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

Author:

Bazin Balthazar12ORCID,Geoffroy Pierre A.234ORCID,Benzaquen Hélène1,Maruani Julia234ORCID,Romier Alix4ORCID,Lejoyeux Michel234ORCID,D'ortho Marie‐Pia13ORCID,Frija‐Masson Justine13ORCID

Affiliation:

1. Multidisciplinary Functional Exploration Department FHU APOLLO Assistance Publique Hôpitaux de Paris, Bichat Hospital Paris France

2. GHU Paris—Psychiatry and Neurosciences Paris France

3. Paris University, Neurodiderot, INSERM Paris France

4. Psychiatry and Addictology Department AP‐HP, GHU Paris Nord, DMU Neurosciences, Bichat Hospital Paris France

Abstract

SummaryNon‐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.

Publisher

Wiley

Subject

Behavioral Neuroscience,Cognitive Neuroscience,General Medicine

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