Review Article Address correspondence to Dr Phyllis C. Zee, Northwestern University, 710 North Lake Circadian Rhythm Shore Dr, Chicago, IL 60611,
[email protected]. Relationship Disclosure: Abnormalities Dr Zee has received personal compensation for activities Phyllis C. Zee, MD, PhD; Hrayr Attarian, MD, FAASM, FCCP; with Jazz Pharmaceuticals; Merck & Co, Inc; Perdue Aleksandar Videnovic, MD, MSc Pharma; Philips Respironics; Sanofi-Aventis; Takeda Pharmaceutical Company Limited; UCB; and Zeo, Inc. ABSTRACT Dr Zee receives research Purpose: This article reviews the recent advances in understanding of the funda- support from Philips mental properties of circadian rhythms and discusses the clinical features, diagnosis, Respironics. Dr Attarian receives personal and treatment of circadian rhythm sleep disorders (CRSDs). compensation for activities Recent Findings: Recent evidence strongly points to the ubiquitous influence of with American Physicians circadian timing in nearly all physiologic functions. Thus, in addition to the prominent Institute. Dr Videnovic reports no disclosure. sleep and wake disturbances, circadian rhythm disorders are associated with cognitive Unlabeled Use of impairment, mood disturbances, and increased risk of cardiometabolic disorders. The Products/Investigational recent availability of biomarkers of circadian timing in clinical practice has improved Use Disclosure: Dr Zee discusses the unlabeled use of our ability to identify and treat these CRSDs. melatonin for the treatment of Summary: Circadian rhythms are endogenous rhythms with a periodicity of circadian disorders. Dr Attarian approximately 24 hours. These rhythms are synchronized to the physical environment discusses the unlabeled use of melatonin and light boxes to by social and work schedules by various photic and nonphotic stimuli. CRSDs result advance or delay circadian from a misalignment between the timing of the circadian rhythm and the external rhythms.