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Irregular sleep-wake syndrome

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

Alternative Names

Sleep-wake syndrome - irregular

Causes

This disorder is very rare. It usually occurs in a person who has a problem with brain function and who does not 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

  • 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 three 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 doctor 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 usually good with treatment. But some people will 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 health care provider.

References

Kanuther N, Harrington J, Lee-Chiong T. Circadian rhythm sleep disorders. Clin Chest Med. 2010;31:319-325.

Zee PC, Vitello MV. Circadian rhythm sleep disorder: irregular sleep wake rhythm. Sleep Med Clin 4;2009:213-218.

Updated: 5/13/2014

Allen J. Blaivas, DO, Clinical Assistant Professor of Medicine UMDNJ-NJMS, Attending Physician in the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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