63:
272:. This disorder has been referred to by many other terms, including: Irregular Sleep Wake Pattern, irregular sleep wake syndrome, Irregular Sleep Wake Cycle or Irregular Sleep Wake Schedule, and Irregular Sleep Wake Disorder (ISWD). Sometimes the words sleep and wake are hyphenated (sleep-wake), sometimes joined with an en dash (sleep–wake) and sometimes open (sleep wake). Sometimes the words are capitalized and sometimes they are not.
235:
83:. It is characterized by numerous naps throughout the 24-hour period, no main nighttime sleep episode, and irregularity from day to day. Affected individuals 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. The disorder is serious—an
602:"Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015: An American Academy of Sleep Medicine Clinical Practice Guideline"
116:
175:
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,
188:
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
259:
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.
256:. 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.
808:
793:
247:
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
193:. 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 ISWRD.
520:"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"
87:. 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.
224:, and other medications may also be used. Exposure to light during the daytime and activities occurring at regular times each day may help to restore a normal rhythm.
201:
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
1604:
159:
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
1212:
1174:
227:
The management of this disorder may vary for different subgroups of patients. Affected individuals with dementia should not be prescribed
160:
131:
should be kept to aid in diagnosis and for chronicling the sleep schedule during treatment. Other ways to monitor the sleep schedule are
136:
575:
1052:
1047:
1019:
1164:
1207:
1138:
897:
483:
253:
80:
149:
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,
753:
453:
1479:
1287:
1149:
281:
231:(sedatives) for ISWRD due to the increased prevalence of adverse effects in this group outweighing the possible benefits.
649:
1159:
1087:
932:
728:
296:
1292:
221:
107:. The risk for the disorder increases with age, but only due to increased prevalence of co-morbid medical disorders.
1154:
1102:
1589:
1370:
1179:
1127:
1594:
927:
823:
177:
140:
578:. National Center for Biotechnology Information, U.S. National Library of Medicine. 9 May 2010. Archived from
1467:
1248:
1057:
1563:
1112:
947:
249:
206:
100:
1385:
1117:
434:
1539:
802:
84:
62:
1534:
1524:
990:
890:
812:
1599:
1544:
1297:
1197:
1062:
518:
Sack RL, Auckley D, Auger RR, Carskadon MA, Wright KP, Vitiello MV, Zhdanova IV (November 2007).
366:
1554:
852:
709:
631:
552:
415:
358:
51:
103:), brain damage, or intellectual disabilities. It is thought that those affected have a weak
1549:
1489:
699:
691:
621:
613:
542:
534:
405:
397:
350:
291:
17:
1420:
1347:
1325:
1272:
1032:
937:
234:
190:
104:
579:
1494:
1365:
1307:
1010:
910:
883:
817:
704:
679:
626:
601:
547:
410:
385:
172:
401:
1583:
1472:
1320:
1277:
1227:
1222:
995:
370:
286:
202:
176:
recording natural sleep and wake up times, over several weeks. Sleep rating with the
863:
487:
123:
with night-time in the middle and the weekend in the middle, to better notice trends
1440:
1217:
1202:
519:
316:
828:
732:
1499:
1375:
1315:
1267:
1262:
1253:
1092:
1042:
1037:
919:
847:
600:
Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM (October 2015).
210:
128:
695:
538:
341:
Oyegbile T, Videnovic A (August 2019). "Irregular Sleep-Wake Rhythm
Disorder".
1558:
1504:
1484:
1282:
1258:
1189:
1107:
1000:
970:
965:
955:
657:
354:
132:
1568:
1519:
1514:
1380:
1342:
1079:
985:
975:
960:
875:
858:
56:
713:
635:
556:
419:
362:
1435:
1410:
1330:
1122:
1097:
228:
217:
96:
785:
115:
1462:
1457:
1452:
1447:
1430:
1335:
1169:
1069:
1027:
980:
617:
1529:
1415:
797:
680:"Circadian Rhythm Sleep Disorder: Irregular Sleep Wake Rhythm Type"
95:
ISWRD has various causes, including neurological disorders such as
1425:
1243:
906:
233:
317:"Irregular sleep-wake syndrome: MedlinePlus Medical Encyclopedia"
879:
1509:
1405:
189:
disorder, seem likely. The overnight sleep study is called
46:
Circadian rhythm sleep disorder - irregular sleep-wake type
268:
The current formally correct name of the disorder is
775:
386:"Treatment of Circadian Rhythm Sleep-Wake Disorders"
1398:
1358:
1306:
1236:
1188:
1136:
1078:
1018:
1009:
946:
917:
838:
779:
50:
42:
37:
570:
568:
566:
452:Cataletto ME, Stöppler MC (25 February 2019).
