More Information on
Circadian Sleep Disorders
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- the more people we have, the more impact we have when we try to raise awareness of
circadian disorders with other organizations, the press, the medical community, and the public.
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Join now! Brochures and Other Handouts
Our brochure is geared to the general public, to introduce DSPS and Non-24 to people experiencing symptoms of these disorders, and to their families.
Please distribute it to anyone who may be interested.
Print on lightly colored paper for some color, if you like. We used ivory.
web display version shows the brochure panels in easy-to-read order. The print versions are meant to be printed out on both sides of a sheet of paper, then folded in thirds, creating a brochure. (In the print version, the panels will appear out of order on-screen.)
We have posted documents describing DSPS and Non-24, in an easy to read Question-and-Answer format.
These are designed to give to family members, friends, employers, and school personnel, to help them
understand these disorders. Feel free to print and distribute these. There are two different (but similar) versions, one for DSPS and the other for Non-24:
formats display nicely in your browser.
The web versions are formatted by your browser for printing a multi-page document.
The printer forms are pre-formatted PDF files that you can print on two sides of a single sheet of paper, which then folds in half into a booklet.
booklet * When printing the booklet, be sure to (select this option if you have a double-sided printer).
flip on the short edge In Other Languages:
We also have a one page
Basic Fact Sheet that introduces DSPS and Non-24 to people who don't know about them.
It's a quick and easy read, just the basics.
Former board member and artist Lily Style has created an infographic describing Circadian Rhythm Sleep Disorders. View it in your browser at www.circadiansleepdisorders.org/docs/CRSDGraphic.php. Feel free to r epost the graphic to help raise awareness.
You can print it directly from your browser (we suggest making the browser window full screen - the image will resize). We are also posting JPG images in various proportions for printing directly on different sizes of paper:
You can download these (in Microsoft Windows, right-click and select
). To print in Microsoft Windows, right-click on the downloaded file (in File Explorer) and select
. Or open it in a photo- or image-processing program to use that program's features such as borderless printing.
Niteowl Email List
This is a free mailing list support group for people with DSPS and Non-24 to share
their experiences. It's a good place for people just discovering these disorders
to hear how others deal with them, as well as for long-time participants to get support and to provide support to others.
There are often discussions of evolving treatment, useful to all.
For further information, and to sign up,
Note that membership in Circadian Sleep Disorders Network and membership on this email list are completely separate.
Circadian Sleep Disorders Network is affiliated with this email list, and our volunteers assist the list administrator with some chores. CSD-N was formed by participants on this list, and many of our members post regularly. But we have no control over what appears or who can join, and list membership is completely separate from membership in CSD-N.
Once you've signed up for the list, you post by sending an email to
Everyone on the mailing list receives that post as an email, and you receive everyone else's posts as emails. If you don't like to get separate emails, you can opt to receive in digest form, typically one email a day containing all the day's posts. You make that selection (after signing up) by logging in at
circadiandisorders . www.circadiandisorders.org/list.
There are some rules:
The rules that the list software enforces are
no messages over 40 KB
no images (including emoticons and that cute little flower in your sig line)
no attachments, and, of course
no messages from non-members
One frequent problem is that people with more than one e-mail account try
to send from an address that isn't registered as a member here. An
infrequent problem is that a few e-mail providers aren't accepted at all so
another e-mail account must be (acquired and) used. gmail generally works well.
An additional rule is PLEASE do not just reply to a message with a subject
line containing "Niteowl Digest, Vol xxx, Issue xxx". That is obviously
not informative and if you aren't careful you may include the whole list of
messages in the Digest, making your message too large for the list.
Digest or not, it is a good idea to trim whatever you are replying to
leaving just enough for people to know what you are replying to.
Of course, don't be snippy or insulting, and please take off-topic
conversations off-list. And no advertising.
Once you've signed up for the list, you can also browse previous posts in the archive at
There is also a mirror of the archive on Yahoo at
This is useful when the primary archives are not working, as sometimes happens.
Login to your Yahoo account, or create one (free) - link is at the top right on that page.
Then you have to Join the Yahoo copy of the list - this is separate from signing up for the list itself - there is a button on the Yahoo page to do this.
To unsubscribe from the Niteowl email list go to
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If you do not know your list password, send email to
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If that doesn't work, you can unsubscribe by sending email to
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For more (or more current) help on list commands, send email to
with HELP in the subject line.
Links to Other Pages and Other Sites
Circadian Sleep Disorders Network does not necessarily agree with the content on other sites that we link to.
Some links have been moved to other pages, where they seem to belong.
For example, treatment related links are on the
If you don't see something here, please look further, or use the Search box above.
For a list of recently added references (since the last newsletter), see
Recently Added References (members only).
Circadian Sleep Disorders (including both DSPS and Non-24)
What Are Circadian Rhythms?
What Are Circadian Rhythm Sleep Disorders?
What Is Delayed Sleep Phase Disorder?
What Is Non-24-Hour Sleep-Wake Disorder?
