Circadian Rhythm Sleep-Wake Disorder, Irregular Sleep-Wake Type

Circadian Rhythm Sleep-Wake Disorder, Irregular Sleep-Wake Type is a circadian rhythm sleep-wake disorder characterized by symptoms of insomnia at night (during the usual sleep period) and excessive sleepiness (napping) during the day. Additionally, there is no discernable sleep-wake circadian rhythm, no major sleep period, and sleep is fragmented into at least three periods during a 24-hour day.

  • The prevalence is not well studied, but it is more common in neurodegenerative disorders (i.e. - dementia) and children with neurodevelopmental disorders.
Risk Factors
Criterion A

A persistent or recurrent pattern of sleep disruption that is primarily due to an alteration of the circadian system or to a misalignment between the endogenous circadian rhythm and the sleep-wake schedule required by an individual’s physical environment or social or professional schedule.

Criterion B

The sleep disruption leads to excessive sleepiness or insomnia, or both.

Criterion C

The sleep disturbance causes clinically significant distress or impairment in social, occupational, and other important areas of functioning.

Irregular sleep-wake type specifier

Specify whether:

  • Irregular sleep-wake type: A temporally disorganized sleep-wake pattern, such that the timing of sleep and wake periods is variable throughout the 24- hour period.

Length Specifier

Specify if:

  • Episodic: Symptoms last at least 1 month but less than 3 months.
  • Persistent: Symptoms last 3 months or longer.
  • Recurrent: 2 or more episodes occur within the space of 1 year.
For Patients
For Providers