STUDY OBJECTIVES We investigated biological and behavioural rhythm period lengths (i.e., taus) of Delayed Sleep-Wake Phase Disorder (DSWPD) and Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD). Based on circadian phase timing (temperature and dim light melatonin onset), DSWPD participants were dichotomised into a circadian-delayed and a circadian non-delayed group to investigate etiological differences. METHODS Participants with DSWPD (n = 26, 17m, age: 21.85 ± 4.97 years), full-sighted N24SWD (n = 4, 3m, age: 25.75 ± 4.99 years) and 18 controls (10m, age: 23.72 ± 5.10 years) participated in an 80-hour modified constant routine. An ultradian protocol of 1-hour 'days' in dim light, controlled conditions alternated 20-minute sleep/dark periods with 40-minute enforced wakefulness/light. Subjective sleepiness ratings were recorded prior to every sleep/dark opportunity and median reaction time (vigilance) was measured hourly. Obtained sleep (sleep propensity) was derived from 20-minute sleep/dark opportunities to quantify hourly objective sleepiness. Hourly core body temperature was recorded, and salivary melatonin assayed to measure endogenous circadian rhythms. Rhythm data were curved using the 2-component cosine model. RESULTS Patients with DSWPD and N24SWD had significantly longer melatonin and temperature taus compared to controls. Circadian non-delayed DSWPD had normally timed temperature and melatonin rhythms but were typically sleeping at relatively late circadian phases compared to those with circadian-delayed DSWPD. CONCLUSIONS People with DSWPD and N24SWD exhibit significantly longer biological circadian rhythm period lengths compared to controls. Approximately half of those diagnosed with DSWPD do not have abnormally delayed circadian rhythm timings suggesting abnormal phase relationship between biological rhythms and behavioral sleep period or potentially conditioned sleep onset insomnia.

中文翻译：

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延迟睡眠 - 觉醒相位障碍和视力非 24 小时睡眠 - 觉醒节律障碍的昼夜节律差异和节律关联

研究目标 我们调查了延迟睡眠-觉醒阶段障碍 (DSWPD) 和非 24 小时睡眠-觉醒节律障碍 (N24SWD) 的生物和行为节律周期长度（即 taus）。基于昼夜节律阶段时间（温度和昏暗的褪黑激素开始），DSWPD 参与者被分为昼夜节律延迟组和昼夜节律非延迟组，以研究病因差异。方法 DSWPD 参与者（n = 26, 17m，年龄：21.85 ± 4.97 岁），全视 N24SWD（n = 4, 3m，年龄：25.75 ± 4.99 岁）和 18 名对照组（10m，年龄：23​​.72 ± 5.10 岁）参加了一个 80 小时的修改恒定程序。在昏暗、受控条件下 1 小时“天”的超电协议将 20 分钟睡眠/黑暗期与 40 分钟强制清醒/光照交替。在每个睡眠/黑暗机会之前记录主观嗜睡等级，每小时测量中位反应时间（警觉性）。获得的睡眠（睡眠倾向）来自 20 分钟的睡眠/黑暗机会，以量化每小时的客观嗜睡。记录每小时核心体温，并测定唾液褪黑激素以测量内源性昼夜节律。使用 2 分量余弦模型弯曲节律数据。结果 与对照组相比，DSWPD 和 N24SWD 患者的褪黑激素和温度 taus 显着更长。昼夜节律非延迟 DSWPD 具有正常定时的温度和褪黑激素节律，但与昼夜节律延迟 DSWPD 相比，通常在相对较晚的昼夜节律阶段入睡。结论 与对照组相比，DSWPD 和 N24SWD 患者表现出明显更长的生物昼夜节律周期长度。大约一半被诊断为 DSWPD 的人没有异常延迟的昼夜节律时间，这表明生物节律与行为睡眠期或潜在的条件性睡眠发作失眠之间存在异常的相位关系。