Urgent Need For Awaraeness And Accommodation
Circadian Rhythm Sleep Disorders (American Academy of Sleep Medicine (AASM), 2008) Laber-Warren, Emily,
Out of Sync (Scientific American Mind, Sept/Oct 2015) - nice description of CRDs and especially Non-24 Curtis, L,
Delayed Sleep Phase Syndrome and Non-24-Hour Circadian Rhythm Disorder (2004) - an excellent description a mother sent to her son's school
Circadian rhythm sleep disorder - in ScienceDaily Lockley, Steven,
Sleep Research in the Blind May Help Us All (2012) Griffith-Haynie, Madelyn,
JetLagged for Life (2012) - excellent description by someone suffering from DSPS/Non-24 (and apparently sometimes one or the other), and ADD as well Peters, Brandon,
Does Shift Work Become More Difficult as We Get Older? (2013) - we assume this applies to CRDs, too Gallagher, James,
Night work 'throws body into chaos' (2014)
New Study Finds Mistimed Sleep Disrupts Rhythms of Genes in Humans (2014) Borel, Brooke,
The connection between sleep and mental health: A Q&A with circadian neuroscientist Russell Foster (2013)
Carboni, Anthony, How Your Brain's Internal Clock Works (2013)
Koppel, Ted, Nightline: Circadian Sleep Disorders Part 1 (2/21/1996) - Part 2 Part 3 - including our vice president, James Fadden, as one of the guests Mansbach, Peter,
Misconceptions about Circadian Rhythm Disorders (SleepyHead Central, Nov 29, 2014) Coturnix,
Clock Tutorial #6: To Entrain Or Not To Entrain, That Is The Question (ScienceBlogs, July 7, 2009) - including scalloping and phase jumping Laliberte, Richard,
Self-Diagnose Successfully: Patients sometimes understand their baffling conditions better than their physicians. Learn how to build a convincing case and work with your doctor to find answers (Neurology Now: October/November 2016 - 12,5, p 16-20)
Circadian Rhythm Disorders (Tuck.com, Feb 2017) - easy definitions Research Papers
Zee PC, Attarian H, and Videnovic A,
Circadian Rhythm Abnormalities (Continuum (Minneap Minn). Feb 2013; 19(1 Sleep Disorders): 132-147) Sack, RL et al,
Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep-Wake Rhythm (Sleep. Nov 1, 2007; 30(11): 1484-1501) - AASM Review article on Circadian Rhythm Sleep Disorders, diagnosis and treatment Sack, RL et al,
Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work and Jet Lag Disorders (Sleep. Nov 1, 2007; 30(11): 1460-1483) - AASM Review article on Circadian Rhythm Sleep Disorders, background Dodson, ER and Zee, PC,
Therapeutics for Circadian Rhythm Sleep Disorders (Sleep Med Clin. Dec 2010; 5(4): 701-715) Dagan, Y,
Circadian rhythm sleep disorders (CRSD) (2002) - An excellent review article. Zhu L and Zee PC,
Circadian Rhythm Sleep Disorders (Neurol Clin. 2012 Nov; 30(4): 1167-1191) Dagan, Y and Abadi, J,
Sleep Wake Schedule Disorder Disability: A Life-Long Untreatable Pathology of the Circadian Time Structure (2001) - A wonderfully supportive article. Dagan, Y and Borodkin, K,
Behavioral and psychiatric consequences of sleep-wake schedule disorders (2005) Drake, CL,
The characterization and pathology of circadian rhythm sleep disorders (2010) Okawa M and Uchiyama M,
Circadian rhythm sleep disorders: Characteristics and entrainment pathology in delayed sleep phase and non-24 sleep-wake syndrome (Sleep Medicine Reviews (2007) 11, 485-496) Research Papers - Adverse Effects
Wright KP Jr, et al,
Sleep and wakefulness out of phase with internal biological time impairs learning in humans (2006) Scheer, FAJL et al,
Adverse metabolic and cardiovascular consequences of circadian misalignment (2009) Buxton, OM et al,
Adverse Metabolic Consequences in Humans of Prolonged Sleep Restriction Combined with Circadian Disruption (2012) - Obesity and Diabetes. Summa, KC, Vitaterna, MH, and Turek, FW,
Environmental Perturbation of the Circadian Clock Disrupts Pregnancy in the Mouse (2012) Gibson, EM et al,
Experimental 'Jet Lag' Inhibits Adult Neurogenesis and Produces Long-Term Cognitive Deficits in Female Hamsters (2010) Dumbell R, Matveeva O, and Oster H,
Circadian Clocks, Stress, and Immunity (Front. Endocrinol., 02 May 2016)
Classification of CRSDs
American Psychiatric Association,
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (1994) - not available online American Psychiatric Association,
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (2013) - not available online. The American Psychiatric Association
wanted to charge us $1500 just to quote a portion of the new DSPS and Non-24 definitions. Medina, Johnna,
Circadian Rhythm Sleep-Wake Disorder Symptoms (PsychCentral 2014) - definition of CRSD updated for DSM-5
ICD-10-CM Circadian Rhythm Sleep Disorders classifications
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) - describes what ICD-10-CM is, plus additional links American Academy of Sleep Medicine,
The International Classification Of Sleep Disorders, Revised (ICSD-R) (2001) - full text American Academy of Sleep Medicine,
The International Classification Of Sleep Disorders, 2nd edition (ICSD-2) (2005) - not available online Mann, Jeff,
Full List Of Sleep Disorders (ICSD-2) (2012) - list of disorder names American Academy of Sleep Medicine,
The International Classification Of Sleep Disorders, 3rd edition (ICSD-3) (2014) - not public, costs $60
Also see additional articles above under
How Your Bedtime Is Affecting Your Job Performance (2012)
Change Your Career, Not Your Sleep Habits (2013)
Should Some Employees Be Allowed to Start Work Late? (2013)
Why Working 9 to 5 Might Be Bad for Your Health (2013)
Are Night Owls Lazy Employees? (2013) DSPS owl,
A Little Bit Special: DSPS, a sleep disorder (2007) - on Daily Kos Hedrick, Bill,
THE Unknown Sleep Disorder (2011) - in Kilgore News Herald
Delayed Sleep-Phase Syndrome (2009) - in Sleep and Health Journal
Delayed Sleep Phase Syndrome - in Sleep Disorders Guide
Medlink Neurology: Delayed sleep phase syndrome - An excellent summary - click on ClinicalSummaries/Alphabetical/D/Delayed....
