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Irregular sleep-wake syndrome

Sleep-wake syndrome - irregular; Circadian rhythm sleep disorder - irregular sleep-wake type

 

Irregular sleep-wake syndrome is sleeping without any real schedule.

Causes

 

This disorder is very rare. It usually occurs in people with a brain function problem who also don't have a regular routine during the day. The amount of total sleep time is normal, but the body clock loses its normal circadian cycle.

People with changing work shifts and travelers who often change time zones may also have these symptoms. These people have a different condition, such as shift work sleep disorder or jet lag syndrome .

 

Symptoms

 

Symptoms may include any of the following:

  • Sleeping or napping more than usual during the day
  • Trouble falling asleep and staying asleep at night
  • Waking up often during the night

 

Exams and Tests

 

A person must have at least 3 abnormal sleep-wake episodes during a 24-hour period to be diagnosed with this problem. The time between episodes is usually 1 to 4 hours.

If the diagnosis is not clear, the health care provider may prescribe a device called an actigraph. The device looks like a wristwatch, and it can tell when a person is sleeping or awake.

 

Treatment

 

The goal of treatment is to help the person return to a normal sleep-wake cycle. This may involve:

  • Setting up a regular daytime schedule of activities and mealtimes.
  • Not staying in bed during the day.
  • Using bright light therapy in the morning and taking melatonin at bedtime.
  • Making sure the room is dark and quiet at night.

 

Outlook (Prognosis)

 

The outcome is often good with treatment. But some people continue to have this disorder, even with treatment.

 

When to Contact a Medical Professional

 

Most people have sleep disturbances on occasion. But if this type of irregular sleep-wake pattern occurs regularly and without cause, see your provider.

 

 

References

Abbott SM, Reid KJ, Zee PC. Circadian disorders of the sleep-wake cycle. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 40.

Chokroverty S, Avidan AY. Sleep and its disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 102.

 
  • Irregular sleep - illustration

    Symptoms of sleep-wake syndrome include irregular periods of sleep and wakefulness which disrupt the normal daily sleep-wake cycle. It may be caused by brain dysfunction or not following a normal sleep schedule, ultimately leading to a pattern of insomnia and frequent daytime napping.

    Irregular sleep

    illustration

    • Irregular sleep - illustration

      Symptoms of sleep-wake syndrome include irregular periods of sleep and wakefulness which disrupt the normal daily sleep-wake cycle. It may be caused by brain dysfunction or not following a normal sleep schedule, ultimately leading to a pattern of insomnia and frequent daytime napping.

      Irregular sleep

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

        Tests for Irregular sleep-wake syndrome

         

           

          Review Date: 6/12/2016

          Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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