Personality differences in patients with delayed sleep-wake phase disorder and non-24-h sleep-wake rhythm disorder relative to healthy sleepers

•Patients with delayed sleep-wake phase disorder (DSWPD) and non-24-h sleep-wake rhythm disorder have significantly higher neuroticism scores and significantly lower extraversion, agreeableness and conscientiousness scores relative to their healthy counterparts.•The observed personality traits in DSWPD patients relate to their circadian timing, sleep patterns and lifestyle variables such that those with greater DSWPD severity had more extreme personality traits.•The conscientiousness facet appears particularly related to patients' circadian timing, sleep patterns and lifestyle variables, and thus it should be considered during therapy.•Personality traits may contribute to the treatment outcome for DSWPD patients as well as the more extreme and rare non-24-h sleep-wake rhythm disorder patients.

Objective/BackgroundDelayed sleep-wake phase disorder (DSWPD) is associated with a delayed timing of circadian rhythms, and this delay is suggested to be the basis of the disorder. However, this has been questioned due to frequent relapses following treatment based on this aetiology. Recent studies have emerged suggesting personality factors may contribute to sleep patterns in DSWPD. The aim of this study was to further investigate circadian and personality factors in DSWPD patients as well as patients with non-24-h sleep-wake rhythm disorder (N24SWD) relative to control sleepers.Patients/MethodsThis sample consisted of 16 DSWPD (age = 21.1 ± 2.8, 10 m, 7 f), and three N24SWD patients (age = 24.0 ± 4.4, 2 m, 1 f). Controls were seven males and seven females (age = 23.4 ± 5.9). Before starting an 80-h modified constant routine, eligible participants' sleep patterns were monitored for a week and they completed a personality questionnaire (NEO PI-R). An ultradian routine with alternating 20-min sleep opportunities and 40 min of enforced wakefulness was used to measure the timing of endogenous circadian temperature and melatonin rhythms.ResultsAs compared with controls, DSWPD patients reported higher neuroticism, significantly lower extraversion, conscientiousness and agreeableness. Similarly, N24SWD patients' patterns of personality traits were similar to that of DSWPD. Conscientiousness, in particular, was associated with phase timings of circadian rhythms as well as sleep measures and lifestyle factors within the DSWPD group.ConclusionsThese findings suggest that circadian rhythm sleep-wake disorders (CRSWDs) may not only stem from circadian abnormalities but personality factors may also drive lifestyle choices, including sleep timing.