891:
754:"Sleeplessness and Circadian Rhythm Disorder"
205:is important, and counseling can be helpful.
8:
454:"Usage of term "Irregular Sleep–Wake Cycle""
1213:Rapid eye movement sleep behavior disorder
1015:
898:
884:
876:
776:
513:
511:
509:
507:
505:
503:
501:
499:
497:
145:The following are possible warning signs:
61:
34:
703:
625:
546:
477:
475:
473:
471:
469:
467:
465:
463:
409:
152:difficulty getting restorative sleep, and
656:. Harvard Medical School. Archived from
433:Vaughn BV, Kataria L. Culebras A (ed.).
114:
308:
1605:Congenital disorders of nervous system
435:"Irregular sleep-wake rhythm disorder"
7:
650:"Division of Sleep Medicine Faculty"
270:Irregular Sleep Wake Rhythm Disorder
73:Irregular sleep–wake rhythm disorder
38:Irregular sleep–wake rhythm disorder
137:Continuous Positive Airway Pressure
606:Journal of Clinical Sleep Medicine
167:Initial visit with sleep physician
25:
690:(2). NIH Public Access: 213–218.
678:Zee PC, Vitiello MV (June 2009).
402:10.2174/1570159X19666210907122933
1053:Obesity hypoventilation syndrome
1048:Central hypoventilation syndrome
1208:Periodic limb movement disorder
1175:Non-24-hour sleep–wake disorder
576:"Irregular sleep wake syndrome"
161:non-24-hour sleep–wake disorder
81:circadian rhythm sleep disorder
729:"Circadian Rhythm Information"
727:Dement WC (January 22, 1999).
1:
1480:Biphasic and polyphasic sleep
1288:Nocturnal clitoral tumescence
1150:Advanced sleep phase disorder
484:"Handbook of Sleep Disorders"
282:Advanced sleep phase syndrome
155:excessive daytime sleepiness.
1160:Delayed sleep phase disorder
1088:Excessive daytime sleepiness
297:Delayed sleep phase disorder
254:Brigham and Women's Hospital
171:A physician specializing in
1293:Nocturnal penile tumescence
1165:Irregular sleep–wake rhythm
229:sleep-promoting medications
18:Irregular sleep–wake rhythm
1621:
1155:Cyclic alternating pattern
696:10.1016/j.jsmc.2009.01.009
654:Division of Sleep Medicine
1371:Behavioral sleep medicine
1180:Shift work sleep disorder
1128:Sleep state misperception
355:10.1016/j.ncl.2019.04.002
928:Rapid eye movement (REM)
539:10.1093/sleep/30.11.1484
384:Sun SY, Chen GH (2022).
238:Circadian rhythm labeled
178:Epworth Sleepiness Scale
139:(CPAP) machine that can
1249:Exploding head syndrome
1058:Obstructive sleep apnea
1564:Sleeping while on duty
1113:Idiopathic hypersomnia
684:Sleep Medicine Clinics
250:Harvard Medical School
239:
124:
1386:Neuroscience of sleep
1118:Night eating syndrome
1103:Kleine–Levin syndrome
237:
118:
1540:Sleep and creativity
490:on 18 February 2008.
85:invisible disability
79:) is a rare form of
1535:Sleep and breathing
991:Sensorimotor rhythm
390:Curr Neuropharmacol
101:Alzheimer's disease
1545:Sleep and learning
1298:Nocturnal emission
1198:Nightmare disorder
1063:Periodic breathing
839:External resources
240:
163:or like insomnia.