Delayed Sleep-Phase Syndrome - American Sleep Association
I Have Delayed Sleep Phase Syndrome - DSPS stories on the Experience Project Gardner, Amanda,
Is 'social jet lag' harming your health? (2012) - connection with obesity; "Paying more attention to our body clocks may be good for the economy as well as our health" Harris, Shelby Freedman,
Snoozing Till Noon? It Could Be A Sleep Disorder (2012) Strange, Ava,
Not lazy, just different: Living with Delayed Sleep-Phase Syndrome (Offbeat Home & Life, Feb 12, 2015) Auger, RR,
'Night owls': Reset the physiologic clock in delayed sleep phase disorder (Current Psychiatry (8)3 pp 55-65, Mar 2009) - applies to adults too Konnikova, Maria,
No, Mornings Don't Make You Moral (New Yorker, Feb 25, 2015) Auger, R Robert,
'Night owls': Reset the physiologic clock in delayed sleep phase disorder (Current Psychiatry, 8,3 p55, Mar 2009) Resnick, Brian,
If you're just not a morning person, science says you may never be (Vox Science & Health, Mar 18, 2016)
Late sleeper? Blame your genes. (Vox, June 1, 2016) Cormier, Jordyn,
It's Okay That You're Not a Morning Person (Care2.com, Feb 2017) Fox, Maggie,
This night owl gene mutation turns people into sleep Martians (CNBC.com, 4/7/17) Research Papers
Weitzman, ED, Czeisler, CA et al,
Delayed sleep phase syndrome. A chronobiological disorder with sleep-onset insomnia (Arch Gen Psychiatry, 1981 Jul;38(7):737-46) - The original paper describing DSPS (abstract) Oren, DA and Wehr, TA,
Hypernyctohemeral Syndrome after Chronotherapy for Delayed Sleep Phase Syndrome (1992) - Chronotherapy for DSPS may lead to Non-24-Hour Disorder Revell, VL, Burgess, HJ, et al,
Advancing Human Circadian Rhythms with Afternoon Melatonin and Morning Intermittent Bright Light (2006) Uchiyama M, Okawa M, et al,
Poor compensatory function for sleep loss as a pathogenic factor in patients with delayed sleep phase syndrome (Sleep. 2000 Jun 15;23(4):553-8) Uchiyama M, Okawa M, et al,
Poor recovery sleep after sleep deprivation in delayed sleep phase syndrome (Psychiatry and Clinical Neurosciences (1999), 53, 195-197) Crowley, SJ, Acebo, C, and Carskadon, MA,
Sleep, circadian rhythms, and delayed phase in adolescence (2007) - Much of this applies to adults too Schrader H, Bovim G, and Sand T,
The prevalence of delayed and advanced sleep phase syndromes (J Sleep Res. 1993 Mar;2(1):51-55) - 0.17% based on 10,000 people [Norway] Yazaki, M et al,
Demography of sleep disturbances associated with circadian rhythm disorders in Japan (Psychiatry and Clinical Neurosciences, 53: 267-268, Apr 1999) - 0.13% based on 1500 people [Japan] Paine SJ, Fink J, Gander PH, Warman GR,
Identifying advanced and delayed sleep phase disorders in the general population: a national survey of New Zealand adults (Chronobiol Int. 2014 Jun;31(5):627-36) - 1.51% using strict definition, but based on self-report questionnaire Campbell SS and Murphy PJ,
Delayed sleep phase disorder in temporal isolation (Sleep 2007 Sep 1, 30(9): 1225-1228) - a longer circadian period, and altered relationship with temperature, and disturbed sleep even at his preferred schedule (one DSPS subject) Micic G, de Bruyn A, Lovato N et al,
The endogenous circadian temperature period length (tau) in delayed sleep phase disorder compared to good sleepers (J Sleep Res, Dec 2013, 22: 61-624) - DSPD patients had a longer circadian period Shibui K, Uchiyama M, Kim K, et al,
Melatonin, cortisol and thyroid-stimulating hormone rhythms are delayed in patients with delayed sleep phase syndrome (2003) Baehr EK, Revelle W, Eastman CI,
Individual differences in the phase and amplitude of the human circadian temperature rhythm: with an emphasis on morningness-eveningness (J Sleep Res. 2000 Jun;9(2):117-27) - DSPS people had later and lower minimum temperature Oren DA, Turner EH, and Wehr TA,
Abnormal circadian rhythms of plasma melatonin and body temperature in the delayed sleep phase syndrome (J Neurol Neurosurg Psychiatry. Mar 1995; 58(3): 379) Strogatz SH, Kronauer RE, Czeisler CA,
Circadian pacemaker interferes with sleep onset at specific times each day: role in insomnia (Am J Physiol. 1987 Jul;253(1 Pt 2):R172-8) - sometimes referred to as the "forbidden zone" Zhdanova IV, Masuda K, Boshokin SV et al,
Familial Circadian Rhythm Disorder in the Diurnal Primate, Macaca mulatta (PLoS One. 2012; 7(3): e33327) - DSPD in monkeys, normal intrinsic period, and desynchrony of their rhythms Richardson CE, Gradisar M, and Barbero SC,
Are cognitive "insomnia" processes involved in the development and maintenance of delayed sleep wake phase disorder? (Sleep Medicine Reviews, Apr 2016) Micic G, Lovato N, Gradisar M et al,
The etiology of delayed sleep phase disorder (Sleep Med Rev. 2016 Jun;27:29-38) - an excellent discussion of various possible causes of DSPD Technical articles on genetic differences:
Ebisawa, T, Uchiyama, M et al,
Association of structural polymorphisms in the human period3 gene with delayed sleep phase syndrome (EMBO Rep. 2001 Apr;2(4):342-6) Mishima, K et al,
The 3111T/C Polymorphism of hClock Is Associated with Evening Preference and Delayed Sleep Timing in a Japanese Population Sample (2005) Lim AS, Chang AM, Shulman JM, et al,
A common polymorphism near PER1 and the timing of human behavioral rhythms (2012) Ebisawa T, Kajimura N, Uchiyama M et al,
Alleic variants of human melatonin 1a receptor: function and prevalence in subjects with circadian rhythm sleep disorders (Biochem Biophys Res Commun. 1999 Sep 7;262(3):832-7) - non-24 in particular Xu Y, Padiath QS, Shapiro RE et al,
Functional consequences of a CKIdelta mutation causing familial advanced sleep phase syndrome (2005) Kripke DF, Klimecki WT, Nievergelt CM, et al,
