title: Circadian misalignment in mood disturbances.
abstract: Recent refinements in methodology allow chronobiological researchers to answer the following questions: is there circadian misalignment in sleep and mood disturbances, and, if so, is it of the phase-advance or phase-delay type? Measurement of the dim light melatonin onset-to-midsleep interval, or phase-angle difference, in sleep and mood disorders should answer these questions. Although the phase-advance hypothesis of affective disorders was formulated three decades ago, recent studies suggest that many, if not all, mood disturbances have a circadian misalignment component of the phase-delay type, operationally defined as a delay in the dim light melatonin onset relative to the sleep/wake cycle. Phase-delayed disorders can be treated with bright light in the morning and/or low-dose melatonin in the afternoon/evening. Phase-advanced disorders can be treated with bright light in the evening and/or low-dose melatonin in the morning.
authors.affiliation: Oregon Health & Science University, 3181 Southwest Sam Jackson Road, Portland, OR 97239, USA. lewy@ohsu.edu
authors.forename: Alfred J
authors.initials: AJ
authors.lastname: Lewy
mesh_terms: D002940:Circadian Rhythm; D006801:Humans; D008550:Melatonin / Q000627:therapeutic use; D019964:Mood Disorders / Q000628:therapy*; D010789:Phototherapy; D012890:Sleep; D013997:Time Factors
chemical_list: D008550:Melatonin