Skip to main content

Circadian Rhythms and Insomnia

  • Chapter
  • First Online:
Clinical Handbook of Insomnia

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Because our circadian rhythms have a strong influence on sleepiness/alertness, inappropriate timing of these rhythms with respect to the attempted sleep period can produce insomnia. Relatively delayed circadian rhythms have been associated with sleep-onset insomnia and advanced or early timed rhythms have been associated with early morning awakening insomnia. Therefore, management of these insomnias need to include treatments, such as bright light and melatonin, that will retime the circadian rhythms to be more in synchrony with the timing of sleep.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  2. American Academy of Sleep Medicine (2005) International classification of sleep disorders: diagnostic and coding manual, 2nd edn. American Academy of Sleep Medicine, Westchester, IL

    Google Scholar 

  3. Borbély AA, Achermann P (1999) Sleep homeostasis and models of sleep regulation. J Biol Rhythms 14(6):559–568

    Article  Google Scholar 

  4. Klein DC, Moore RY, Reppert SM (1991) Suprachiasmatic nucleus: the mind’s clock. Oxford University Press, New York

    Google Scholar 

  5. Arendt J (2000) Melatonin, circadian rhythms and sleep. New Engl J Med 343:1114–1116

    Article  CAS  PubMed  Google Scholar 

  6. Sack R, Lewy A, Hughes R (1998) Use of melatonin for sleep and circadian rhythm disorders. Ann Med 30:115–121

    Article  CAS  PubMed  Google Scholar 

  7. Dijk DJ, Lockely SW (2001) Functional genomics of sleep and circadian rhythms: invited review: integration of human sleep-wake regulation and circadian rhythmicity. J Appl Physiol 92:852–862

    Article  Google Scholar 

  8. Strogatz SH, Kronauer RE (1985) Circadian wake maintenance zones and insomnia in man. Sleep Res 14:219

    Google Scholar 

  9. Strogatz S, Kronauer R, Czeisler CA (1987) Circadian pacemaker interferes with sleep onset at specific times each day: role in insomnia. Am J Physiol 253:R172–R178

    CAS  PubMed  Google Scholar 

  10. Dijk D-J, Czeisler CA (1995) Contributions of the circadian pacemaker and the sleep propensity, sleep structure, electroencephalographic slow wave, and sleep spindle activity in humans. J Neurosci 15:3526–3538

    CAS  PubMed  Google Scholar 

  11. Strogatz SH, Kronauer RE, Czeisler CA (1986) Circadian regulation dominates homeostatic control of sleep length and prior wake length in humans. Sleep 9:353–364

    CAS  PubMed  Google Scholar 

  12. Czeisler CA, Duffy JF, Shanahan TL, Brown EN et al (1999) Stability, precision, and near-24-hour period of the human circadian pacemaker. Science 284:2177–2181

    Article  CAS  PubMed  Google Scholar 

  13. Campbell SS, Murphy PJ (2007) Delayed sleep phase disorder in temporal isolation. Sleep 30:1225–1228

    PubMed  PubMed Central  Google Scholar 

  14. Morris M, Lack L, Dawson D (1990) Sleep-onset insomniacs have delayed temperature rhythms. Sleep 13:1–14

    CAS  PubMed  Google Scholar 

  15. Wright H, Lack L, Bootzin R (2006) Relationship between dim light melatonin onset and the timing of sleep in sleep onset insomniacs. Sleep Biol Rhythms 4:78–80

    Article  Google Scholar 

  16. Lack L, Wright H, Paynter D (2007) The treatment of sleep onset insomnia with bright morning light. Sleep Biol Rhythms 5:173–179

    Article  Google Scholar 

  17. Taylor A, Wright HR, Lack LC (2008) Sleeping-in on the weekend delays circadian phase and increases sleepiness on the following week. Sleep Biol Rhythms 6:172–179

    Article  Google Scholar 

  18. Burgess HJ, Eastman CI (2006) A late wake time phase delays the human dim light melatonin rhythm. Neurosci Lett 395:191–195