141:log sleeping times
125:
1577:
1576:
1555:Sleep deprivation
1394:
1393:
873:
872:
756:. WebMDnewsletter
618:10.5664/jcsm.5100
70:
69:
32:Medical condition
16:(Redirected from
1612:
1590:Circadian rhythm
1550:Sleep and memory
1490:Circadian rhythm
1237:Benign phenomena
1139:Circadian rhythm
1016:
900:
893:
886:
877:
777:
765:
764:
762:
761:
750:
744:
743:
741:
740:
731:. Archived from
724:
718:
717:
707:
675:
669:
668:
666:
665:
646:
640:
639:
629:
612:(10): 1199–236.
597:
591:
590:
588:
587:
572:
561:
560:
550:
533:(11): 1484–501.
524:
515:
492:
491:
486:. Archived from
479:
458:
457:
449:
443:
442:
430:
424:
423:
413:
396:(6): 1022–1034.
381:
375:
374:
338:
332:
331:
329:
327:
313:
292:Circadian rhythm
66:
65:
35:
21:
1620:
1619:
1615:
1614:
1613:
1611:
1610:
1609:
1595:Sleep disorders
1580:
1579:
1578:
1573:
1468:Procrastination
1421:Four-poster bed
1390:
1354:
1348:Polysomnography
1326:Sleep induction
1302:
1273:Sleep paralysis
1232:
1184:
1143:
1140:
1132:
1074:
1033:Mouth breathing
1011:Sleep disorders
1005:
942:
933:Quiescent sleep
913:
911:sleep disorders
904:
874:
869:
868:
834:
833:
788:
774:
769:
768:
759:
757:
752:
751:
747:
738:
736:
726:
725:
721:
677:
676:
672:
663:
661:
648:
647:
643:
599:
598:
594:
585:
583:
574:
573:
564:
522:
517:
516:
495:
481:
480:
461:
451:
450:
446:
432:
431:
427:
383:
382:
378:
340:
339:
335:
325:
323:
321:medlineplus.gov
315:
314:
310:
305:
278:
266:
245:
214:
199:
191:polysomnography
186:
184:Medical testing
169:
113:
105:circadian clock
93:
60:
33:
28:
23:
22:
15:
12:
11:
5:
1618:
1616:
1608:
1607:
1602:
1597:
1592:
1582:
1581:
1575:
1574:
1572:
1571:
1566:
1561:
1552:
1547:
1542:
1537:
1532:
1527:
1522:
1517:
1512:
1507:
1502:
1497:
1495:Comfort object
1492:
1487:
1482:
1477:
1476:
1475:
1470:
1460:
1455:
1450:
1445:
1444:
1443:
1438:
1433:
1428:
1423:
1418:
1413:
1402:
1400:
1396:
1395:
1392:
1391:
1389:
1388:
1383:
1378:
1373:
1368:
1366:Sleep medicine
1362:
1360:
1356:
1355:
1353:
1352:
1351:
1350:
1340:
1339:
1338:
1333:
1323:
1318:
1312:
1310:
1304:
1303:
1301:
1300:
1295:
1290:
1285:
1280:
1275:
1270:
1265:
1256:
1251:
1246:
1240:
1238:
1234:
1233:
1231:
1230:
1225:
1220:
1215:
1210:
1205:
1200:
1194:
1192:
1186:
1185:
1183:
1182:
1177:
1172:
1167:
1162:
1157:
1152:
1146:
1144:
1137:
1134:
1133:
1131:
1130:
1125:
1120:
1115:
1110:
1105:
1100:
1095:
1090:
1084:
1082:
1076:
1075:
1073:
1072:
1067:
1066:
1065:
1060:
1055:
1050:
1045:
1035:
1030:
1024:
1022:
1013:
1007:
1006:
1004:
1003:
998:
993:
988:
983:
978:
973:
968:
963:
958:
952:
950:
944:
943:
941:
940:
935:
930:
924:
922:
915:
914:
905:
903:
902:
895:
888:
880:
871:
870:
867:
866:
855:
843:
842:
840:
836:
835:
832:
831:
820:
805:
789:
784:
783:
781:
780:Classification
773:
772:External links
770:
767:
766:
745:
719:
670:
641:
592:
562:
493:
459:
444:
425:
376:
349:(3): 553–561.
