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

Management

• increase structured exposure to light
• increase exercise
• increase social activities
• melatonin 30 minutes before desired bedtime*

* hard to believe, but per ref

More general terms

• sleep disorder