r/N24

N24 always derails my personal goals. I’m fine for 2-3 weeks and then I have to do chronotherapy to get back to a suitable sleep schedule according to society norms. It has absolutely derailed my personal life, goals and relationships. How do you guys tackle that?

For months, I was just very delayed. Sleeping 7am to 5pm, give or take. But after several weeks of having to get up earlier, something snapped. One day, I stayed up all night and day, crashed out at 9pm. Slept until 4pm. Then, couldn’t sleep that morning either, stayed awake till 7:30pm. Crashed out, woke up to get a snack around 2:30-4am, crashed out again, slept until 4pm. Now it’s the next morning and once again, haven’t slept, don’t feel like sleeping.

This shit is awful for my brian. I feel like shit. I’m not eating. I’m not taking my meds. But once I’ve been awake that long, I shut have to sleep. I had to pry myself out of bad at 4pm. I think I could’ve kept sleeping for 5 more hours. It’s like, for 24 hours I can’t sleep at all, and then the next 24 hours all I can do is sleep. I don’t even know what this is at this point. It’s not bipolar is it?? I don’t have any other symptoms of mania. But this shit is insane. I thought it couldn’t get any worse than being nocturnal but I was so wrong. So funny all those people who say “just stay up all day and go to bed early and it’ll re-adjust you!” But what they dork account for is how I then just sleep all day to account for the lost sleep and end up sleeping even less the following day because of how long I just slept to make up for the lost sleep. What I nightmare. I’m severely disabled with constant neurological symptoms so when I don’t sleep well I’m just barely able to even feed myself.

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I had an appointment with my psychiatrist today and we were discussing medication, so I had to tell her about my inability to take it at a regular time in relation to my N24. (I am primarily being treated for depression, anxiety and ADHD and I want to focus on those symptoms without touching sleep because I need life to get easier overall before trying to shift my sleep in any way.)

I’ve mentioned the symptoms before, but the classic N24 isn’t present anymore since I take melatonin so it's been hard to explain to her. It still seems to be an erratic version of it but you can still see the N24. The thing is, I still don’t take melatonin at the same time every day for a few reasons, so right now I’m mostly using it to treat insomnia and quieten my brain before sleep rather than treating the N24 itself. But it gives me enough control to slow down or accelerate phases of my cycle when needed.

Anyway, I managed to very nervously tell her about the condition. It didn’t seem like she had heard of it before, but thankfully she wasn’t dismissive and she did hear me out. I also stood up for myself by sharing what I’ve discovered and understood from being on here.

It's funny in retrospect because she kept asking me "So what time do you wake up?" even though I was telling her it keeps changing. She seemed to find it hard to understand.

It feels so difficult telling someone I have some super rare sleep disorder. It’s hard to validate myself and feel like I’ll be taken seriously. Cause any day-walker who hears this seems to find it so bizarre, and I don't blame them. It is bizarre, but it doesn't mean it's not real.

I feel like I’m collecting disorders like trophies at this point, and I worry I come across like some silly girl self-diagnosing for attention. It’s especially difficult with doctors because it feels like I’m telling someone who’s supposed to be an authority on my health what I have.

All my life I've been careful not to make doctors feel threatened about their authority, but I am starting to believe that I am the best authority over myself. A lot of doctors can be too egotistical to take that well, especially when they’re unlikely to even have heard of the condition. Honestly, I get the feeling even the few sleep clinics where I live mostly just treat sleep apnea in 99% of cases, so people with N24 are probably often misdiagnosed even if they got a consultation.

She said she’d like me to think about fixing it at some point and moving to a day cycle. She mentioned that research suggests important hormones are released during certain hours and that it’s beneficial to sleep in accordance with that rhythm. She did acknowledge I might be in the tiny percentage of people who don’t fit into that, though I felt she mainly said that because I was firm in saying I am different.

Socially, it makes perfect sense why I might want a more regular routine. But even from a purely physical standpoint, she seems to believe there are benefits to a regular night-sleep/day-awake rhythm. At one point I got frustrated and asked her why I need to change it if I’m able to work with it socially, and that’s when she brought up the physical benefits. She does seem open to my experiences, and I plan on sharing some research and my sleep data with her. But I just feel very overwhelmed by all of it.

I know there isn’t enough research on N24, and it was evident she didn’t know of it, though to her credit, she didn’t pretend that she did. I think I just feel overwhelmed because I’ve spent my whole life fighting to be heard and validated, and throwing a rare sleep disorder into the mix doesn’t exactly help. I mean, I’ve always had this, and now I finally have the words and tools to understand it better, but it's hard to be taken seriously.

