Registry and survey of circadian rhythm sleep-wake disorder patients.

Objective: Circadian Sleep Disorders Network has created a registry of circadian rhythm sleep-wake disorder (CRSWD) patients, and a survey of their experiences. The purpose of the registry is to provide volunteers willing to participate in research; the purpose of the survey is to fill some of the knowledge gaps on these disorders, including information on subjective patient experience and the efficacy and durability of treatments.Researchers are invited to contact Circadian Sleep Disorders Network for permission to use the registry to find potential research participants, and to further analyze the survey data. Patients: Over 1627 patients have participated; 1298 have completed the entire survey. Here we present results based on the 479 clinically diagnosed CRSWD patients. Methods: The survey covers a variety of topics relating to CRSWDs, including diagnosis, comorbidities, treatments, and work/educational accommodations. Conclusions: Results of this survey diverged from much of the literature. More than half the participants reported tiredness even when sleeping on their preferred schedule. While depression may cause sleep problems, our data suggests that sleep/circadian problems often precede depression.There were more people suffering from sighted non-24-hour sleep-wake rhythm disorder than some of the literature would lead us to expect.Current treatments did not appear to be helpful to a large percentage of our participants. Most of them did not find light therapy helpful and nearly all participants who tried phase-delay chronotherapy reported at best only short-term improvement. A sizable proportion of people who tried phase-delay chronotherapy subsequently developed non-24-hour sleep-wake rhythm disorder.

The experience of orthorexia from the perspective of recovered orthorexics.

PURPOSE: Orthorexia is a proposed disorder that involves a pathological obsession with healthy eating. The condition has received much attention in popular media in recent years, but more empirical research is needed. Currently, orthorexia is an emerging construct with multiple proposed versions of diagnostic criteria, and there is confusion regarding the exact symptoms and pathology. This qualitative study aimed to explore the experiences of orthorexia from the perspective of recovered persons, as defined by Dunn and Bratman's 2016 criteria (Eat Behav 21:11-17, 2016). METHODS: Eight participants from around the world were interviewed via Skype. These interviews were analysed using a descriptive and interpretive thematic analysis (Elliott and Timulak. A handbook of research methods for clinical and health psychology. Oxford University Press, London, pp 147-159, 2005). Informed consent was obtained from all participants. RESULTS: Data analysis revealed four domains: (1) strong external influences; (2) psychological effects; (3) interpersonal functioning effects; and (4) classic eating disorder (ED) behaviours and processes. Some symptoms mirrored those seen in EDs and in obsessive compulsive disorder. CONCLUSIONS: Orthorexia negatively impacted participants' physical, psychological, and social health. Additional research exploring valid and reliable screening instruments, body image, and psychological functioning would help to further understand this proposed disorder. LEVEL OF EVIDENCE: Level V, qualitative interview study.