333:
307:
306:
304:
301:
300:
299:
294:
289:
284:
277:
274:
265:
262:
244:
241:
212:
198:
195:
185:
182:
173:sleep medicine
168:
165:
157:
156:
153:
150:
112:
109:
99:(particularly
92:
89:
68:
67:
54:
48:
47:
44:
40:
39:
31:
27:Sleep disorder
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1617:
1606:
1603:
1601:
1598:
1596:
1593:
1591:
1588:
1587:
1585:
1570:
1567:
1565:
1562:
1560:
1556:
1553:
1551:
1548:
1546:
1543:
1541:
1538:
1536:
1533:
1531:
1528:
1526:
1523:
1521:
1518:
1516:
1513:
1511:
1508:
1506:
1503:
1501:
1498:
1496:
1493:
1491:
1488:
1486:
1483:
1481:
1478:
1474:
1471:
1469:
1466:
1465:
1464:
1461:
1459:
1456:
1454:
1451:
1449:
1446:
1442:
1439:
1437:
1434:
1432:
1429:
1427:
1424:
1422:
1419:
1417:
1414:
1412:
1409:
1408:
1407:
1404:
1403:
1401:
1397:
1387:
1384:
1382:
1379:
1377:
1374:
1372:
1369:
1367:
1364:
1363:
1361:
1357:
1349:
1346:
1345:
1344:
1341:
1337:
1334:
1332:
1329:
1328:
1327:
1324:
1322:
1321:Sleep hygiene
1319:
1317:
1314:
1313:
1311:
1309:
1305:
1299:
1296:
1294:
1291:
1289:
1286:
1284:
1281:
1279:
1278:Sleep inertia
1276:
1274:
1271:
1269:
1266:
1264:
1260:
1257:
1255:
1252:
1250:
1247:
1245:
1242:
1241:
1239:
1235:
1229:
1228:Sleep-talking
1226:
1224:
1223:Sleep driving
1221:
1219:
1216:
1214:
1211:
1209:
1206:
1204:
1201:
1199:
1196:
1195:
1193:
1191:
1187:
1181:
1178:
1176:
1173:
1171:
1168:
1166:
1163:
1161:
1158:
1156:
1153:
1151:
1148:
1147:
1145:
1142:
1135:
1129:
1126:
1124:
1121:
1119:
1116:
1114:
1111:
1109:
1106:
1104:
1101:
1099:
1096:
1094:
1091:
1089:
1086:
1085:
1083:
1081:
1077:
1071:
1068:
1064:
1061:
1059:
1056:
1054:
1051:
1049:
1046:
1044:
1041:
1040:
1039:
1036:
1034:
1031:
1029:
1026:
1025:
1023:
1021:
1017:
1014:
1012:
1008:
1002:
999:
997:
996:Sleep spindle
994:
992:
989:
987:
984:
982:
979:
977:
974:
972:
969:
967:
964:
962:
959:
957:
954:
953:
951:
949:
945:
939:
936:
934:
931:
929:
926:
925:
923:
921:
916:
912:
908:
901:
896:
894:
889:
887:
882:
881:
878:
865:
861:
860:
856:
854:
850:
849:
845:
844:
841:
837:
830:
826:
825:
821:
819:
815:
814:
810:
806:
804:
800:
799:
795:
791:
790:
787:
782:
778:
771:
755:
749:
746:
735:on 2011-08-19
734:
730:
723:
720:
715:
711:
706:
701:
697:
693:
689:
685:
681:
674:
671:
660:on 2010-12-03
659:
655:
651:
645:
642:
637:
633:
628:
623:
619:
615:
611:
607:
603:
596:
593:
582:on 2013-10-29
581:
577:
571:
569:
567:
563:
558:
554:
549:
544:
540:
536:
532:
528:
521:
514:
512:
510:
508:
506:
504:
502:
500:
498:
494:
489:
485:
478:
476:
474:
472:
470:
468:
466:
464:
460:
455:
448:
445:
440:
436:
429:
426:
421:
417:
412:
407:
403:
399:
395:
391:
387:
380:
377:
372:
368:
364:
360:
356:
352:
348:
344:
337:
334:
322:
318:
312:
309:
302:
298:
295:
293:
290:
288:
287:Chronobiology
285:
283:
280:
279:
275:
273:
271:
263:
261:
257:
255:
251:
242:
236:
232:
230:
225:
223:
219:
215:
208:
204:
203:sleep hygiene
196:
194:
192:
183:
181:
180:may be used.