Circadian Polymorphisms in Night Owls, in Bipolars, and in Non-24-Hour Sleep Cycles (Psychiatry Investig. 2014 Oct;11(4):345-362) Patke A, Murphy PJ, Onat OE, et at,
Mutation of the Human Circadian Clock Gene CRY1 in Familial Delayed Sleep Phase Disorder (Cell 2017.03)
Articles Focusing on Adolescents or Children
Non-Technical Articles Rosenberg, Russell,
Is It Typical Teenage Behavior -- Or A Sleep Disorder? (2011) Snider, Terra Ziporyn,
Teens need to start school later (CNN Opinion, Aug 28, 2014) Snider, Terra Ziporyn,
The Start School Later Movement (SleepyHead Central, Nov 2014) Kelley, Paul and Lee, Clark,
Later School Start Times in Adolescence: Time for Change (Education Commission of the States, 2014) - a summary report Popova, Maria,
Sleep and the Teenage Brain (Brain Pickings, July 2013) - biological need for starting school later Preidt, Robert,
Less Sleep in Teen Years Tied to More Pounds at 21 (US News HealthDay, Aug 28, 2014) van der Vinne V, Zerbini G, Siersema A, et al,
Timing of Examinations Affects School Performance Differently in Early and Late Chronotypes (J Biol Rhythms Dec 2014)
Lighting the Way for Sleepless Teens (Pediatrician, Johns Hopkins Children's Center, Spring 2004) - the article is on page 3 see additional references on the Start School Later website Research Papers Carskadon, MA,
Sleep in Adolescents: The Perfect Storm (2011) Crowley, SJ, Acebo, C, and Carskadon, MA,
Sleep, circadian rhythms, and delayed phase in adolescence (2007) Wright KP Jr, et al,
Sleep and wakefulness out of phase with internal biological time impairs learning in humans (2006) Hazama GI, Inoue Y, Kojima K et al,
The prevalence of probable delayed-sleep-phase syndrome in students from junior high school to university in Tottori, Japan (2008) - 0.48% Saxvig IW, Pallesen S et al,
Prevalence and correlates of delayed sleep phase in high school students (Sleep Med. 2012 Feb;13(2):193-9) - 8.4% and a Book on the Subject: Emsellem, Helene A and Whitely, Carol,
Snooze... or Lose!: 10 "No-War" Ways to Improve Your Teen's Sleep Habits (2006)
Also see additional articles above under
Non-24-Hour Sleep-Wake Disorder (WebMD 2015)
Non-24-hour sleep-wake disorder - Wikipedia entry
Non 24-Hour Sleep-Wake Syndrome Support Group - on Facebook Fadden, James,
What You Need to Know About Non-24 (Sleep Review, May 11, 2015) Fadden, James and Sharkey, Katherine,
Non-24-Hour Sleep-Wake Disorder (2013) - detailed description on the NORD (National Organization for Rare Disorders) web site Fadden, James,
N24 Awareness Day 2014: Myths and Reality (Nov 24, 2014) - misperceptions arising from the Vanda ad campaign
Hypernychthemeral syndrome - on Orphanet - ORPHA73267
Medlink Neurology: Circadian rhythm sleep disorder: free-running type - An excellent summary - click on ClinicalSummaries/Alphabetical/C/Circadian....
What is Non-24 Hour Sleep Wake Disorder? (Sound Sleep Institute, May 16, 2013)
Non-24 (Vanda Pharmaceuticals, 2015) - mostly in regard to blind people
Lighting the Way for Sleepless Teens (2007) - successful Treatment of a Teen with Non-24 Lloyd, Janice,
Sleep disorder leaves author in sync only with himself (2009) - USA Today article on an author, George Dawes Green, with Non-24 - no longer accessible Roth, Thomas,
Insights into Non-24-Hour Disorder (2013) - slide presentation Smith, Wendy,
Book review: 'Glow,' by Ned Beauman (2015) - 'Glow' is a novel whose protagonist has Non-24
The Cause and Effects of Non-24-Hour Sleep-Wake Disorder (Vanda Pharmaceuticals, 2015) - geared toward Non-24 in the blind
Non 24 hour sleep wake disorder (NIH Genetic and Rare Diseases Information Center (GARD) 2014)
Non-24-Hour Sleep Wake Disorder: How to live with and manage it (National Sleep Foundation, 2014) Research Papers
Sack, RL et al,
Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep-Wake Rhythm (2007) - AASM Review article on Circadian Rhythm Sleep Disorders, diagnosis and treatment Uchiyama M and Lockley SW,
Non-24-Hour Sleep-Wake Rhythm Disorder in Sighted and Blind Patients (Sleep Med Clin. 2015 Dec;10(4):495-516) - (abstract only). An excellent review article, but we don't have a link to the full article Uchiyama M et al,
Larger phase angle between sleep propensity and melatonin rhythms in sighted humans with non-24-hour sleep-wake syndrome (Sleep. 2002 Feb 1;25(1):83-8) Hayakawa T et al,
Clinical analyses of sighted patients with non-24-hour sleep-wake syndrome: a study of 57 consecutively diagnosed cases (2005) Sack RL, Lewy AJ, et al,
Circadian rhythm abnormalities in totally blind people: incidence and clinical significance (1992) Uchiyama M, Okawa M, et al,
Delayed phase jumps of sleep onset in a patient with non-24-hour sleep-wake syndrome (Sleep. 1996 Oct;19(8):637-40) Shibui K, Uchiyama M, et al,
Periodic fatigue symptoms due to desynchronization in a patient with non-24-h sleep-wake syndrome (1998) Wever RA,
Fractional desynchronization of human circadian rhythms. A method for evaluating entrainment limits and functional interdependencies (1983) Oren DA, Giesen HA, Wehr TA,
Restoration of detectable melatonin after entrainment to a 24-hour schedule in a 'free-running' man (Psychoneuroendocrinology. 1997 Jan;22(1):39-52)
Treatment of DSPS and Non-24
Treatment of DSPS and Non-24 - our Treatments page including sleep hygeine, light therapy, melatonin, chronotherapy, light restriction, sleep deprivation/phase advance, light boxes, goggles, etc
These stories are in the words of the people submitting them. We do not verify the information they contain,
and do not judge their applicability to others. What works for some may not work for others.
