Complete Guide To Irregular Sleep-Wake Rhythm


It’s not unnatural to find yourself a little sleepy during the day, especially at work or at school.

However, if you find yourself randomly taking several, involuntary naps during the day and are unable to sleep all throughout the night, then you might be suffering from irregular sleep-wake rhythm disorder.

irregular sleep wake rhythm disorder

Let’s take a look at what an irregular sleep-wake rhythm is, what causes it, and the various treatment methods you can use to cure it.

What Is Irregular Sleep-Wake Rhythm?

Irregular sleep-wake rhythm is a rare sleep disorder that adversely affects a person’s circadian rhythm.

The circadian rhythm is often referred to as the “body’s clock” because it follows a stringent 24-hour cycle that tells us when we should sleep, get up, and eat throughout the day. It regulates many of your body’s physiological processes and can be affected by environmental cues like sunlight and temperature.

When your circadian rhythm is disrupted or thrown off, you may feel sleepy or hungry at odd times of the day or night. This can also lead to a variety of adverse health problems, such as an increased chance of cardiovascular disease, obesity, depression, and bipolar disorder among other physical or mental issues.

Irregular sleep-wake rhythm disorder is typically characterized by taking random naps all throughout the day, feeling incredibly sleepy all day, and having no main time when you go to sleep at night.

In fact, a person who has this disorder might also suffer from insomnia because they stay up for long periods of time during the night. This is because people who suffer from this disorder don’t have a strict physiological pattern of wakefulness and sleepiness.

The result is poor sleep and various social, familial, or work problems, such as the ability to maintain relationships and responsibilities.

Surprisingly, people who suffer from irregular sleep-wake rhythm disorder aren’t considered sleep-deprived. They do get the recommended amount of sleep within a 24-hour period; it’s just that they sleep in one- to four-hour increments throughout this period, rather than the usual seven to eight during the night.

According to a 2009 study, the longest period of continuous sleep a person with this disorder gets is between the hours of 2 and 6 a.m.

Irregular Sleep-Wake Rhythm Causes

Not being regularly exposed to light and strict mealtimes can contribute to irregular sleep-wake rhythm disorder.

sleep wake rhythm disorder

Light, especially sunlight, acts as a cue for our bodies’ circadian rhythms, which is why we feel more energy during the day. On the reverse, darkness usually signals that it is time for you to head off to bed.

Make sure you are exposed to some form of light every day or to keep yourself busy with some activity in the daylight hours. This helps keep your circadian rhythm in a more natural timeframe.

Practicing poor sleeping habits, such as consistently sleeping late or sleeping at different times at night, may weaken your circadian rhythm and cause you to fall prey to this disorder.


People with this sleep disorder may have:

  • Difficulty falling asleep.
  • Difficulty staying asleep.
  • Daytime sleepiness that may last all day.
  • Fragmented, short periods of sleep throughout the night.
  • Sleep in bursts of one to four hours over a 24-hour period.

When a patient is able to sleep during the times they feel like it, they may find their insomnia and daytime fatigue temporarily relieved—at the expense of being unable to maintain a typical work or social schedule, of course.

Unfortunately, most of the time, people with this disorder will still experience daytime fatigue and continuously disrupted sleep due to this off-track circadian cycle.

Who Suffers From Irregular Sleep-Wake Rhythm Disorder?

Again, this condition is very rare, and the actual prevalence of it is still unknown. Nonetheless, the most common sufferers are:

Elderly People

This disorder is known to mostly affect older people who live in nursing homes, hospitals, group homes, or other institutions. This is due to age-related changes to hormone levels and a lack of exposure to normal social and daylight cues throughout their day.

irregular sleep wake rhythm disorder

Typically, older people who suffer from neurodegenerative disorders like Alzheimer’s disease and dementia are hit the hardest.

This is because these people have lost neurons in their suprachiasmatic nuclei, resulting in reduced melatonin and pineal secretions in the brain.

Basically, this means that they don’t produce as many important chemicals in their brain that signal the body when to wake up and when to go to sleep.

Newborn Infants

Of course, there are people who don’t have any neurological problems who may suffer from this disease as well.

Newborn infants, for instance, are known to have irregular sleeping patterns. They sleep for about 12 hours each day, but these sleeping periods are spread apart within a single 24-hour period.

Fortunately, most babies grow out of this behavior by six months of age, when they have become accustomed to one major sleep period at night and a few naps during the day.

Those with Unusual Schedules

People who have shifts that change around frequently or those who often have to travel to different time zones for work may also display some of these symptoms. However, these people have a different sleep disorder altogether.

If this describes you, then you may be suffering from shift work sleep disorder or jet lag instead. There may be other medical, neurologic, genetic and/or psychiatric disorders that can cause this condition, too.

Researchers are also looking into certain medications’ side effects to see if they have any connection to the disorder.

This video goes into more detail about irregular sleep wake rhythm disorder.

How is it Diagnosed?

A patient must have at least three recorded abnormal sleep-wake episodes throughout a 24-hour period to be properly diagnosed with irregular sleep-wake rhythm disorder. Again, these episodes must last between one to four hours.

It may help to keep a sleep diary of these incidents when they occur. Writing down when you go to bed and when you wake up again later in the night (or day) for several weeks before seeing a sleep specialist will help them come to a more conclusive diagnosis.

