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Sleep-wake Cycle Disorders

A sleep-wake cycle disorder, also known as a Circadian rhythm disorder, is when the internal body clock is out of sync with natural light and dark cycles. Twenty to 40 percent of stroke survivors are reported to experience SWD. Causes of sleep-wake cycle disorders in stroke survivors include environmental factors (e.g., staying in the hospital), side effects of a medication or the stroke itself.

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Symptoms

The most glaring symptom of a sleep-wake cycle disorder is feeling anxious at night and unusually drowsy and tired during the day. Further indications of sleep-wake cycle disorders are if a stroke survivor frequently wakes up during the night or needs more sleep in general, a condition called hypersomnia. Insomnia describes trouble falling or staying asleep, and is another symptom of SWD.

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Treatment

If the cause of sleep-wake patterns is due to staying in the hospital or a side effect from medication, then the symptoms will go away on their own when a stroke survivor checks out of the hospital or stops taking the medication. Even when the cause of SWD is a residual effect of the stroke, in time the internal body clock can adjust to a more conventional sleep schedule. However, getting enough sleep is an important part of post-stroke recovery, and there are treatments to speed up recovery from SWD.

One method is called bright light therapy. The idea is that exposing a stroke survivor to a concentrated bright light that is three to five times more powerful than a typical indoor light source will correct the sleep-wake cycle. A head-mounted light visor is common in bright light therapy. The treatment is typically administered in the morning and may last about 30 minutes.

Another common treatment is melatonin. Melatonin is a hormone that can be prescribed to be taken at night. It acts like a sedative and can help induce sleep at night, and in time help correct the sleep-wake cycle.

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Management

Sleep-wake cycle disorders are not usually permanent and a combination of time and treatment will correct SWD in most cases.

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Content Updated: August 2012

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