case_images: PMC5167487_01
case_images: Double-plotted sleep-awake cycle of a patient.. Note: The times of sleep are shown as black bars and are double-plotted for clarity.
case_images: ndt-12-3199Fig1.jpg
case_images: PMC5167487_01_ndt-12-3199Fig1.jpg
case_images: f1-ndt-12-3199
case_images: The patient had kept a sleep diary over the past 5.5 years, starting from 2008 (Figure 1).
case_images: Circadian rhythms (tau-value: red), depressive symptoms (MADRS: green), and drug history (lines).. Notes: Tau-values were determined from actogram and periodogram data every 4 weeks. Remission of depressive symptoms is defined as a score <=8 on the Montgomery-Asberg Depression Rating Scale (MADRS).
case_images: ndt-12-3199Fig2.jpg
case_images: PMC5167487_01_ndt-12-3199Fig2.jpg
case_images: f2-ndt-12-3199
case_images: Her mean MADRS score over the same period was 17.0+-12.3 points (n=47, Figure 2), and was unstable during episodes of non-24-hour sleep-wake syndrome. Non-pharmacologic measures, including several treatments of phototherapy (20,000 lux) and efforts to improve sleep hygiene by avoiding daytime sleeping, also failed (Figure 2).
case_images: Valproic acid concentration (blue bars) and circadian rhythms throughout (red points) the course of treatment.. Abbreviation: VPA, valproic acid.
case_images: ndt-12-3199Fig3.jpg
case_images: PMC5167487_01_ndt-12-3199Fig3.jpg
case_images: f3-ndt-12-3199
case_images: The patient's sleep diary during this period showed that the 24-hour sleep-wake cycle synchronized to 24.03+-0.05 hours (n=19 periods, Figure 3) at a valproic acid concentration of 5.0+-2.7 microg/mL.