A Path to Successful Light Therapy (2012) - a successful experience
Living with Delayed Sleep Phase Syndrome (DSPS) (2012) Peter,
My Story with DSPS (2012) - a lucky break
My Life with DSPS (2012) E.,
The Effects of Delayed Sleep Phase Syndrome on My Life (2012) K.,
K's Narrative (2011) Amy,
Amy's Story (2015) Armstrong, Brian,
Tired in the morning and awake at night? Here is a REAL solution (undated) - light therapy works for him
Craig, Sleep Disorders - Delayed Sleep Phase Syndrome (2010) - YouTube video Elyse,
Tenacity Got Me Accommodations for DSPS (2016) Foeth, Annechien,
My "Marriage" to Mr. DSPS (2016) Gefter, Amanda,
The Night Girl Finds a Day Boy (New York Times, Dec 23, 2016) - a lovely (and true) romance Non-24
Cat's Story with Non-24 (2014) Curtis, L,
Having trouble adjusting to the time change? Imagine doing it EVERY DAY. (2004) - a parent's description of her son's DSPS/Non-24 and its treatment Clay,
My experience trying to cure N24 (2012)
Like an Orchestra Out of Tune with No Conductor (2012) Mark,
Mark's Story With Non-24 (2012) - in the UK Hume, Jonathan,
Non-24-Hour Sleep-Wake Disorder: when night and day keep changing (2016) Hume, Jonathan,
Wordthings of Jon: Living with N24 - some select quotes (2013) Baphuacs, Oijo,
The Sandman is from Mars: Defeating the Non-24hr sleep-wake syndrome (2009) - primarily light restriction and meditation Number 6,
Stuff In My Head (ongoing) - a blog
Duncan, Brad, A video about my Non 24 (Sighted) (2015) - written for his young son
Special Topics of Interest, by Our Members
Why Treatment May Not Work For Everyone (2012) Fadden, James,
Scalloping (2012) Fadden, James,
Vitamin B-12 and Circadian Sleep Disorders (2012)
Length of Circadian Cycle in Humans (2012) - it's 24.2 hours, not 25 Mansbach, Peter,
Lux (2013) - an introduction to lux Mansbach, Peter,
Phase Response Curve (PRC) (2014) Fadden, James,
N24 Awareness Day 2014: Myths and Reality (Nov 24, 2014) - misperceptions arising from the Vanda ad campaign
Fadden, James, Chronotherapy and the risk of N24 (2015) Fadden, James,
Can Chronotherapy Cause Non-24? (Q&A) (2015) Fadden, James,
Non-24: Think Zebras (Nov 24, 2015) - N24 Awareness Day 2015 Fadden, James,
Genetics, the New Face of N24 and DSPS (Nov 24, 2016) - N24 Awareness Day 2016
Talks, Papers, and Meetings on Behalf of CSD-N
In reverse chronological order:
CRD patients represented at the NIH Sleep Disorders Research Advisory Board Apr 14, 2016 (2016) Mansbach, Peter,
Presentation to the NIH Sleep Disorders Research Advisory Board Apr 14, 2016 (2016) Fadden, James,
What You Need to Know About Non-24 (Sleep Review, May 11, 2015) CSD-N Board of Directors,
Circadian Sleep Disorders Network COMMENTS on the 2015 AASM Draft Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders (May 2015) Mansbach, Peter,
Presentation to the NIH Sleep Disorders Research Advisory Board Apr 29, 2015 (2015) Mansbach, Peter,
Circadian Rhythm Sleep Disorders - Talk at ASBA (American Sleep & Breathing Academy) Sleep and Wellness Conference, May 2014 (2014) - text
talk (audio) with slides Mansbach, Peter,
Circadian Rhythm Sleep Disorders - ASBA (American Sleep & Breathing Academy) Webinar Mar 19, 2014 (2014) - text
talk (audio) with slides Mansbach, Peter,
Testimony submitted to FDA re narcolepsy drug development (2013) Mansbach, Peter,
Talk at Narcolepsy Network National Conference Oct 19, 2013 (2013) - text
video re-enactment of the above talk Mansbach, Peter,
Presentation to the NIH Sleep Disorders Research Advisory Board Sep 23, 2013 (2013) - and notes from the meeting Fadden, James and Sharkey, Katherine,
Non-24-Hour Sleep-Wake Disorder (2013) - detailed description on the NORD (National Organization for Rare Disorders) web site Mansbach, Peter,
Presentation to NSART (National Sleep Awareness RoundTable) (2013) Mansbach, Peter,
Presentation to the NIH Sleep Disorders Research Advisory Board Feb 25, 2013 (2013) - and notes from the meeting
video re-enactment of part of the above talk Mansbach, Peter,
Narcolepsy Network Conference (2012) - items of interest to CSD people Mansbach, Peter,
Introduction to Circadian Sleep Disorders Network (2012) - presentation to the NIH Sleep Disorders Research Advisory Board May 30, 2012, on the difficulties faced by CRSD sufferers
video re-enactment of the above talk Mansbach, Peter,
Narcolepsy Network Conference (2011) - items of interest to CSD people
Several members have contributed letters which they or their doctors have written in support of accommodation for CSDs.
We include them here in case they can be of use to others.
Names have been changed or removed.
They are provided as guidance, but will generally have to be rewritten to suit your individual circumstances.
You must be a member of Circadian Sleep Disorders Network to access these.
You may join here.
For Monitoring or Charting Your Sleep at Home
In-Depth: Tracking winks — Digital health and the growing importance of sleep (MobiHealthNews Sept 5, 2014) - a review of currently available sleep monitors
Zeo - tracks your sleep stages (wake, REM, light, deep) with headband sensor NOTE: Zeo has gone out of business and is no longer supported
SleepTracker - tracks sleep stages via wrist movement
note: This watch-type unit claims to track sleep stages using only wrist movement. The accuracy claimed on the website refers only to the accuracy of movement detection, not to the accuracy of determining sleep stages. For all that, the data the manufacturer sent us supports only 87% accuracy of motion detection, not the 95% claimed on the web site. Ok as an inexpensive motion detector (sleep/wake detection), we cannot recommend for analyzing sleep stages.
Sleep Cycle - tracks wake and sleep via mattress movement (iPhone/iPad)
Sleep As Android - tracks wake and sleep via wrist movement (Android devices)
Sleepmeter Free - Android Monitoring Core Body Temperature
We have not used or evaluated these devices.
Monitoring Melatonin Level
We have not used or evaluated these sources. See your doctor to order these tests.
