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Case Reports
. 2023 Aug;32(4):e13859.
doi: 10.1111/jsr.13859. Epub 2023 Feb 17.

Continuous positive airway pressure as an accurate marker for non-24-hour sleep-wake rhythm disorder

Balthazar Bazin  1   2 , Pierre A Geoffroy  2   3   4 , Hélène Benzaquen  1 , Julia Maruani  2   3   4 , Alix Romier  4 , Michel Lejoyeux  2   3   4 , Marie-Pia D'ortho  1   3 , Justine Frija-Masson  1   3
Affiliations
Case Reports

Continuous positive airway pressure as an accurate marker for non-24-hour sleep-wake rhythm disorder

Balthazar Bazin et al. J Sleep Res. 2023 Aug.

Abstract

Non-24-h sleep-wake rhythm disorder is quite rare in sighted patients and frequently associated with psychiatric disorders. We report the case of a 46-year-old man with autism spectrum disorder (ASD) and agoraphobia who had been referred for a suspicion of obstructive sleep apnea syndrome (OSAS). Polysomnography and arterial blood gas confirmed moderate OSAS associated with hypoventilation. Continuous positive airway pressure (CPAP) was started on fixed mode with excellent results. At follow-up, his CPAP report data revealed an irregular sleep-wake rhythm with a progressive offset of sleep schedule and wake time delayed from 1 h from day to day. Melatonin (or agonist) is efficacious and safe for long-term treatment in ASD and circadian rhythm sleep-wake disorder (CRSWD) with light therapy and wakefulness promoting medication. This case underlines the importance to sensitise psychiatrists to sleep and CRSWD, and also that CPAP data offer a possible objective alternative to sleep diary.

Keywords: agoraphobia; apnea; autism spectrum disorder; circadian rhythm sleep-wake disorder; melatonin.

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References

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