Circadian Rhythm Sleep-Wake disorder

The Circadian Rhythm Sleep-Wake Disorder refers to a recurrent pattern of sleep disruption which leads to either insomnia or excessive sleepiness. It occurs following a mismatch of the sleep-wake schedule according to an individual’s environment and the circadian sleep-wake patterns (Tufik, Bittencourt & Andersen, 2016). Based on the DSM-V criteria, a diagnosis of Circadian Rhythm Sleep-Wake Disorder is made when: a patient reports of a continuous disruption of the sleep pattern resulting to insomnia or excessive sleepiness, the sleep disturbance causes a lot of distress, social, physiological and occupational impairment for a client, sleep disturbance does not only happen in the existence of a mental or sleep disorder and lastly, the sleep disturbance is not as a result of the effects of medications, substance abuse or generally a medical condition(Tufik, Bittencourt & Andersen, 2016). Circadian Rhythm Sleep-Wake disorder

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The management of Circadian Rhythm Sleep-Wake Disorders is highly dependent on the type of disorder and the degree of severity. However, high chances of treatment success have been associated with individualized treatment. Therefore, management includes pharmacological and non- pharmacological approaches where psychotherapy is used. Most specifically, CBT helps clients to maintain regular sleep-wake patterns, to avoid caffeine, regular exercise routine and for stimulating body activity before bedtime (Auger, et al., 2015). The bright light therapy which functions by adjusting the circadian clock has also proven to be effective for either delaying or advancing sleep. The medications used are such as melatonin which provides short term or long term assistance as a promoting agent in maintaining the sleep wake cycle.

Another form of therapy is chronotherapy where there is continuous delay or increase of sleep time depending on how severe it is. However, its major risk is that it requires strict commitment for both the caregiver and the patient which means that, it takes longer for the sleep-wake cycle of a client to successfully shift (Abbott, Reid & Zee, 2015). The risk of the bright light therapy is that, by using high light intensity with variations in the exposure duration from 1-2 hours, some clients are at risk of retinal and skin damage. However, as highlighted by Abbott, Reid & Zee, (2015), clients are able to maintain regular sleep-wake patterns with an overall increase in social and physiological functioning which are indicators for good health outcomes. Circadian Rhythm Sleep-Wake disorder

References

Abbott, S. M., Reid, K. J., & Zee, P. C. (2015). Circadian rhythm sleep-wake disorders. Psychiatric Clinics, 38(4), 805-823.

Auger, R. R., Burgess, H. J., Emens, J. S., Deriy, L. V., & Sharkey, K. M. (2015). Do evidence-based treatments for circadian rhythm sleep-wake disorders make the GRADE? Updated guidelines point to need for more clinical research. Journal of Clinical Sleep Medicine, 11(10), 1079-1080.

Sateia, M. J. (2014). International classification of sleep disorders. Chest, 146(5), 1387-1394.

Tufik, S., Bittencourt, L. R., & Andersen, M. L. (2016). Circadian rhythm sleep–wake disorders. International Neurology, 616-617.

Circadian Rhythm Sleep-Wake disorder

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