They may still ask you about your medical history, including any neurological problems you might have, prescription or non-prescription medications you have taken, alcohol use, family history, and any other sleep problems you suffer from. They may measure your sleep rating on the Epworth Sleepiness Scale as well.

To rule out any other neurological conditions or medical problems, they may order blood tests, a CT scan, or an MRI. Usually, an overnight sleep study isn’t necessary for a diagnosis, but your sleep specialist may order one anyway to see if you are suffering from other sleep disorders that may share similar symptoms.

This study charts your brain waves, heartbeat, muscle activity (such as the movements of your arms and legs, for instance), and breathing while you sleep.

If the results are still inconclusive, they may then prescribe you an actigraph. This device can tell when you’re sleeping or awake, and it looks like your average wristwatch.

Irregular Sleep-Wake Rhythm Treatment

There are plenty of effective treatment plans for all circadian rhythm disorders out there. Many of these plans center around resetting your circadian rhythm back to a normal 24-hour schedule.

Recovery can be a long process if you have an irregular sleep-wake rhythm, but just remember to be patient and stick with it.


You may be prescribed melatonin, sleeping pills, or other sleep aids to help you sleep longer during the night and to cut back on your daily naps.

Melatonin is the hormone that makes you feel tired. More of it is secreted at night to help you sleep, and it’s crucial to the regulation of all sleep-wake cycles. While you can easily buy melatonin supplements, melatonin is also present in certain foods, too.

Of course, eating these foods alone will not provide you with enough melatonin to fall asleep, but it may still help in addition to taking supplements.

irregular sleep wake rhythm

Some examples of foods that contain melatonin include:

  • Bananas.
  • Oats.
  • Pineapples.
  • Oranges.
  • Tomatoes.
  • Potatoes.
  • Cherries.
  • Walnuts.
  • Almonds.

Foods that are rich in vitamins and tryptophan may also assist in serotonin and melatonin production.

Once you are able to sleep at a normal time again for longer than four hours, then your medications may be slowly phased out of your daily regimen.

Natural Remedies

Of course, if you’re afraid that taking supplements could mess up your already messed-up sleep schedule, then you can always try other treatment options, too.

The main goal of these treatments is to reset your circadian rhythm to one main sleeping period and one main waking period. This usually involves reducing the number of naps you take and increasing the amount of time you sleep during the night.

Keeping a daily sleep log will help you ensure you’re following a proper sleep schedule, as well as track your progress and see if your body clock is improving at all.

Light and Dark Therapy

The most effective natural treatment method is a combination of phototherapy, or light therapy, and scototherapy, or dark therapy. This method works in 2 phases.

Light Therapy

Light therapy usually involves using a lightbox, which, as its name suggests, is a box that exudes light.

It works best if is used in the early morning for around two hours to help wake you up. It’s best to start this therapy when your circadian rhythm has already started to shift to this wake time.

This is due to the fact that light is registered by special cells in the retina of the eye. These send a signal to your brain via the retinohypothalamic tract. The signal then suppresses the output of melatonin and shifts your body’s natural sleep time.

Dark Therapy

Conversely, dark therapy is when you avoid exposure to any light later in the day. Even ordinary lightbulbs can delay your sleep time.

irregular sleep wake rhythm disorder

So, if you plan to sleep soon, it’s best to remain in dim light, shut your blinds or curtains, or use special darkened goggles that reduce your exposure to light throughout the evening or night.

Implementing both light and dark therapies will help your body become conditioned to the waking and sleeping times that you want. They will work best after your natural sleeping pattern has already been reduced to one or two long sleeping periods a day.

You need to follow through with these therapies at the same time every day or risk worsening your symptoms even further.

Avoiding Blue Light

Keep in mind that blue light also has a huge impact on your circadian rhythm. Computers, smartphones, tablets, TVs, and many other electronics emit blue light, which is what helps keep them glowing even in the dark.

This is helpful in the daytime when the sun is out, but it can be harmful to those with irregular sleep-wake rhythm disorder when they are trying to sleep.

As tempting as it may be, do not wind down at night by looking at any electronics before you go to sleep. If you really need to, for work or other pressing matters, then wear special goggles that block out blue light when doing so before you go to sleep.

This video goes into more detail on using light to treat irregular sleep-wake rhythm disorder.

How to Prevent It

Following proper sleep hygiene is the best thing you can do for yourself. You always run the risk of falling into old patterns again, of course, but you should follow strict bedtimes and waking times as much as possible.

If you have trouble waking up earlier in the morning, simply set an alarm to a specific time every day, even when you don’t have to wake up early.

You will also need to severely or even completely cut out your intake of any kinds of stimulants (such as caffeine) or sedatives (unless otherwise prescribed by your doctor) at all times.

Can It Be Cured?

Unfortunately, there is no definitive cure for irregular sleep-wake rhythm disorder.

Most treatments only reduce the severity of your symptoms, instead of wholly eliminating them.


Irregular sleep-wake rhythm disorder can be tough to deal with.

Hopefully, the above treatment methods can help to reduce your symptoms, so you can live a happier, more productive life.

How do you deal with irregular sleep wake rhythm disorder?


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