Irregular sleep–wake rhythm disorder

Irregular sleep–wake rhythm disorder (ISWRD) is a type of circadian rhythm sleep disorder characterized by a lack of a clear sleep-wake cycle. Individuals with ISWRD experience fragmented periods of sleep and wakefulness throughout the 24-hour day, rather than having a consolidated sleep period at night and being awake during the day.

Symptoms

The primary symptom of ISWRD is a disrupted sleep-wake pattern. Individuals may have multiple sleep periods throughout the day and night, or they may have a single sleep period that is significantly shifted from the typical night-time sleep period. Other symptoms can include excessive daytime sleepiness, insomnia at night, and a reduced ability to perform tasks during the day.

Causes

ISWRD is often associated with neurological disorders such as Alzheimer's disease and Parkinson's disease, as well as other conditions that affect the brain's ability to regulate the sleep-wake cycle. It can also be caused by environmental factors, such as shift work or jet lag, or by lifestyle factors, such as irregular sleep habits or excessive use of electronic devices before bed.

Diagnosis

Diagnosis of ISWRD typically involves a detailed sleep history, which may include a sleep diary or actigraphy. Actigraphy is a non-invasive method of monitoring human rest/activity cycles. A small actigraph unit, also called an actimetry sensor, is worn by a patient to measure gross motor activity. In some cases, a polysomnography may be performed to rule out other sleep disorders.

Treatment

Treatment for ISWRD typically involves improving sleep hygiene and modifying environmental factors that may be contributing to the disorder. This can include establishing a regular sleep schedule, avoiding caffeine and alcohol, and creating a sleep-friendly environment. In some cases, light therapy or melatonin may be used to help reset the body's internal clock.

See also

• Circadian rhythm sleep disorder
• Delayed sleep phase disorder
• Advanced sleep phase disorder
• Non-24-hour sleep–wake disorder

References

Irregular sleep–wake rhythm disorder Resources
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