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Irregular sleep–wake rhythm disorder

– Causes: – ISWRD is caused by neurological disorders such as dementia (particularly Alzheimer’s disease), brain damage, or intellectual disabilities. – Those affected may have […]

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– Causes:
– ISWRD is caused by neurological disorders such as dementia (particularly Alzheimer’s disease), brain damage, or intellectual disabilities.
– Those affected may have a weak circadian clock.
– Risk for the disorder increases with age due to increased prevalence of co-morbid medical disorders.
– Other possible causes include shift work, jet lag, or irregular sleep schedules.
– Genetic factors may also play a role in the development of ISWRD.

– Diagnosis:
– Keeping a sleep diary can aid in diagnosis and treatment by monitoring sleep schedules.
– Actigraphy and CPAP machines can help log sleeping times for diagnosis.
– Warning signs include irregular sleep patterns, difficulty getting restorative sleep, and excessive daytime sleepiness.
– ISWRD may initially be mistaken for other circadian rhythm sleep disorders or insomnia.
– A thorough medical and neurological exam may be necessary for accurate diagnosis.

– Initial visit with sleep physician:
– Physicians specializing in sleep medicine may inquire about medical history, medications, alcohol use, family history, and other sleep problems.
– Patients may be asked to maintain a sleep diary over several weeks.
– The Epworth Sleepiness Scale may be used to assess sleep ratings.
– A medical and neurological exam is typically conducted during the initial visit.
– Sleep physicians may consider various factors to determine the presence of ISWRD.

– Medical testing:
– Blood tests, CT scans, or MRIs may be used to detect neurological conditions or other medical problems.
– Polysomnography, an overnight sleep study, can help identify other sleep disorders like sleep apnea or periodic limb movement disorder.
– Polysomnography records brain waves, heart rate, muscle activity, breathing, and limb movement during sleep.
– Identifying underlying medical conditions is crucial for accurate diagnosis and treatment.
– Other diagnostic tests may be recommended based on individual symptoms and medical history.

– Management:
– Treatment aims to regulate the body clock to achieve a normal long sleep period at night.
– Education on sleep hygiene and counseling are essential components of management.
– Melatonin, vitamin B, sleep aids, wake aids, and other medications may be prescribed.
– Exposure to light during the day and maintaining regular daily activities can help restore a normal sleep-wake rhythm.
– Management strategies may vary depending on the patient’s age, medical history, and underlying conditions.

Irregular sleep–wake rhythm disorder (Wikipedia)

Irregular sleep–wake rhythm disorder (ISWRD) is a rare form of circadian rhythm sleep disorder. It is characterized by numerous naps throughout the 24-hour period, no main nighttime sleep episode, and irregularity from day to day. Affected individuals have no pattern of when they are awake or asleep, may have poor quality sleep, and often may be very sleepy while they are awake. The total time asleep per 24 hours is normal for the person's age. The disorder is serious—an invisible disability. It can create social, familial, and work problems, making it hard for a person to maintain relationships and responsibilities, and may make a person home-bound and isolated.

Irregular sleep–wake rhythm disorder
Other namesCircadian rhythm sleep disorder - irregular sleep-wake type
SpecialtyNeurology Edit this on Wikidata
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