    Article  CAS  PubMed  Google Scholar 

  19. Yang C-M, Spielman A, D’Ambrosio P et al (2001) A single dose of melatonin prevents the phase delay associated with delayed weekend sleep pattern. Sleep 24:272–281

    CAS  PubMed  Google Scholar 

  20. Jones CR, Campbell SS, Zone SE, Cooper F, DeSano A, Murphy PJ et al (1999) Familial advanced sleep-phase syndrome: a short-period circadian rhythm variant in humans. Nature 5:1062–1065

    CAS  Google Scholar 

  21. Lack L, Wright H (1993) The effect of evening bright light in delaying the circadian rhythms and lengthening the sleep or early morning awakening insomniacs. Sleep 16:436–443

    CAS  PubMed  Google Scholar 

  22. Lack LC, Mercer JD, Wright HR (1996) Circadian rhythms of early morning awakening insomniacs. J Sleep Res 5:211–219

    Article  CAS  PubMed  Google Scholar 

  23. Lack L, Wright H, Kemp K, Gibbon S (2005) The treatment of early-morning awakening insomnia with 2 evenings of bright light. Sleep 28:616–623

    PubMed  Google Scholar 

  24. Czeisler CA, Kronauer RE, Allan JS, Duffy JF, Jewett ME, Brown EN et al (1989) Bright light induction of strong (Type 0) resetting of the human circadian pacemaker. Science 244:1328–1333

    Article  CAS  PubMed  Google Scholar 

  25. Jewett ME, Rimmer DW, Duffy JF, Klerman EB, Kronauer RE, Czeisler CA (1997) Human circadian pacemaker is sensitive to light throughout subjective day without evidence of transients. Am J Physiol 273:R1800–R1809

    CAS  PubMed  Google Scholar 

  26. Minors DS, Waterhouse JM, Wirz-Justice A (1991) A human phase-response curve to light. Neurosci Lett 133:36–40

    Article  CAS  PubMed  Google Scholar 

  27. Khalsa SBS, Jewett ME, Cajochen C, Czeisler CA (2003) A phase response curve to single bright light pulses in human subjects. J Physiol 549:945–952

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Brainard GC, Hanifen JP, Greeson JM, Byrne B, Glickman G, Gerner E et al (2001) Action spectrum for melatonin regulation in humans: evidence for a novel circadian photoreceptor. J Neurosci 21:6405–6412

    CAS  PubMed  Google Scholar 

  29. Wright HR, Lack LC (2001) Effect of wavelength on suppression and phase delay of the melatonin rhythm. Chronobiol Int 18:801–808

    Article  CAS  PubMed  Google Scholar 

  30. Wright HR, Lack LC, Kennaway DJ (2004) Differential effects of light wavelength in phase advancing the melatonin rhythm. J Pineal Res 36:140–144

    Article  CAS  PubMed  Google Scholar 

  31. Lack L, Bramwell T, Wright H (2007) Morning bright blue light can advance the melatonin rhythm in mild delayed sleep phase syndrome. Sleep Biol Rhythms 5:78–80

    Google Scholar 

  32. Lack L, Wright H (1993) The effect of evening bright light in delaying the circadian rhythms and lengthening the sleep or early morning awakening insomniacs. Sleep 16:436–443

    CAS  PubMed  Google Scholar 

  33. Lack L, Wright H, Kemp K, Gibbon S (2005) The treatment of early-morning awakening insomnia with 2 evenings of bright light. Sleep 28:616–623

    PubMed  Google Scholar 

  34. Revell VL, Burgess HJ, Gazda CJ et al (2006) Advancing human circadian rhythms with afternoon melatonin and morning intermittent bright light. J Clin Endocrinol Metab 91:54–59

    Article  CAS  PubMed  Google Scholar 

  35. Lewy AJ, Bauer VK, Ahmed S et al (1998) The human phase response curve (PRC) to melatonin is about 12 hours out of phase with the PRC to light. Chronobiol Int 15:71–83

