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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Circadian rhythm sleep disorders (CSDRs)