Circadian Rhythm Sleep-Wake Disorders in Older Adults

Sleep Med Clin. 2018 Mar;13(1):39-50. doi: 10.1016/j.jsmc.2017.09.004. Epub 2017 Nov 27.


The timing, duration, and consolidation of sleep result from the interaction of the circadian timing system with a sleep-wake homeostatic process. When aligned and functioning optimally, this allows wakefulness throughout the day and a long consolidated sleep episode at night. Mismatch between the desired timing of sleep and the ability to fall and remain asleep is a hallmark of the circadian rhythm sleep-wake disorders. This article discusses changes in circadian regulation of sleep with aging; how age influences the prevalence, diagnosis, and treatment of circadian rhythm sleep-wake disorders; and how neurologic diseases in older patients affect circadian rhythms and sleep.

Keywords: Advanced sleep phase; Alzheimer disease; Circadian rhythm disruption; Circadian rhythm sleep disorders; Delayed sleep phase; Light therapy; Melatonin.

Publication types

  • Review

MeSH terms

  • Aged
  • Central Nervous System Depressants / therapeutic use
  • Circadian Clocks / physiology*
  • Circadian Rhythm / physiology
  • Humans
  • Jet Lag Syndrome / diagnosis
  • Jet Lag Syndrome / epidemiology
  • Jet Lag Syndrome / physiopathology
  • Jet Lag Syndrome / therapy
  • Melatonin / therapeutic use
  • Phototherapy
  • Sleep / physiology
  • Sleep Disorders, Circadian Rhythm / diagnosis
  • Sleep Disorders, Circadian Rhythm / epidemiology
  • Sleep Disorders, Circadian Rhythm / physiopathology*
  • Sleep Disorders, Circadian Rhythm / therapy
  • Wakefulness / physiology


  • Central Nervous System Depressants
  • Melatonin