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Circadian rhythm sleep disorders (CSDRs)

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Circadian rhythm sleep disorders (CSDRs) are defined as disturbances in the sleep pattern caused either by an change in the endogenous circadian timing system or a misalignment between the endogenous circadian system and the 24-hour social and physical environment (1).

According to the second International Classification of Sleep Disorders the general criteria for CRSD are as follows

  • 1. persistent or recurrent pattern of sleep disturbance that is thought to be primarily due to either alteration in the circadian timing system or a misalignment between endogenous circadian rhythms and external factors that affect the timing of sleep
  • 2. sleep disturbance that leads to insomnia, excessive sleepiness, or both;
  • 3. sleep disturbance that is associated with impairment of function (2)

CSRDs can be divided into

  • timing of sleep and wakefulness altered by exogenous factors
    • shift work disorder (SWD)
    • jet lag disorder (JLD)
  • timing of sleep and wakefulness altered by endogenous circadian clock
    • advanced sleep phase disorder (ASPD)
    • delayed sleep phase disorder (DSPD)
    • free-running disorder (FRD)
    • irregular sleep-wake rhythm disorder (ISWR) (3)

CSRDs should be taken into account in the differential diagnosis in a patient presenting with symptoms of insomnia and/or hypersomnia (2).

Since both behavioural and environmental factors play an important role in the development and maintenance of the disease, management strategies should include a multimodal treatment approach of behavioral and/or pharmacologic approaches (2)

Reference:

Last reviewed 01/2018

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