    Article  CAS  PubMed  Google Scholar 

  36. Sack R, Lewy A, Hughes R (1998) Use of melatonin for sleep and circadian rhythm disorders. Ann Med 30:115–121

    Article  CAS  PubMed  Google Scholar 

  37. Burgess HJ, Revell VL, Eastman CI (2008) A three pulse phase response curve to three milligrams of melatonin in humans. J Physiol 586(2):639–647

    Article  CAS  PubMed  Google Scholar 

  38. Deacon S, English J, Arendt J (1997) Sensitivity of the human circadian pacemaker to melatonin timed to phase delay: a dose dependent study. Chronobiol Int 14:41

    Google Scholar 

  39. Buscemi N, Vandermeer B, Hooton N et al (2005) The efficacy and safety of exogenous melatonin for primary sleep disorders a meta-analysis. J Gen Int Med 20:1151–1158

    Article  Google Scholar 

  40. Kräuchi K, Cajochen C, Möri D et al (1997) Early evening melatonin and S-20098 advance circadian phase and nocturnal regulation of core body temperature. Am J Physiol 272:R1178–R1188

    PubMed  Google Scholar 

  41. Leproult R, Van Onderbergen A, L’Hermite-Balériaux M et al (2005) Phase-shifts of 24-h rhythms of hormonal release and body temperature following early evening administration of the melatonin agonist agomelatine in healthy older men. Clin Endocrinol 63:298–304

    Article  CAS  Google Scholar 

  42. Nickelsen T, Samel A, Vejvoda M et al (2002) Chronobiotic effects of the melatonin agonist LY 156735 following a simulated 9h time shift: Results of a placebo-controlled trial. Chronobiol Int 19:915–936

    Article  CAS  PubMed  Google Scholar 

  43. Mini L, Wang-Weigand S, Zhang J (2008) Ramelton 8mg/d versus placebo in patients with chronic insomnia: post hoc analysis of a 5-week trial using 50% or greater reduction in latency to persistent sleep as a measure of treatment effect. Clin Ther 30:1316–1323

    Article  CAS  PubMed  Google Scholar 

  44. Simpson D, Curran MP (2008) Ramelteon: a review of its use in insomnia. Drugs 68:1901–1919

    Article  CAS  PubMed  Google Scholar 

  45. Roth T, Seiden D, Sainati S, Wang-Weigand S et al (2006) Effects of ramelteon on patient-reported sleep latency in older adults with chronic insomnia. Sleep Med 7:312–318

    Article  PubMed  Google Scholar 

  46. Zammit G, Erman M, Wang-Weigand S et al (2007) Evaluation of the efficacy and safety of ramelteon in subjects with chronic insomnia. J Clin Sleep Med 3:495–504

    PubMed  PubMed Central  Google Scholar 

  47. Zemlan FP, Mulchahey J, Scharf MB et al (2005) The efficacy and safety of the melatonin agonist ß-methyl-6-chloromelatonin in primary insomnia: a randomized, placebo-controlled crossover clinical trial. J Clin Psychiatry 66:384–390

    Article  CAS  PubMed  Google Scholar 

  48. Bootzin RR (1972) A stimulus control treatment for insomnia. Proc Am Psychol Assoc 7:395–396

    Google Scholar 

  49. Bootzin RR, Nicassio P (1978) Behavioral treatments for insomnia. In: Hersen M, Eisler RM, Miller PM (eds) Progress in behavior modification, vol 6. Academic Press, New York, pp 1–45

    Google Scholar 

  50. Spielman AJ, Saskin P, Thorpy MJ (1987) Treatment of chronic insomnia by restriction of time in bed. Sleep 10:45–56

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Lack, L.C., Wright, H.R. (2010). Circadian Rhythms and Insomnia. In: Attarian, H., Schuman, C. (eds) Clinical Handbook of Insomnia. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-042-7_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-042-7_18

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-033-5

  • Online ISBN: 978-1-60327-042-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics