Irregular Sleep Wake Rhythm Disorder

This is a circadian disorder that does not fit neatly into other categories such as delayed sleep disorder.  People with ISWRD get the right amount of sleep, but it is not uniphasic (all in one lump at night).  Instead it is spread out over three or more periods though the 24-hour day.  Each period is longer than a nap, lasting one to four hours.

IWSRD is more common in older adults, although it is not a normal consequence of aging.  People with traumatic brain injuries and mental retardation are more apt to suffer it.  Degeneration of cells in the SCN (spell out) related to the development of Altzheimer’s Disease could also be related to IWSRD, but scientists just conjecture this; they have no real proof.

WSRD is worth treating only if it interferes with your life.  For instance, if you have to work days and cannot afford to take naps during the day, you may wish to make sure you get all your sleep at night.  The tried-and-true light exposure approach works for many. Make sure to be exposed to bright light (outdoors) during the day, especially the morning.  In the evening, keep away from bright lights. This can help set your circadian rhythm.  Phototherapy with artificial light is also an option. Melatonin might sound like a good treatment for IWSRD, if melatonin worked as its advocates claim.  Scientific evidence for its efficacy for this kind of disorder is scant, though.

Sedatives and insomnia medicines will put patients to sleep, but they are not good treatment choices for long-term addressing ISWRD.  The person with this disorder gets enough sleep – just at the “wrong” time.  Making him or her sleep more at the right time can help push the circadian cycle around the clock, but it isn’t as desirable a solution as light therapy and paying attention to good sleep hygiene

How do you know if treatment is successful?  If you return to a “normal” pattern - one long sleep period at night and no serious sleeping during the day – you are “cured”.  You fit in the social norms.

Sleep Disorders

Dyssomnias

Parsomnias

Insomnia Medications