Measuring Reaction Time
Accommodation and Disability
The ADA: Your Employment Rights as an Individual With a Disability - this does not mention sleeping as a major life activity, which was added in 2008
JAN - Job Accommodation Network
JAN: Accommodation and Compliance Series: Employees with Sleep Disorders
JAN: Accommodation and Compliance Series: The ADA Amendments Act of 2008 - a discussion of the 2008 amendments to the ADA, including sleep
JAN: Employees' Practical Guide to Negotiating and Requesting Reasonable Accommodations Under the Americans with Disabilities Act (ADA)
U.S. Equal Employment Opportunity Commission - enforces laws on discrimination on account of disability (etc)
flexjobs - listings for flexible jobs, including part time and telecommuting
Employment Disability Resources - (Narcolepsy Resource Group
You may need to offer flex schedule as ADA accommodation (Business Management Daily, Nov 1, 2003) Rubino, Kathryn,
Biglaw Firm Gets Hit With ADA Lawsuit (AboveTheLaw.com, May 8, 2015) - law firm sued for not letting DSPD attorney work later shift (not yet resolved)
Guide for Employees with Disabilities and Their Employers (Pingboard, 2016) - has lots of other links Goren, William D,
Guide for Job Seekers & Workers with a Disability (MoneyGeek.com, 2016)
The Night Girl Finds a Day Boy (New York Times, Dec 23, 2016) - a lovely (and true) romance Jacqueline, Ilana,
How Do You Deal with Relatives Who Don't Understand Your Chronic Illness? (Dec 2013) Frieman, Richie,
3 Morning Etiquette Rules for Early Risers (Aug 27, 2014) Miserandino, Christine,
The Spoon Theory written by Christine Miserandino (2010) - the spoon analogy is sometimes used by people with invisible disabilities to help others understand their limited personal energy
Specific Sleep Disorders
Other groups concerned with circadian sleep differences
Rare Disease Organizations
You can find Non-24 here (DSPS is not rare enough)
General Sleep Information
Sleep - General
- PubMed search the medical literature (U.S. National Library of Medicine) Lockley, Steven W, and Foster, Russell G,
Sleep: A Very Short Introduction (2012 book) - an excellent summary
NIH Sleep Disorders Research Plan (NIH National Center On Sleep Disorders Research, Nov 2011) Zee PC, Badr MS, Kushida C et at,
Strategic Opportunities in Sleep and Circadian Research: Report of the Joint Task Force of the Sleep Research Society and American Academy of Sleep Medicine (Sleep. 2014 Feb 1; 37(2): 219-227) - a follow-up to the NIH plan above
NIH Sleep Infographic (NIH National Heart, Lung, and Blood Institute, May 2013) Glovinsky, Paul and Spielman, Arthur,
The Insomnia Answer (2006 book)
Sleep Disorders (on Medline (U.S. National Library of Medicine))
NIH Curriculum Supplements for High School: Sleep, Sleep Disorders, and Biological Rhythms
The Bedroom: Insomnia Resource Center (2012) - this page was useful to some, but note: the DSPS link on this page is outdated, do not depend on the info it links to Shahid A, Chung SA, Phillipson R, Shapiro CM,
An approach to long-term sedative-hypnotic use (2012) - long-term use may not be as bad as has been suggested Sheldon SH, Kryger MH, Ferber R, and Gozal D,
Principles and Practice of Pediatric Sleep Medicine, 2nd Ed (2014 book) Duerr, Anna,
Common biomarkers of sleep debt found in humans, rats, study finds (Medical Press Feb 12,2015) Sellman, Tamara Kaye,
SleepyHead Central (ongoing) - lively blog about sleep topics Zaitchik, Alexander,
Is It Bedtime for Benzodiazepines? (Van Winkle's, June 8, 2015) - dangers of benzos, including Xanax, Ambien, Lunesta Sellman, Tamara Kaye,
What is sleep architecture? (Stages and Cycles) (Sleep Resolutions, June 7, 2016) Hales, Derek,
A Kid's Guide to Understanding Sleep (2016) Yonatan, Reuben,
18 Science-Backed Sleep Tips to Make You More Productive (2017)
Internal Time: Chronotypes, Social Jet Lag, and Why You're So Tired (2012) Popova, Maria,
Internal Time: The Science of Chronotypes, Social Jet Lag, and Why You're So Tired (2012) - review of above book, good summary Refinetti R,
Circadian Physiology (CRC Press, 2005) Binkley, Susan,
Biological Clocks (1997) Dunlap, Jay C, Loros, Jennifer J, and DeCoursey, Patricia J,
Chronobiology: Biological Timekeeping (2009) Koukkari, Willard L and Sothern, Robert B,
Introducing Biological Rhythms: A Primer on the Temporal Organization of Life, with Implications for Health, Society, Reproduction, and the Natural Environment (2006) Schur, Carolyn,
Birds of a Different Feather: Early Birds and Night Owls Talk About Their Characteristic Behaviours (1994) Hoyt, Alia,
Why are some people early birds and others are night owls? (howstuffworks.com, Aug 2015) Non-Technical Articles
Circadian Rhythms Fact Sheet (NIH (NIGMS), 2012)
The Drive to Sleep and Our Internal Clock (2007) Macdonald, Cynthia,
Timing is Everything (2012) - an introduction to circadian rhythms Siegel, LJ,
The Time of Our Lives (2012) - a discussion of the body clock and its underlying genes Cromie, William J,
Human Biological Clock Set Back an Hour (1999) - circadian rhythm is 24.2 hours, not 25 hours as previously thought Zimmer, Carl,
Our Strange, Important, Subconscious Light Detectors (2012) - on the third kind of light receptor, ipRGCs
Photosensitive ganglion cell (Wikipedia article on ipRGCs)
Roenneberg, Till, Social Jetlag and Its Consequences (2012) Ghose, Tia,
Arctic Reindeer Go Off the Circadian Clock (Wired, 2/11/2010)
Key insights into how the internal body clock is tuned (Aug 21, 2014)
Foster, Russell, How the eye regulates your body clock... (2013)
Kyriacou, Charalambos, Model Organisms - Drosophila (2011) - circadian rhythms and fruit fly genes Yong, Ed,
How Jetlag Disrupts The Ticks of Your Microbial Clock (Phenomena, National Geographic Online, 2014) Block, Gene D,
