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Has sleep disorder that prevents from holding job. Sleep clock changing. Prescribed melatonin. Suggestions?

Nov 2013
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Practicing since : 1994
Answered : 5556 Questions
My son has a sleep disorder that prevents him for holding a job due to the sleep cycle he is in. It is non 24 - or circadian rhythm. He has been suffering from this for most of his life. He is trying to keep a job but it seems impossible at this point. Shift work still requires him to be on the job at the same shift on a regular basis. His sleep clock is changing all the time. If he could find a job that would allow him to check in when he was awake and work for a full 8 hours or longer until his sleep cycle changed that would be great. His sleep cycle will last about a week and then it changes, but in essence it changes about gradually every day about 15 minutes.
He has been to a sleep doctor and she prescribed melatonin - to help him stay awake but it did not work and only gave him headaches.
He is looking for a neurologist because that is what disability for social security require. He needs to be able to get some assistance from Social Security so he can have enough income to at least pay his doctor bills and medicine.
Do you have any suggestions
He is 35 and lives now with his dad, but he is trying to get work and get back on his own like he did when he had the job for 2 years. By the time he left his job he was totally exhausted and sick trying to stay on a schedule that would allow him to work normal hours.
Thank you
Posted Wed, 9 Oct 2013 in Sleep Disorders
Answered by Dr. Sudhir Kumar 18 hours later
Brief Answer:
Modafinil could help your son

Detailed Answer:

Thank you for posting your query.

I read the detailed description about your son's illness. It is unfortunate that his abnormal sleep rhythm is causing a lot of difficulties in getting him a permanent job, and also not allowing him to earn a steady income for running his family as well as pay his medical bills.

I assume that his MRI brain is done and it was normal, including the hypothalamus (the part of brain, which regulates sleep and wakefulness cycle). Also, the hormonal profile has been checked and they are normal.

In that case, your son could be labeled as a primary circadian rhythm abnormality.

In this situation, he could use modafinil tablets in the morning to keep awake. At night, he could use a combination of zolpidem and melatonin to fall asleep.

I am sure he would improve with that.

I hope it helps.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
Follow-up: Has sleep disorder that prevents from holding job. Sleep clock changing. Prescribed melatonin. Suggestions? 35 minutes later
Thank You. I will talk with my son about this and see how we can proceed. You have given suggestions that I was not aware of.
Thank you again.
Answered by Dr. Sudhir Kumar 7 hours later
Brief Answer:
Thank you

Detailed Answer:
Thank you and best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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