179:
174:
166:
164:
162:
154:
151:
148:
147:
146:
143:
142:
138:
134:
130:
122:
117:
110:
108:
106:
102:
98:
90:
88:
86:
82:
78:
74:
64:
58:
55:
53:
49:
45:
41:
36:
30:
19:
1441:Sleeping bag
1218:Sleepwalking
1203:Night terror
920:sleep cycles
857:
846:
822:
807:
792:
758:. Retrieved
748:
737:. Retrieved
733:the original
722:
687:
683:
673:
662:. Retrieved
658:the original
653:
644:
609:
605:
595:
584:. Retrieved
580:the original
530:
526:
488:the original
482:Kushida CA.
447:
438:
428:
393:
389:
379:
346:
342:
336:
324:. Retrieved
320:
311:
269:
267:
264:Nomenclature
258:
246:
226:
200:
187:
170:
158:
144:
135:or use of a
126:
120:
94:
76:
72:
71:
29:
1525:Second wind
1500:Dream diary
1376:Sleep study
1316:Sleep diary
1268:Hypnopompia
1263:Sleep onset
1254:Hypnic jerk
1093:Hypersomnia
1043:Catathrenia
1038:Sleep apnea
948:Brain waves
918:Stages of
848:MedlinePlus
343:Neurol Clin
129:sleep diary
121:sleep diary
43:Other names
1584:Categories
1559:Sleep debt
1505:Microsleep
1485:Chronotype
1399:Daily life
1283:Somnolence
1259:Hypnagogia
1190:Parasomnia
1108:Narcolepsy
1020:Anatomical
1001:Theta wave
971:Gamma wave
966:Delta wave
956:Alpha wave
760:2010-10-07
739:2010-10-07
664:2010-10-07
586:2010-10-07
303:References
218:sleep aids
197:Management
133:actigraphy
1600:Syndromes
1569:Sleepover
1520:Power nap
1515:Nightwear
1381:Melatonin
1343:Somnology
1308:Treatment
1141:disorders
1080:Dyssomnia
986:PGO waves
981:Mu rhythm
976:K-complex
961:Beta wave
938:Slow-wave
864:neuro/655
859:eMedicine
371:190896771
222:wake aids
211:vitamin B
207:Melatonin
111:Diagnosis
57:Neurology
52:Specialty
1436:Mattress
1411:Bunk bed
1331:Hypnosis
1123:Nocturia
1098:Insomnia
714:20160950
636:26414986
557:18041481
420:34493186
363:31256789
326:21 March
276:See also
243:Research
97:dementia
1463:Bedtime
1458:Bedroom
1453:Bedding
1448:Bed bug
1431:Hammock
1336:Lullaby
1170:Jet lag
1070:Snoring
1028:Bruxism
829:D021081
705:2768129
627:4582061
548:2082099
439:MedLink
411:9886819
1530:Siesta
1416:Daybed
1244:Dreams
853:000806
818:327.33
803:G47.23
712:
702:
634:
624:
555:
545:
418:
408:
369:
361:
91:Causes
59:
1473:Story
1426:Futon
1359:Other
907:Sleep
527:Sleep
523:(PDF)
367:S2CID
77:ISWRD
909:and
824:MeSH
813:9-CM
710:PMID
632:PMID
553:PMID
416:PMID
359:PMID
328:2019
252:and
1510:Nap
1406:Bed
809:ICD
794:ICD
700:PMC
692:doi
622:PMC
614:doi
543:PMC
535:doi
406:PMC
398:doi
351:doi
1586::
1557:/
1261:/
862::
851::
827::
816::
801::
798:10
708:.
698:.
686:.
682:.
652:.
630:.
620:.
610:11
608:.
604:.
565:^
551:.
541:.
531:30
529:.
525:.
496:^
462:^
437:.
414:.
404:.
394:20
392:.
388:.
365:.
357:.
347:37
345:.
319:.
220:,
216:,
213:12
209:,
127:A
119:A
899:e
892:t
885:v
811:-
796:-
786:D
763:.
742:.
716:.
694::
688:4
667:.
638:.
616::
589:.
559:.
537::
456:.
441:.
422:.
400::
373:.
353::
330:.
75:(
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
