Rate/rhythm irregular day before-sleep

The Rythme irregular day before-sleep is a sleep disorder belonging to the disorders of the circadian rate/rhythm. It is the expression of a total disorganization of the nychthemeral rate/rhythm day before-sleep.

Epidemiology

The frequency of the disorder is unknown. An associated Démence or other degenerative cerebral attacks are rather often found.

Diagnosis

One does not observe an complete absence of rate/rhythm day before-sleep. There does not exist fixed hour of sleep. The periods of sleep are multiple on 24:00, with multiple naps during the day and of the night awakenings quite as many. The subject generally presents an excessive diurnal somnolence. Often severe cognitive disorders are generally associated. The total time of sleep on 24:00 can be normal for the age.

Physiopathology

The vast majority of the subjects present lesions of the suprachiasmatic area (localization of the biological clock) and/or centers of regulation day before-sleep. These lesions can be of origin degenerative (insanities of Alzheimer for example), traumatic, vascular or tumoral. The disturbances of the rate/rhythm are also accentuated by a state of dependence and grabatisation.

Treatment

In general they are little not very effective. The strict organization of the Nycthémère (meal, visits, Nap S…) little to allow an improvement by synchronizing the patient on the donors of time. Mélatonine and Vitamine B12 can be used, but did not show their effectiveness.

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