Irregular Sleep-Wake Rhythm

Sleep is very much needed for physical, emotional, and mental health. Irregular sleep−wake rhythm is found mainly among children with neurodevelopmental disorders, older adults, and patients who neurogenerative disorders like Alzheimer's dementia. It can also be found in patients with traumatic brain injury. This disorder can lead to several factors like cholesterol, sugar, and obesity.

What is an Irregular Sleep-Wake Rhythm?

Irregular sleep-wake rhythm is a type of circadian rhythm disorder. The circadian rhythm is an internal biological clock that controls various changes in the body like sleep and wakefulness over the 24 hours’ day. Individuals with the rare sleep-wake disorder do not have a particular time of sleeping and waking up and face random sleeping and wake-up periods during the 24 hours of the day.

Symptoms of Irregular Sleep-Wake Rhythm

There are some symptoms of Irregular sleep−wake rhythm. Those are −

  • Problems with sleeping at night

  • Nighttime waking

  • Drowsiness during the daytime

  • Siesta during the daytime

  • Non−rejuvenating sleep

  • Having total sleep time which is not appropriate for their age

  • No particular timing between sleeping and waking up

Causes and Effects of Irregular Sleep-Wake Rhythm

Irregular sleep−wake rhythm is caused due to various reasons. The reasons are −

  • Irregular sleep−wake rhythm disorder is also connected with age−related diseases. This disorder is very rare and is sometimes caused by several medicinal and neurological conditions which increase the risk of developing the rare sleep−wake disorder. Some factors are related to risks such as Alzheimer's, dementia, autism, decreased social and physical ability to function, and many more.

  • Abnormalities in the brain or body that affect circadian rhythm. It is common among individuals facing neurodegenerative conditions, brain dysfunction, and developmental disorders.

  • An Individual's environment and lifestyle can also cause irregular sleep−wake rhythm disorder.

  • Traumatic brain injury can also lead to this type of disorder.

Individuals can be affected in several ways due to irregular sleep-wake disorder. The effects are −

  • Lack of sleep due to this order leads to sleep deprivation.

  • Health−related problems like a higher level of obesity, high cholesterol, and high blood sugar.

  • Drowsiness during daytime and decreased ability of activity and functioning.

  • Cause problems in family life and work life.

  • Make life hard to maintain relationships and responsibilities.

  • Individuals become home seekers and isolated.

Diagnosis of Irregular Sleep-Wake Rhythm

Doctors should ask individuals about their medical, neurological, and sleeping symptoms. Doctors ask about medications, use of alcohol, and family history if anyone faced this disorder. Health caregivers use sleep logs and actigraphy monitoring systems to diagnose irregular sleep-wake rhythm disorder. Sleep logs, also known as sleep diaries, are detailed records of self-reports of a person's sleeping and waking up schedule. The actigraphy monitoring system is an information collector of sleep-wake movement through an actigraphy; it is a movement-detecting watch−shaped device worn on the wrist.

Sleep data is analyzed from the sleep logs or actigraphy by a professional health care provider to recognize whether there are any abnormalities by checking three or more sleep-wake periods within 24 hours. Both sleep logs and actigraphy follow up on the 24 hours sleep types for seven to 14 days to understand whether an individual's circadian clock has a regular or irregular rhythm. A health care professional may suggest a complete blood test and computed tomography (CT scan) if the irregular sleep-wake rhythm is detected to know the risks and diagnose neurogenerative conditions. To know about the circadian rhythm, 24-hour monitoring of changes related to body temperature, cortisol levels, and melatonin is done.

Treatment of Irregular Sleep-Wake Rhythm

Treatment of irregular sleep-wake rhythm disorder is very much needed as it leads to several other causes. There are various options for the treatment of irregular sleep-wake rhythm disorder, and the treatments for curing this type of disorder are −

  • Bright light therapy − In bright light therapy, a patient is unmasked to a light that imitates the power of sunlight. This therapy must be taken by the patients facing this disorder during the morning, which helps them reduce their daytime drowsiness, controls melatonin production in the body, and helps them sleep earlier.

  • Sleep hygiene − To maintain the rhythm of circadian disorder, an individual must improve his/her lifestyle, habits, sleeping routines, and diet.

  • Medication − Medication like melatonin supplements or other supplements can help improve night−time insomnia and drowsiness during the day. Nevertheless, one must contact a doctor before taking these supplements as they also have side effects.

Maintaining sleep hygiene can improve irregular sleep-wake rhythm disorder. Sleep hygiene includes −

  • Maintaining a persistent sleeping routine − A sleeping routine must be maintained by keeping the same sleeping time and waking up on the weekdays and weekends.

  • Restriction on time spent in bed − It is better to elude lying in bed if an individual is not sleepy. Furthermore, the individual must get out of bed and do something comforting enough before trying to sleep again.

  • Managing light unmasking − One must increase daylight exposure to remove drowsiness in the daytime.

  • Decrease in alcohol use − Alcohol consumption leads to sleep deprivation, causing nighttime awakenings and daytime drowsiness.

  • Avoiding siesta during daytime − Taking multiple siestas throughout the day, specifically late in the afternoon, can hamper nighttime sleep.

  • Creating a proper environment for sleeping − A dark, calm, cool bedroom environment can help sleep.


From the above discussion, it can be concluded that irregular sleep−wake disorder is mainly faced by older adults and people with some neurological problems and is sometimes caused as a side effect of any medication. It has several symptoms and effects, like sleep deprivation, health-related issues, insomnia, and daytime drowsiness. Irregular sleep-wake rhythm disorder sometimes needs treatment like bright light therapy, some medicinal supplement, a proper lifestyle, and a proper routine for sleeping and waking up.

Updated on: 06-Apr-2023


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