime hypersomnia and nighttime insomnia, occasionally leading to <3 hours of sleep per day. Previous polysomnography showed an apnea hypopnea index of 6.2 events per hour. A sleep log of 3 months showed irregular time of sleep onset, and an average of 3 hours of sleep per day. Wrist actigraphy confirmed N24SWD. A trial of tasimelteon 20 mg/day resulting in improved daytime hypersomnia (pre-Epworth Sleepiness Scale (ESS) = 21/24, post-ESS = 5/24; a score of > 10/24 is considered sleepy). Follow-up actigraphy showed marked resolution of phase delay with an average of five hours of sleep. The case demonstrates that tasimelteon is a possible treatment for N24SWD in sighted individuals.

中文翻译：

---

使用褪黑激素受体激动剂治疗的视力正常者的非 24 小时睡眠觉醒节律紊乱得到改善

非 24 小时睡眠觉醒节律障碍 (N24SWD) 通常出现在患有视力障碍的患者中，视力障碍会扰乱 24 小时太阳周期的能力。我们讨论了一位 43 岁的视力正常的男性，他出现周期性的白天失眠和夜间失眠，偶尔导致每天睡眠 <3 小时。之前的多导睡眠图显示呼吸暂停低通气指数为每小时 6.2 次。 3个月的睡眠日志显示入睡时间不规律，平均每天睡眠3小时。手腕活动记录仪证实了 N24SWD。一项他司美琼 20 mg/天的试验可改善白天嗜睡（Epworth 嗜睡量表 (ESS) = 21/24，ESS 后 = 5/24；评分 > 10/24 被视为困倦）。后续体动记录仪显示相位延迟得到显着解决，平均睡眠时间为五个小时。该病例表明，他司美琼是视力正常者 N24SWD 的一种可能治疗方法。