Abstract
The body’s inability to regulate a 24-hour body clock can result in irregular patterns of sleep and wake and lead to an irregular sleep-wake rhythm disorder. This can present with insomnia and/or sleepiness. This condition is commonly seen in patients with neurodegenerative conditions such as dementia. Evidence-based treatment options for this condition are limited. Phototherapy in the morning has been shown to lead to some improvements. Other strategies such as environmental changes, exercise programs, and strategic avoidance of light have shown minimal benefit but because of the minimal risks associated with these options they could be tried in patients with irregular sleep-wake rhythm disorders.
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Suggested Reading
Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM. 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. J Clin Sleep Med. 2015;11(10):1199–236.
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Meinen, C., Kolla, B.P., Mansukhani, M.P. (2019). Wandering in the Nursing Home. In: Khawaja, I., Hurwitz, T. (eds) Comorbid Sleep and Psychiatric Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-11772-6_10
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DOI: https://doi.org/10.1007/978-3-030-11772-6_10
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