Our Internal Sleep Clocks Are Out of Sync (The Wall Street Journal, Aug 14, 2014)
How Bright the Night? Light and Human Health (Illinois Coalition for Responsible Outdoor Lighting, Feb 2012) - includes a very readable description of circadian rhythms Refinetti R,
Dictionary of Circadian Physiology (CRC Press, 2005) Williams, Sarah CP,
Hacking the biological clock (Stanford 2015) - a nice introduction
Light And Our Health - Introduction to SOLG - short video introducing effects of light on sleep Barnes, Christopher M,
The Ideal Work Schedule, as Determined by Circadian Rhythms (Harvard Business School, Jan 28, 2015) - very general Duhaime-Ross, Arielle,
Being a 'morning person' has a genetic basis, 23andMe study says (The Verge, Feb 2, 2016) - also applies to being an 'evening person' Kaplan, Sarah,
What a year of working the graveyard shift taught me about sleep (Washington Post Online 4/20/2016) - circadian rhythm and shift work
Powering up the circadian rhythm (MedicalXpress, May 26, 2016) - manipulating the amplitude, rather than the phase, of the circadian rhythm Juda, Myriam,
Circadian Light Therapy Blog Lieff, John,
Synchronizing with Brain Clocks (Blog: Searching for the Mind, Jan 1, 2017) Research Papers
Duffy, JF and Wright, KP Jr,
Entrainment of the Human Circadian System by Light (2005) Duffy, JF and Czeisler, CA,
Effect of Light on Human Circadian Physiology (2009) - a fairly recent summary Czeisler CA, Duffy JF, Shanahan TL, et al,
Stability, precision, and near-24-hour period of the human circadian pacemaker (1999) Duffy JF, Cain SW, Chang AM, et al,
Sex difference in the near-24-hour intrinsic period of the human circadian timing system (2011) Bessman, Sara and Brown, Ben,
MBW:Modelling Sleep Regulation (2012) - mathematical model of sleep Burgess HJ, Legasto CS, Fogg LF, Smith MR,
Can small shifts in circadian phase affect performance? (2013) Cuesta M, Cermakian N, Boivin DB,
Glucocorticoids entrain molecular clock components in human peripheral cells (The FASEB Journal, Dec 2014 [online]) Chang A-M, Aeschbach D, Duffy JF, Czeisler CA,
Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness (PNAS, Nov 2014) Walmsley L, Hanna L, Mouland J, et al,
Colour As a Signal for Entraining the Mammalian Circadian Clock (PLOS Biology, April 17, 2015)
- list of new articles on circadian issues in the past week PubCrawler
Circadian Rhythm and Other Disorders
ADHD Baird AL et al,
Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels. (2012)
Marching to a different beat: ADHD and circadian rhythms (2012) - a discussion of the Baird paper above, has more info than the above abstract Thakkar, Vatsal G,
Diagnosing the Wrong Deficit (2013) - many people diagnosed with ADHD are really suffering from lack of good sleep Griffith-Haynie, Madelyn,
Sleep Basics affecting Sleep TIMING (2013) Dodson, William,
ADHD Sleep Problems: Causes and Tips to Rest Better Tonight! (undated) Guyardo, Gail,
Health Alert: ADHD or sleep disorder? New study suggests similar symptoms (WFLA, 2015) Alzheimer's
UCI study finds jet lag-like sleep disruptions spur Alzheimer's memory, learning loss (EurekAlert (AAAAS), Oct. 28, 2015)
Sleep Loss Precedes Alzheimer's Symptoms (National Sleep Foundation, 2016) Autism Glickman, G,
Circadian rhythms and sleep in children with autism (2010) Hare DJ, Jones S, Evershed K,
A comparative study of circadian rhythm functioning and sleep in people with Asperger syndrome (2006) Dawson, M,
The circadian prison (2012) Unstrangemind,
Too Many Hours (Unstrangemind autism blog, Mon 24, 2014) - lay description of CRDs Nuwer, Rachel,
Body clock genes may set pace for sleep issues in autism (SFARI, Jun 19, 2015) Depression, Bipolar, Addiction, OCD Carey, Benedict,
Sleep Therapy Seen as an Aid for Depression (2013) - not clear which causes which
Bipolar Disorder and Sleep Problems (WebMD, undated) Welsh DK and Moore-Ede MC,
Lithium lengthens circadian period in a diurnal primate, Saimiri sciureus (Biol Psychiatry. 1990 Jul 15;28(2):117-26) Milios, Rita,
What Role does Your Biological Clock Play in Recovery? (recovery.org, 2015) - touches on alcohol and drug addiction Lange KW, Lange KM, Hauser J, et al,
Circadian rhythms in obsessive-compulsive disorder (J Neural Transm. 2012 Oct;119(10):1077-83) Takaesu Y, Inoue Y, Murakoshi A, et al,
Prevalence of Circadian Rhythm Sleep-Wake Disorders and Associated Factors in Euthymic Patients with Bipolar Disorder (PLOS One, July 21, 2016) - 32.4% had CRSDs Friedman, Richard A,
Yes, Your Sleep Schedule Is Making You Sick (New York Times, Mar 10, 2017) - depression, triple chronotherapy Dagan Y, Stein D, Steinbock M et al,
Frequency of delayed sleep phase syndrome among hospitalized adolescent psychiatric patients (J Psychosom Res. 1998 Jul;45(1):15-20) Diabetes Colwell CS and Matveyenko AV,
Timing Is Everything: Implications for Metabolic Consequences of Sleep Restriction (Diabetes June 2014 vol. 63 no. 6 1826-1828) Gale JE, Cox HI, Qian J, et al,
Disruption of Circadian Rhythms Accelerates Development of Diabetes through Pancreatic Beta-Cell Loss and Dysfunction (J Biol Rhythms. 2011 Oct;26(5):423-33) Spiegel K, Leproult R, L'hermite-Balériaux M, et al,
Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin (J Clin Endocrinol Metab. 2004 Nov;89(11):5762-71) Robards, Ginny,
Research Reveals an Odd Connection Between Melatonin and Type 2 Diabetes (Dan's Plan blog, Jun 15, 2016) Migraine Claustrat B, Brun J, Chiquet C et al,
Melatonin secretion is supersensitive to light in migraine (2004) - low levels of light affects melatonin in migraine sufferers, even when headache-free Rovers J and Smits M,
