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Prior to the introduction of this code, the nonspecific code 307.45, Circadian rhythm sleep disorder of non-organic origin, was available, and as of 2014 remains the code recommended by the DSM-5. ICD-10-CM: Circadian rhythm sleep disorder, free running type; code G47.24 was due to take effect October 1, 2014.
A circadian rhythm is an entrainable, endogenous, biological activity that has a period of roughly twenty-four hours. This internal time-keeping mechanism is centralized in the suprachiasmatic nucleus (SCN) of humans, and allows for the internal physiological mechanisms underlying sleep and alertness to become synchronized to external environmental cues, like the light-dark cycle. [4]
According to the International Classification of Sleep Disorders, Revised (ICSD-R, 2001), [10] the circadian rhythm sleep disorders share a common underlying chronophysiologic basis: The major feature of these disorders is a misalignment between the patient's sleep-wake pattern and the pattern that is desired or regarded as the societal norm...
327.10 G47.10 Circadian Rhythm Sleep Disorders: Circadian rhythm sleep disorder, delayed sleep phase type 327.31 G47.21 Circadian rhythm sleep disorder, advanced sleep phase type 327.32 G47.22 Circadian rhythm sleep disorder, irregular sleep-wake type 327.33 G47.23 Circadian rhythm sleep disorder, free-running (non-entrained) type 327.34 G47.24
Circadian rhythm sleep-wake disorders, Advanced sleep phase type 307.45 G47.21 Circadian rhythm sleep-wake disorders, Delayed sleep phase type 307.45 G47.23 Circadian rhythm sleep-wake disorders, Irregular sleep-wake type 307.45 G47.24 Circadian rhythm sleep-wake disorders, Non-24-hour sleep-wake type 307.45 G47.26
But sundowning has some unique signs that make it stand out from just being tired. “Fatigue can occur at all times of the day. Sundowning is truly confusion,” Dr. Kobylarz says.
Specifically, exposure to light at night can throw your circadian rhythm out of whack, which raises the risk of inflammation. This increases the odds you’ll develop a host of different diseases.
Treatment for irregular sleep–wake rhythm tries to enable the body clock in the brain, such that a normal long sleep period at night can be achieved. Education about sleep hygiene is important, and counseling can be helpful. Melatonin, vitamin B 12, sleep aids, wake aids, and other medications may also be used.