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Circadian rhythm disorders
Circadian rhythm disorders
Published: 2015/06/07
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The Cause and Effects of Non-24-Hour Sleep-Wake Disorder
The Cause and Effects of Non-24-Hour Sleep-Wake Disorder
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Channel: Non-24-Hour Sleep-Wake Disorder
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Circadian Rhythm Sleep Disorder
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Ubik - Irregular Sleep Wake (Tryptophan)
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Insomnia/irregular sleeping patterns
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Irregular Sleeping Patterns Linked to Cancer
Irregular Sleeping Patterns Linked to Cancer
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To Sleep, Perchance to Dream - Crash Course Psychology #9
To Sleep, Perchance to Dream - Crash Course Psychology #9
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Channel: CrashCourse
Your Gut Processes Emotion and Regulates Health While You Sleep | Dr. Emeran Mayer
Your Gut Processes Emotion and Regulates Health While You Sleep | Dr. Emeran Mayer
Published: 2016/10/31
Channel: Big Think
Sleep-Wake Disorders - CRASH! Medical Review Series
Sleep-Wake Disorders - CRASH! Medical Review Series
Published: 2015/11/28
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Abnormal sleep patterns
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Irregular Sleep Cycle [VLOG #115]
Irregular Sleep Cycle [VLOG #115]
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Channel: Just 2 Guys Creative
Sleep Disorders Related to Biological Clock by Dr. Hassan S.Alhariri
Sleep Disorders Related to Biological Clock by Dr. Hassan S.Alhariri
Published: 2016/11/18
Channel: Dr. Rami Hamed
Sleep-Wake Disorders
Sleep-Wake Disorders
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Channel: Jay Memmott
Dyssonmia Sleep Wake Disorders
Dyssonmia Sleep Wake Disorders
Published: 2016/04/10
Channel: DSM VI-DEO
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IRREGULAR SLEEP PATTERNS LINKED TO CANCER; GOT TO BLAME SOARING INCREASE ON SOMETHING, CAUSE
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What Is Delayed Sleep Phase Disorder?
What Is Delayed Sleep Phase Disorder?
Published: 2017/08/31
Channel: Duck the Question
Circadian Rhythm Sleep Disorders and Narcolepsy
Circadian Rhythm Sleep Disorders and Narcolepsy
Published: 2013/11/08
Channel: Circadian Disorders
SteveMillers Abnormal Psychology Sleep Wake Disorders F16
SteveMillers Abnormal Psychology Sleep Wake Disorders F16
Published: 2016/11/12
Channel: Steve Miller
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Circadian Rhythms and Mental Disorders: Jin Yi at TEDxFountainValleyHighSchool
Circadian Rhythms and Mental Disorders: Jin Yi at TEDxFountainValleyHighSchool
Published: 2014/01/03
Channel: TEDxYouth
RE: Delayed Sleep Phase Syndrome
RE: Delayed Sleep Phase Syndrome
Published: 2012/12/05
Channel: nervousneuron
Darj - Irregular Sleeping Pattern
Darj - Irregular Sleeping Pattern
Published: 2015/12/22
Channel: NocturnalNemesis
HLSC4808: Sleep Wake Disorder- Sleep Paralysis
HLSC4808: Sleep Wake Disorder- Sleep Paralysis
Published: 2017/03/14
Channel: Howrh Alsinan
The Teensleep Study  - Why It Matters
The Teensleep Study - Why It Matters
Published: 2015/11/11
Channel: Teen Sleep
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Published: 2015/07/20
Channel: khanacademymedicine
What Causes Drowsiness During The Day?
What Causes Drowsiness During The Day?
Published: 2017/08/31
Channel: Duck the Question
Hypnosis for Insomnia
Hypnosis for Insomnia
Published: 2017/09/12
Channel: Dr. Natalie Ma
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Published: 2015/01/28
Channel: NoteToJon
Lucid Dreaming Sleep Track (8 Hour Sleep Cycle Track) with Binaural beats and Isochronic Tones
Lucid Dreaming Sleep Track (8 Hour Sleep Cycle Track) with Binaural beats and Isochronic Tones
Published: 2014/09/23
Channel: Brainwave Power Music
Irregular Sleep Habits Are Associated with Obesity in Adolescents
Irregular Sleep Habits Are Associated with Obesity in Adolescents
Published: 2015/03/05
Channel: AHAScienceNews
Treatment for sleeping disorders in children with Autism
Treatment for sleeping disorders in children with Autism
Published: 2015/01/02
Channel: Tui Na Centre, London
Circadian rhythm, endocrine system
Circadian rhythm, endocrine system
Published: 2014/05/03
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Published: 2015/11/13
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Published: 2015/12/28
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Published: 2016/03/22
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Published: 2016/09/29
Channel: Causes Of Sleeping Disorders
What Is Delayed Sleep Phase Disorder?
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Published: 2017/09/04
Channel: Last Question
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Published: 2013/12/23
Channel: retimertechnologies
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Published: 2017/07/26
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Sleep Disorders
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Published: 2016/02/03
Channel: University of California Television (UCTV)
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Published: 2016/03/10
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Published: 2013/06/26
Channel: Alaska NorthernLights
Sleep Wake Disorders Narcolepsy Part 2
Sleep Wake Disorders Narcolepsy Part 2
Published: 2016/03/10
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Polyphasic Sleep Patterns, Optimal for building muscle?
Published: 2014/01/03
Channel: Strength Over Benches (SOB)
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Can Camping Cure Insomnia?
Published: 2013/08/02
Channel: Seeker
It’s That Time of The Day Again: Biological Clocks, Behavior, and Psychiatric Disorders
It’s That Time of The Day Again: Biological Clocks, Behavior, and Psychiatric Disorders
Published: 2016/10/18
Channel: International Bipolar Foundation
Sleep Disorders, Sleep Abnormal Behaviour, Cataplexy and narcolepsy
Sleep Disorders, Sleep Abnormal Behaviour, Cataplexy and narcolepsy
Published: 2012/12/26
Channel: Seddik Sam
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How to tell if the palpitations you are getting are serious or not
Published: 2014/04/21
Channel: York Cardiology
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WIKIPEDIA ARTICLE