Headache and Sleep: Also Assess Circadian Rhythm Sleep Disorders (Headache: The Journal of Head and Face Pain, Vol 54, No 1, 175-177, Jan 2014) Hamilton, Jon,
A Sleep Gene Has A Surprising Role In Migraines (Shots: Health News from NPR, May 1, 2013) Pringsheim T,
Cluster headache: evidence for a disorder of circadian rhythm and hypothalamic function (Can J Neurol Sci. 2002 Feb;29(1):33-40) Stoschitzky K, Sakotnik A, Lercher P et al,
Influence of beta-blockers on melatonin release (Eur J Clin Pharmacol. 1999 Apr;55(2):111-5) - beta-blockers decrease melatonin Fares, Auda,
Night-time exogenous melatonin administration may be a beneficial treatment for sleeping disorders in beta blocker patients (J Cardiovasc Dis Res. 2011 Jul-Sep; 2(3): 153-155) Multiple Sclerosis
Multiple Sclerosis and Sleep (National Sleep Foundation) - doesn't mention CRDs, but we believe these are likely also associated PTSD Green, Peter S,
For Our Returning Troops, Post-Traumatic Sleep Disorders Are the New PTSD (Van Winkle's, Oct 20, 2015) Weight Gain Laber-Warren, Emily,
Eating Late at Night: The New Science of Why It's Making You Fat (Reader's Digest, May 2016)
Effects of Sleep Deprivation
Banks, S and Dinges, DF,
Behavioral and Physiological Consequences of Sleep Restriction (2007)
Sleeping Too Little May Contribute To Depression (2011)
Sleep Deprivation Effects: 8 Scary Side Effects Of Too Little Shut-Eye (2013)
What Are Sleep Deprivation and Deficiency? (NIH Natl Heart Lung & Blood Inst, undated)
Short sleep reduces effectiveness of vaccines (2012) St Onge, MP, et al,
Short Sleep Duration, Glucose Dysregulation and Hormonal Regulation of Appetite in Men and Women (2012) - shortened sleep leads to overeating Breus, Michael J,
Chronic Poor Sleep May Lead to Lasting Brain Damage (Huffpost Healthy Living, June 21, 2014) Gaudreau H, Morettini J, Lavoie HB, Carrier J,
Effects of a 25-h sleep deprivation on daytime sleep in the middle-aged (Neurobiol Aging. 2001 May-Jun;22(3):461-8) - it gets worse with age Doheny, Kathleen,
Long-term Shift Work May Drain the Brain, Study Reports (HealthDay, Nov 3, 2014) Spiegel K, Tasali E, Penev P, Van Cauter E,
Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite (Ann Intern Med. 2004 Dec 7;141(11):846-50) Medications
For information about melatonin, please see
Melatonin on our Treatments page.
Lo, HS et al,
Treatment effects of gabapentin for primary insomnia (2010) Kripke, DF, Langer, RD, and Kline, LE,
Hypnotics' association with mortality or cancer: a matched cohort study (2012) - associates higher mortality rates with sleeping pills Scharf, Steven,
Sleeping Pills (hypnotics) For Use in Insomnia - What Are The Risks? (2012) - refutes the above study that associated higher mortality rates with sleeping pills Other
In The News
Temporal Isolation And Glucocorticoid Tablets Reset Biological Clocks In Study (Science 2.0, Jan 16, 2015) Strauss, Ilana E,
Not Everyone's Internal Clock Is Set for the 9-to-5 (The Atlantic, Jan 13 2015) Peters, Brandon,
How Does Hetlioz Compare to Melatonin to Treat Non-24 (About Health, Jun 6, 2014) - no data yet
Way to control internal clocks discovered (ScienceDaily, 23 Dec 2014) Klein, Sarah,
9 Things We Learned About Sleep In 2014 (Huff Post Dec 23, 2014)
Circadian Clock at the Interface of Lung Health and Disease (2014) - NIH workshop summary
Final pieces to the circadian clock puzzle found (2014) - (well, one piece of the puzzle) Konnikova, Maria,
A Gene That Makes You Need Less Sleep? (The New Yorker [online], Aug 21, 2014) Zee, PC, Badr, MS, Kushida, C, et al,
Strategic Opportunities in Sleep and Circadian Research: Report of the Joint Task Force of the Sleep Research Society and American Academy of Sleep Medicine (SLEEP, 2014 Feb 1;37(2):219-27) Akash, M, Soma, H, Yamamoto, T, et al,
Noninvasive method for assessing the human circadian clock using hair follicle cells (2010) - notes that "the 3-wk adaptation period is not enough to advance the phase of the molecular clock by 4 h"
What Is Non-24 (2013) - Vanda Pharmaceuticals video explaining Non-24, directed at blind patients Underwood, Emily,
Ancowitz, Nancy, series about DSPS, published on salary.com:
Sleep: The Ultimate Brainwasher? (2013) - the body cleans the brain of toxic metabolic byproducts during sleep
How Your Bedtime Is Affecting Your Job Performance (2012)
Change Your Career, Not Your Sleep Habits (2013)
Should Some Employees Be Allowed to Start Work Late? (2013)
Why Working 9 to 5 Might Be Bad for Your Health (2013)
Are Night Owls Lazy Employees? (2013) Gelling, Cristy,
Full moon may mean less sleep (2013) Mott, Meghan,
Brain Protein Affects Aging and Sleep (2013) - affects the expression of circadian genes Weber, Lauren,
Go Ahead, Hit the Snooze Button (2012) - Wall Street Journal on the costs of not enough sleep Chan, Amanda L,
Suvorexant: New Kind Of Sleeping Pill Works By Blocking Wakefulness. (2012)
Discovery of Chemical That Affects Biological Clock Offers New Way to Treat Diabetes (2012)
Czeisler, C et al, Fighting The Clock: How America's Sleep Deficit is Damaging Longterm Health (2012) - forum at Harvard (video)
Body Clock Receptor Linked to T2 Diabetes in New Genetic Study (2012) - links between melatonin and diabetes Tarkan, L,
Aging of Eyes Is Blamed for Range of Health Woes (2012) - including reducing circadian response Avril, Tom,
Jefferson neuroscientist helping astronauts sleep better (2012) - using different colored lights at different times of day Recently Added References
This is a
list of refences added to our Info page since the last newsletter. The newsletter lists references added since the previous newsletter. These lists are generally available to members only.
More to come - the list keeps growing!
© 2017 Circadian Sleep Disorders Network
Last modified Apr 25, 2017