Jump to navigation Jump to search

WikiDoc Resources for Chronotherapy


Most recent articles on Chronotherapy

Most cited articles on Chronotherapy

Review articles on Chronotherapy

Articles on Chronotherapy in N Eng J Med, Lancet, BMJ


Powerpoint slides on Chronotherapy

Images of Chronotherapy

Photos of Chronotherapy

Podcasts & MP3s on Chronotherapy

Videos on Chronotherapy

Evidence Based Medicine

Cochrane Collaboration on Chronotherapy

Bandolier on Chronotherapy

TRIP on Chronotherapy

Clinical Trials

Ongoing Trials on Chronotherapy at Clinical

Trial results on Chronotherapy

Clinical Trials on Chronotherapy at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Chronotherapy

NICE Guidance on Chronotherapy


FDA on Chronotherapy

CDC on Chronotherapy


Books on Chronotherapy


Chronotherapy in the news

Be alerted to news on Chronotherapy

News trends on Chronotherapy


Blogs on Chronotherapy


Definitions of Chronotherapy

Patient Resources / Community

Patient resources on Chronotherapy

Discussion groups on Chronotherapy

Patient Handouts on Chronotherapy

Directions to Hospitals Treating Chronotherapy

Risk calculators and risk factors for Chronotherapy

Healthcare Provider Resources

Symptoms of Chronotherapy

Causes & Risk Factors for Chronotherapy

Diagnostic studies for Chronotherapy

Treatment of Chronotherapy

Continuing Medical Education (CME)

CME Programs on Chronotherapy


Chronotherapy en Espanol

Chronotherapy en Francais


Chronotherapy in the Marketplace

Patents on Chronotherapy

Experimental / Informatics

List of terms related to Chronotherapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


People who suffer from Delayed Sleep Phase Syndrome are generally unable to reset their circadian rhythm by moving their bedtime and rising time earlier. In chronotherapy an attempt is made to move bedtime and rising time later and later each day, around the clock, until these times reach the number of hours of sleep per night an individual needs to be fully functional. According to Michael B Russo, MD, the number of hours of sleep per night necessary for an individual to be fully functional is still unknown because the function of sleep has yet to be fully determined. Some people claim full effectiveness with only 3-5 hours of sleep per night, while others admit to needing 8 (or more) hours of sleep per night to perform effectively.

While Chronotherapy has been successful for some, it is necessary to rigidly maintain the desired sleep/wake cycle thenceforth. Any deviation in schedule tends to allow the body clock to shift later again.

Here's an example of how Chronotherapy could work over a week's course of treatment, with the patient going to sleep three hours later every day until the desired sleep and waketime is reached. This technique assumes that an individual can perform effectively with 8 hours of sleep per night. Shifting the sleep phase by 3 hours per day may not always be possible. Shorter increments of 1-2 hours are needed in such cases.[citation needed]


   * Day 1: sleep 4 a.m. to noon
   * Day 2: sleep 7 a.m. to 3 p.m.
   * Day 3: sleep 10 a.m. to 6 p.m.
   * Day 4: sleep 1 p.m. to 9 p.m.
   * Day 5: sleep 4 p.m. to midnight
   * Day 6: sleep 7 p.m. to 3 a.m.
   * Day 7 to 13: sleep 10 p.m. to 6 a.m.
   * Day 14 and thereafter: sleep 11 p.m. to 7 a.m.

Whilst this technique can provide temporary respite from sleep deprivation, patients often find the desired sleep and waketimes soon slip, returning them to a state of delayed sleep onset within a few weeks or even days. The desired pattern can be maintained - to a degree - by following a strictly disciplined timetable for sleeping and rising, but all too often this cannot be maintained, as the body returns to its previous pattern of late sleep onset, regardless of when the patient rises.

A modified chronotherapy (Thorpy et al in J Adolesc Health Care, 1988;9) is called controlled sleep deprivation with phase advance, SDPA. One stays awake one whole night and day, then goes to bed 90 minutes earlier than usual and maintains the new bedtime for a week. This process is repeated weekly until the desired bedtime is reached.

Reverse chronotherapy

Sometimes, although extremely infrequently, "reverse" chronotherapy - i.e., gradual movements of bedtime and rising time earlier each day - has been used in treatment of patients with abnormally short circadian rhythms, in an attempt to move their bedtimes to later times of the day. Because circadian rhythms substantially shorter than 24 hours are extremely rare, this type of chronotherapy has remained largely experimental, with very little large-scale study.