From Wikipedia, the free encyclopedia
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Irregular Sleep Wake Rhythm Type
Classification and external resources
Specialty neurology
ICD-10 G47.23
ICD-9-CM 327.33
MedlinePlus 000806
eMedicine neuro/655
MeSH D021081

Irregular sleep–wake rhythm 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.[1] Sufferers 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.[2][3][4] 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.

Nomenclature[edit]

The current formally correct name of the disorder is Circadian Rhythm Sleep Disorder: Irregular Sleep Wake Rhythm Type.[5] This disorder has been referred to by many other terms, including: Irregular Sleep Wake Pattern,[6] irregular sleep wake syndrome,[7] Irregular Sleep Wake Rhythm (ISWRD),[8] Irregular Sleep Wake Cycle,[9] Irregular Sleep Wake Schedule[10] and Irregular Sleep Wake Disorder (ISWD).[4] Sometimes the words sleep and wake are hyphenated (sleep–wake). Sometimes the words are capitalized and sometimes they are not.

Causes[edit]

ISWD has various causes, including neurological disorders such as dementia (particularly Alzheimer's Disease), brain damage, or mental retardation.[7] It is thought that sufferers have a weak circadian clock.[3][4] The risk for the disorder increases with age, but only due to increased prevalence of co-morbid medical disorders.[7]

Diagnosis[edit]

A sleep diary with nighttime in the middle and the weekend in the middle, to better notice trends

A sleep diary should be kept to aid in diagnosis and for chronicling the sleep schedule during treatment. Other ways to monitor the sleep schedule are actigraphy[3][4] or use of a Continuous Positive Airway Pressure (CPAP) machine that can log sleeping times

The following are possible warning signs:

  • sleeping off and on in a series of naps during the day and at night, with no regular pattern but with normal total sleep time,
  • difficulty getting restorative sleep, and
  • excessive daytime sleepiness.[3][4]

Because of the changes in sleep/wake time, and because this is a rare disorder, initially it can seem like another circadian rhythm sleep disorder such as non-24-hour sleep–wake disorder or like insomnia.

Initial visit with sleep physician[edit]

A physician specializing in sleep medicine may ask patients about their medical history; for example: neurological problems, prescription or non-prescription medications taken, alcohol use, family history, and any other sleep problems. A thorough medical and neurological exam is indicated. The patient will be asked to complete a sleep diary, recording natural sleep and wake up times, over several weeks. Sleep rating with the Epworth Sleepiness Scale may be used.[3][4]

Medical testing[edit]

A neurological condition or another medical problem may be suspected, in which case, blood tests, a CT scan or an MRI may be used. An overnight sleep study is usually not needed to detect this disorder, but may be indicated if other sleep disorders, such as sleep apnea and periodic limb movement disorder, seem likely. The overnight sleep study is called polysomnography. It charts brain waves, heart beat, muscle activity, and breathing during sleep. It also records arm and leg movement. It will show if there are other sleep disorders that are causing or increasing the problems with ISWD.

