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Circadian rhythms and disorders of the timing of sleep

Research output: Contribution to journalReview articlepeer-review

Nicholas Meyer, Allison G. Harvey, Steven Lockley, Derk-Jan Dijk

Original languageEnglish
Pages (from-to)1061-1078
Number of pages18
JournalThe Lancet
Issue number10357
Accepted/In press11 May 2022
Published24 Sep 2022

Bibliographical note

Funding Information: SWL has received consulting fees from EyeJust, Rec Room, Six Senses, and Stantec; has current consulting contracts with Akili Interactive, Apex 2100, Consumer Sleep Solutions, Hintsa Performance, KBR Wyle Services, Light Cognitive, Lighting Science Group Corporation/HealthE, Look Optic, Mental Workout/Timeshifter, and View; has received honoraria and travel or accommodation expenses from MIT, Roxbury Latin School, and University of Toronto; and travel or accommodation expenses (no honoraria) from Wiley; has received royalties from Oxford University Press; holds equity in iSleep; has received an unrestricted equipment gift from f.lux Software; holds an investigator-initiated grant from f.lux Software; has a Clinical Research Support Agreement and a Clinical Trials Agreement with Vanda Pharmaceuticals; is an unpaid Board Member of the Midwest Lighting Institute (non-profit); is co-investigator on National Institutes of Health grants (R01HL159207, R03AG071922, R21NR018974); was a Programme Leader for the Cooperative Research Centre for Alertness, Safety, and Productivity, Australia, through an adjunct professor position at Monash University (2015–19); has served as a paid expert in legal proceedings related to light, sleep, and health; and has several patents related to circadian applications. D-JD has consulted for and received research support from pharmaceutical and non-pharmaceutical companies with an interest in developing treatments for sleep and circadian rhythm disorders; was a paid consultant to or received research support from F Hoffmann-La Roche, Pfizer, Eli Lilly, Novo Nordisk, Ono Pharma UK, Janssen Research and Development, GW Pharma, Phillips Lighting, H Lundbeck, Merck, Vanda Pharmaceuticals, Cephalon, Servier, UCB, Procter & Gamble, and Ferring Pharmaceuticals; and is supported by the UK Dementia Research Institute which is funded by the UK Medical Research Council, Alzheimer's Society, and Alzheimer's Research UK. NM has been supported by the UK Medical Research Council (MR/P 001378/1). AGH is in receipt of NIH grants (R01MH120147 and R01 HD071065). Funding Information: We thank Simon Archer (University of Surrey) for his valuable comments on the manuscript. Publisher Copyright: © 2022 Elsevier Ltd

King's Authors


The daily alternation between sleep and wakefulness is one of the most dominant features of our lives and is a manifestation of the intrinsic 24 h rhythmicity underlying almost every aspect of our physiology. Circadian rhythms are generated by networks of molecular oscillators in the brain and peripheral tissues that interact with environmental and behavioural cycles to promote the occurrence of sleep during the environmental night. This alignment is often disturbed, however, by contemporary changes to our living environments, work or social schedules, patterns of light exposure, and biological factors, with consequences not only for sleep timing but also for our physical and mental health. Characterised by undesirable or irregular timing of sleep and wakefulness, in this Series paper we critically examine the existing categories of circadian rhythm sleep–wake disorders and the role of the circadian system in their development. We emphasise how not all disruption to daily rhythms is driven solely by an underlying circadian disturbance, and take a broader, dimensional approach to explore how circadian rhythms and sleep homoeostasis interact with behavioural and environmental factors. Very few high-quality epidemiological and intervention studies exist, and wider recognition and treatment of sleep timing disorders are currently hindered by a scarcity of accessible and objective tools for quantifying sleep and circadian physiology and environmental variables. We therefore assess emerging wearable technology, transcriptomics, and mathematical modelling approaches that promise to accelerate the integration of our knowledge in sleep and circadian science into improved human health.

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