Chronobiology and insomnia: pathophysiology and treatment of circadian rhythm sleep disorders

Abstract

This review summarizes current knowledge of sleep disorders with a chronobiological basis, including: delayed sleep phase syndrome, advanced sleep phase syndrome, non24 h sleep–wake syndrome and irregular sleep–wake pattern disorder. These circadian rhythm sleep disorders are characterized by a misalignment between the timing of the sleep period with respect to the day–night cycle and as a consequence of patients attempting to maintain ‘normal’ social hours, reduced sleep quality. In addition to the specific circadian rhythm sleep disorders, this review will also examine current drug (e.g., hypnotics and melatonin) and nondrug (e.g., bright light therapy and chronotherapy) treatments, the overlap with psychophysiological insomnia and future directions.