Edit: TLDR: I very nervously told my psychiatrist about my likely N24 and stood up for myself. She hadn’t heard of it before and wasn’t entirely dismissive, but suggested I should try to shift to a normal sleep schedule. I feel overwhelmed by how hard it is to be taken seriously with a rare disorder.

We were discussing the problem of Doctors treating N24 as "Insomnia" (If you hear hoofsteps, suspect a horse, not a zebra) and then viewing it as a symptom of underlying disorder, rather than as a standalone diagnosis, and a commenter asked, "Yes, but are they wrong?" And I thought that was a good question worthy of an attempt at an answer (Thank you for the comment!). So here's mine:

They aren't wrong from their point of view. And they have good reasons for thinking the way that they do. But they are wrong in a subtle sense. In general, you can't treat a symptom. You treat an underlying cause. If all you have is a symptom, you can't do anything. For instance, "headache". If a patient has a headache, you don't look at a list of causes for headache, and start with "Astrocytoma" because it's first on the list, and immediately prescribe brain surgery. A doctor would (rightly) search for the underlying cause of the headache before cutting into the patient's brain.

But with N24, the cause is basically unknown. The proper path is… I will address what they should be, but aren't doing a little later.

Their instinct with a "causeless" symptom like N24 is to group it with other symptoms and see what common causes there are for the symptom cluster. This leads them to a few treatment pathways and patient pipelines that completely miss what's going on and send people with N24 into decades long blind alleys following useless treatment protocols some of which have extreme adverse effects.

The first thing they do is simplify "N24" (something they haven't heard of, and the "rule of thumb" they follow is: if you hear hoofprints, don't think of a zebra, think of a horse) to "Insomnia". Then, if you are overweight, Insomnia + Overweight = sleep apnea!

BAM! Refer to sleep clinic! I AM A GOOD DOCTOR! I GET AN A+!

PROBLEM SOLVED Go golfing.

Six months later, patient returns. They are wearing a Darth Vader mask and still complaining about Insomnia. They said something about "N24" but you aren't listening. You are looking at their chart and their chart says, "Insomnia". And patients are idiots (and you're almost always right in assuming this). And they seem a little… crazy…

So start them down the psych pipeline. Insomnia plus generally frazzled? DEPRESSION… Refer them to the Behavioral Clinic.

PROBLEM SOLVED! You are a good doctor! You get an A+! Go golfing.

And when you get to the behavioral clinic? Well… Now you're in for six to fifty years of varied and fashionable treatment pipelines that will leave you 500 pounds overweight, groggy all the time, in a straitjacket, delirious, locked in a padded room, drooling into your pillow, wondering where your life went, if you are capable of any thought at all. But still nothing is being done to address the circadian rhythm disorder. Because it is "just a symptom" of depression/anxiety/… (They will treat your "sleep problems" as a symptom of 100 different "underlying causes" as long as your insurance holds out).

So what should they do?

Basic science. Drop all assumptions about what is causal for the symptom. Drop all assumptions about WHAT IS "NORMAL." Some people can climb Mt. Everest without oxygen. That's very rare. Do they have a disease? No. They are different in some way. Some people stay awake for 26 hours and then sleep for 13. Are they diseased? Perverted? Let's NOT ASSUME ANYTHING. Let's do some basic science. Just because a person's behavior is different from some norm expected of them doesn't necessarily mean they are "diseased." And the norm of sleeping like a machine in a factory arose with factories about two hundred years ago.

So what would basic science look like? Drop the assumption that a person is "supposed" to be awake for 16 hours and sleep for 8 like they are a machine with an on and an off switch. If you tell a group of people that they hold this assumption, they will say, "I never said anything like that!" And indeed, they never did. They assumed it, without ever having thought about it, which is revealed by looking at the methodology and analysis of every sleep study ever conducted. It is never said, no one needs to say it. They all assume it, without thought.

Drop that assumption, and observe. "Allow" the person to sleep when they are tired and be awake when they are awake. Take an actigraph. Take saliva samples every hour and track hormone cycles. Put the person in a fmri and observe how their brain functions. And do the same things for a control group… TWO control groups, in fact. Control Group One: people living "normal" lives. You know the type. Every day, they wake up, guzzle two gallons of coffee, go to a panicked workplace, come home in a state of panic and anxiety. Watch tv for eight hours, take a Xanax, sleep (barely) for 6 hours, wake up, guzzle two gallons of coffee and do it all again, and then sleep twelve hours on Saturday and Sunday. Control Group Two: People who "never had a problem" with sleep. They fall asleep at 10 o'clock at night and wake up at 6, no problem, ever since they were a kid.

Then you might, might start to see something. Then you might have a leg to stand on, a wobbly one, scientifically.

How much would such a study cost? A billion dollars? How many people does N24 affect? 0.05%? Is it worth it? Nope. Would you initiate a billion dollar study to try to take people who can climb Mt. Everest without oxygen and make them into people who can't climb Mt. Everest without oxygen? Nope. So people with N24? Thrown out like garbage. Your chronotype doesn't match societal expectation… B'bye! Have a nice life, you useless sack of crap. Or… go to the sleep clinic and hope something sorta works and go to the Behavioral Clinic and hope something sorta works.

All of this is not to suggest that there is maliciousness among the doctors. It's just to speculate as to why nothing is done about the real problem, and why those suffering from it are shunted into useless and often detrimental treatment pipelines that are blind alleys. The irony is, we probably spend ten times as much treating people with N24 for diseases that they don't have as we would spend studying it to try to untangle an underlying "cause". If there is a cause. I don't think there is necessarily. I think it's normal variation in human function.

The directory didn't have someone I could afford, so it seemed I have to try a Dr who didn't seem to have a review mentioning n24. Another Dr said they cover it, but I feel confused not having much n24 specific info about them.

If they're not a circadian rhythm specialist, are they not specialized enough?

Things that are apparently not evidence of N24:

- exhibiting a clear progression pattern that other people have noticed and mentioned

- not responding to insomnia meds but responding at least a little to circadian rhythm meds

- literally being diagnosed with N24 by a doctor in a different Kaiser region

I have no idea what counts as hard proof, especially if you’re on literally any medication-apparently that makes diagnosis impossible.

Anyway, if you’re in the SF Bay Area and putting up with Kaiser, ask for Dr Marcos. The other doctor (I forget his name) doesn’t believe in circadian rhythm disorders, and will try to catch you out as being off your meds if you have bipolar (I don’t think that was even to do with my sleep, he was so pushy and weird about it that I got the impression he legit doesn’t believe that anyone actually takes their prescribed mood stabilizers.) Dr Marcos will be skeptical unless you can fully free run with no meds, but he’ll at least try to treat it anyway.

I've seen a lot of posts/comments about fixing sleep times with things like low dose melatonin hours before bed or long light therapy. But it seems that the common theme is that these treatments only allow the person to sleep at night without actually changing the internal shifting rhythm. People either get more and more distupted over time and go back to free-running, or they have a higher tolerance for feeling tired and foggt and just accept the lower quality of life that comes with this "entrainment". This is what happened to me too, each time I tried entraining.

Has anyone experienced this differently? Have you entrained and stopped the internal cycle from moving and causing you problems in the background? If so, how did you do it? Were you originally DSPD and were able to go back to that, or was it something else?

I am wondering if we as a community can figure out why this sleep-circadian rhythm disconnect happens so often and how we can fix it. Personally, I wonder if there are some other organs we need to specifically target that are causing the problems, or maybe we need a new way to directly target the SCN? Please share your thoughts.

>A study suggests that middle-aged and older adults with stronger, more regular daily patterns of activity and rest showed signs of slower biological aging.

>Participants with clearer differences between daytime activity and nighttime rest, and less fragmented routines, had more ‘youthful’ physiological age scores.

>The associations remained significant even after researchers accounted for factors including chronological age, sex, education, and certain health conditions.

>The findings suggest that rest-activity rhythms could become targets for interventions, potentially using wearable devices or lifestyle changes, aimed at slowing the aging process.

I just wanted to make this post for those who are potentially on the fence about it. I am lucky that I found a sleep specialist who suggested this to me. I take it 6 hours before I wish to sleep, I get into bed about an hour before hand and I generally fall asleep roughly when I'm supposed to. Sometimes under sometimes over but it never drifts too far.

Due to the side effects of how it makes you groggy the next day I only take it to reset the pattern, I don't take it everyday. I only take it for a few days to solidify the pattern and then it'll stick for a while before I repeat the process again. I've had my pattern shift as far forward as to 4am in this process and this method has managed to drag it back to a 12am sleep which is my personal sleep goal. Something I've never been able to do before and would have to wait for my pattern to go all the way around again.

I take between 0.5 and 1mg depending on the availability of what is prescribed. As it is a prescription it's guaranteed to be the real deal than something OTC/off the internet which I think is quite important too.

I waited for a good few months of trying this before posting as I simply couldn't believe it was that simple.

Thanks for listening.

