Table of contents

Circadian rhythm sleep disorders


Key sources

The following summarized guidelines for the evaluation and management of circadian rhythm sleep disorders are prepared by our editorial team based on guidelines from the British Thoracic Society (BTS 2023), the European Sleep Research Society (ESRS/EIN 2023), the British Association for Psychopharmacology (BAP 2019), and the American Academy of Sleep Medicine (AASM 2018,2015). ...
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Diagnostic investigations

Clinical assessment: as per BAP 2019 guidelines, obtain clinical assessment in patients with delayed sleep-wake phase disorder and non-24-hour sleep rhythm disorder.
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More topics in this section

  • Actigraphy

Medical management

Setting of care: as per BAP 2019 guidelines, manage patients with circadian rhythm disorders in a specialized sleep disorders center because of the necessity for careful timing of interventions.

More topics in this section

  • Management of advanced SWPD

  • Management of delayed SWPD

  • Management of non-24-hour SWRD

  • Management of irregular SWRD

  • Management of jet lag

Specific circumstances

Pediatric patients
As per BTS 2023 guidelines:
Suspect other diagnoses, including narcolepsy, with possible coexistent cataplexy, sleep paralysis, hypnagogic and hypnopompic hallucinations, and circadian rhythm disorders, in pediatric patients with persisting excessive daytime sleepiness despite exclusion or effective treatment of sleep-disordered breathing.
Ask both the patient and parents/carers about sleep onset and wake-up times to elicit total sleep time and sleep latency to exclude a circadian rhythm disorder associated with excessive daytime sleepiness.