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irregular sleep/wake rhythm disorder
Etiology:
- precipitating or perpetuating factors
- lack of structured exposure to light
- lack of exercise
- lack of social activities
Epidemiology:
- common in older adults with dementia
Pathology:
- daytime napping, at least in part, due to decrease in circadian amplitude
Clinical manifestations:
- fragmented nocturnal sleep
- daytime napping
- at least 3 sleep periods within 24 hours, with no clear nocturnal sleep pattern
Complications:
- increased risk of stroke & impairment of stroke recovery [2]
Management:
- increase structured exposure to light
- increase exercise
- increase social activities
- melatonin 30 minutes before desired bedtime [3]*
* hard to believe, but per ref [3]
General
sleep disorder
References
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- Hermann DM, Bassetti CL
Role of sleep-disordered breathing and sleep-wake disturbances
for stroke and stroke recovery.
Neurology. August 3, 2016
PMID: 27488603
http://www.neurology.org/content/early/2016/08/03/WNL.0000000000003037.short
- NEJM Knowledge+ Neurology