Management[edit]

Treatment for irregular sleep–wake rhythm tries to enable the body clock in the brain, such that a normal long sleep period at night can be achieved. Education about sleep hygiene is important, and counseling can be helpful. Melatonin, vitamin B12, sleep aids, wake aids, and other medications may also be used.[3][4] Light during the daytime, and activities occurring at regular times each day, may help to restore a normal rhythm.[3][4]

Because there are different systems in the body that help establish regulation, it's helpful to employ a multi-modal approach. A 2008 review states that "...each clock is differentially sensitive to zeitgebers. The suprachiasmatic nucleus (SCN) is very responsive to light, the clock in the liver is very sensitive to food, and clocks in muscle are sensitive to exercise."[11]

Circadian rhythm labeled

The following approaches are recommended by one source:[12]

  1. Spend <7–8 hours in bed.
  2. Add environmental cues such as light and social interactions, regular meal times, and regular sleep–wake times.
  3. Morning and eve light at 3000 lux for 2 hours have been shown to improve nocturnal sleep in institutionalized patients and reduce agitation in demented patients.
  4. Melatonin at desired sleep time.

Research[edit]

There is currently a great deal of active research on various aspects of circadian rhythm; this often occurs at major universities in conjunction with sleep research clinics at major hospitals. An example is the program with Harvard Medical School and Brigham and Women's Hospital.[13] This research includes programs that are staffed by researchers from various departments at the university, including psychiatry, neurology, chemistry, biology. Other major sleep research centers are in Tel Aviv in Israel, Munich in Germany and in Japan.[citation needed]

A wide variety of sleep disorders are actively being researched. Measuring body temperature or melatonin levels may be used. Some hospitals do blood tests for melatonin levels. Saliva tests for melatonin are now available for online purchase; its metabolites can also be tested in urine.[3][4]

See also[edit]

References[edit]

  1. ^ http://www.medlink.com (requires free trial or subscription) search on term: Irregular sleep–wake pattern
  2. ^ Usage of term "Irregular Sleep–Wake Cycle": http://www.emedicinehealth.com/sleeplessness_and_circadian_rhythm_disorder/article_em.htm
  3. ^ a b c d e f g h http://www.sleepeducation.com/Disorder.aspx?id=60 [Handbook of Sleep Disorders By Clete A. Kushida accessed online Aug. 11, 2010] /
  4. ^ a b c d e f g h i Sack RL, Auckley D, Auger RR, et al. (2007). "Circadian rhythm sleep disorders: part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep–wake rhythm. An American Academy of Sleep Medicine review" (PDF: full text). Sleep. 30 (11): 1484–501. PMC 2082099Freely accessible. PMID 18041481. 
  5. ^ Zee, Phyllis C.; Michael V. Vitiello (June 2009). "Circadian Rhythm Sleep Disorder: Irregular Sleep Wake Rhythm Type". Sleep Med Clin. NIH Public Access. 4 (2): 213–218. PMC 2768129Freely accessible. PMID 20160950. doi:10.1016/j.jsmc.2009.01.009. 
  6. ^ Dement, William C. (January 22, 1999). "Circadian Rhythm Information". Retrieved 2010-10-07. 
  7. ^ a b c "Irregular sleep wake syndrome". National Center for Biotechnology Information, U.S. National Library of Medicine. Reviewed 5/9/2010. Retrieved 2010-10-07.  Check date values in: |date= (help)
  8. ^ Zee, Phyllis C; Vitiello, Michael V (2010). "Circadian Rhythm Sleep Disorder: Irregular Sleep Wake Rhythm Type". Sleep Med Clin. 4 (2): 213–218. PMC 2768129Freely accessible. PMID 20160950. doi:10.1016/j.jsmc.2009.01.009. Irregular Sleep Wake Rhythm Disorder (ISWRD) is characterized by the relative absence of a circadian pattern ... 
  9. ^ "Sleeplessness and Circadian Rhythm Disorder". WebMDnewsletter. Retrieved 2010-10-07. 
  10. ^ Fieve, Ronald R. Bipolar Disorder and Sleep http://www.athealth.com/consumer/disorders/bipolarandsleep.html
  11. ^ Harvey, Allison G. (July 2008). "Sleep and Circadian Rhythms in Bipolar Disorder: Seeking Synchrony, Harmony, and Regulation". The American Journal of Psychiatry. 165 (7): 824. PMID 18519522. doi:10.1176/appi.ajp.2008.08010098. For the latter, each clock is differentially sensitive to zeitgebers. The SCN is very responsive to light, the clock in the liver is very sensitive to food, and clocks in muscle are sensitive to exercise. 
  12. ^ From "Ultiimate review for the neurology boards..." by Hubert Fernandez (p243)
  13. ^ http://sleep.med.harvard.edu/people/faculty

External links[edit]

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