SLEEP 2026 | Circadian rhythms as a therapeutic target: established and evolving approaches

Yes. So there are definitely circadian interventions that are being used right now in the clinic. For example, bright light therapy and dark therapy have been used for many years for seasonal affective disorder and bipolar disorder. So either using bright light therapy in the morning to shift someone’s circadian rhythms more in line with the light-dark cycle, or using dark therapy in the evening, particularly with mania and bipolar disorder, to help calm someone down and get them ready for sleep when they’re not really wanting to sleep. There’s also a cognitive behavioral therapy called Interpersonal and Social Rhythm Therapy, which is used a lot, again, with bipolar disorder, which is one of the disorders that has the strongest evidence of a circadian basis. In this therapy, people are put on a very strict sleep-wake and social schedule. They get up at the same time every day, go to bed at the same time every day, and keep their social and other activities consistent every day. This can really help stabilize rhythms and prevent episodes from happening, because the thing that will set off episodes more than anything else is a change to schedule. So if somebody works a night shift, travels, or stays up all night doing something, this is what can really trigger episodes. So keeping a really consistent sleep-wake schedule is very important. And then, yes, there’s ongoing therapeutic development, both pharmacological, with people looking at medications that could impact the circadian system in particular ways, but also additional devices and easier ways to deliver light or create darkness. Things like that are being developed all the time.

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