I've had freerunning N24 for years now and I've hit a very stagnant phase

I'm not complaining about it because my current sleep schedule is a more normal one

its still not the majority early bird kind of schedule but it's a more normal day schedule that there is a lot of actual people on

but I feel like I'm just always on edge waiting for it to shift and still refusing to believe it's predictable so I don't jinx myself and have it shift again as soon as I start thinking that

but after my last cycle went fully around the clock this one at first started moving extremely fast like shifting every 2 days

but now I've been on the same schedule for like about 2-4 weeks now

it has only briefly shifted for one day during that time then went backwards again

like my body is fighting my brain about it or something

which is so insane to me

edit: the title autocorrected freerunning to freelancing

I genuinely wish there was a non-24 social club that ran from like 12-4AM a few days a week, so that people with n24 could socialize with other n24 people in non - bar / nightclub settings which seem to be the only thing that goes on during those hours.

Like, wouldn't it be cool if there was always *somebody* there, even if half the time you wouldn't be on that cycle.

I'm just daydreaming probably but I wish I could meet other n24 people face to face. I've never met anybody else in person with the disorder.

I’ve been trying out light/dark therapy for several months now, but I’m still struggling and am trying out a few supportive measures to see if they make a difference. Has anyone found that magnesium supplements make a difference for them, and if so what dose and timing worked best?

Hello, I am 32 F

I was referred here by a different Redditor from r/insomnia because of my discription of the bout of insomnia I am going through right now

Shortened Version:

It is now 10days since this insomnia first started, I have only slept in chunks on the 4th day for about 5-6hours(on Seroquel, stuff left me feeling worse the next day), the 7th day off & on for 12 hours(7 hours after taking Trezodone) & yesterday from 1pm - 7pm(no medical assistance)with only one wakeup, but was so tired I kept sleeping in chunks off & on until now, 4am. I woke up rather dizzy(not as bad while still) whenever I move, mainly my head, that's new.

What made them think I belong here:

Forn many years, I can even remember some in young childhood/teenhood, I often slept late, even now before this all started my most comfortable time to sleep was usually 3am-12pm & from time to time 5am - 3 or 5pm.

I just need some helpful advice & suggestions, going though this insomnia has left me rather hopeless & emotional 😭

Here is a link to my original post for anyone interested: https://www.reddit.com/r/insomnia/comments/1t90niy/comment/ol1jgsg/

Like lets say i want to START an alarm at 1pm, then tomorrow 2pm, the next day 3pm- 1 hour offset. Looping forever, of course.

IS there an alarm app out there that supports this? cus im plain ol tired of randomly forgetting to take my meds and finding out the alarm is going off while im asleep, and startinjg to get woken up by the pill alarm that im supposed to be taken when im FALLING asleep

Looked thru the subreddit and i just found a bunch of weird confusing hypermonetized apps and one that seems like it might do what i want but is overly confusing and hypermonetized and has icky language(talking about success and willpower)(for archival, it is by set3523 and called Chronos)(more archival, a tool i keep seeing popping up is Multitimer for its countup timers, a concept im still wrapping my head around and am actively testing, its just gonna take multiple days to see if it works. I just dont like thaqt multitimer has ads and collects data when all i want is a freaking pill alarm that adjusts with my sleep schedule so i dont get woken up by my bedtime pill)

If you're poor and have no prospects/connections like me, in the United States, (and maybe elsewhere), the normal work you'd have available to you is all designed to destroy the N24-enjoyer, except for 1 job.

If you work as a fedex ground package handler you can do occasional status and only have to work a minimum of 2 shifts in the last 30 days. You can pick up whatever shifts you want with the app. But first you have to make it through a few weeks of part time training period (but you can still give away some shifts while doing so on the app).

Common shift times are in the early morning range, start times from 1 AM to 6 AM end times from 8 AM to 10 AM. Afternoon/evening shifts. Sometimes overnight depending on location. Sometimes around noon depending on location.

Pay is bottom end but not all the way bottom. Turnover is horrendous, no interviews/resumes. It can be quite miserable and physically demanding. The trick is not to push yourself and always prioritize safety/skill/efficiency over speed/hustle. Speed can come with time/skill and body adaptation.

I’m married and my sleep (or lack thereof) has always been a bit tension point. My husband is used to it now, but still gets sad sometimes. I can’t help but feel guilty, especially when I enter a daytime cycle and realize I’m basically going to bed around the time he wakes up for awhile. It leads me to bad decisions where I don’t follow my natural cycle and then can’t sleep for days.

Disclaimer: I’m not *officially* diagnosed N24, but only because I haven’t sought it out yet. My body naturally runs on a 26-28 hour cycle, meaning I gradually drift through the entire clock and end up fully nocturnal (or vice versa) within about a week. It’s frustrating for both of us. Even for N24, my cycle is pretty extreme. I try to freerun it, but it feels impossible sometimes.