Non-24-Hour Sleep-Wake Disorder in Children and Adolescents: A Case Series

May 31, 2026Behavioral sleep medicine

Irregular Sleep-Wake Patterns in Children and Teens: Case Reports

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Abstract

Six sighted children with non‑24‑hour sleep‑wake disorder (N24SWD) were identified, with five having autism spectrum disorder.

  • All six children exhibited free-running sleep cycles ranging from 24 to 29 hours, leading to progressive delays in sleep and periodic day-night reversal.
  • Behavioral and functional impairments worsened during periods of circadian misalignment.
  • Entrainment strategies, such as melatonin and bright light therapy, showed variable success, with long-term adherence being rarely achievable.
  • Families often chose to maintain flexible sleep schedules, reporting improved mood and functioning when natural sleep patterns were accommodated.
  • Pediatric N24SWD is frequently associated with neurodevelopmental comorbidities.

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