Program in Psychiatric Chronotherapy

What is chronotherapy?

Chronotherapy is a set of interventions that use light and darkness exposure, modification of the sleep-wake cycle, melatonin and melatonin-like drugs, and various behavioral methods to improve medical conditions by altering the bodies’ underlying biological clock and circadian rhythms.

When chronotherapeutic interventions are used to treat emotional conditions, they are referred to as psychiatric chronotherapy.

For additional information about psychiatric chronotherapy:

What are the major forms of psychiatric chronotherapy?

Bright light therapy. This therapy uses a specially-designed light box to administer high intensity, florescent light at a specific time of day, for a specific duration. It is most commonly used to treat depression and bipolar depression.

Dawn simulation. This treatment uses a different type of light device which involves a timed, low-intensity onset beginning during the end of the standard sleep period and lasting for 30 to 60 minutes.

Sleep deprivation (also known as Wake therapy). Sleep deprivation uses a prolonged period of wakefulness, typically combined with light therapy and an advance of the sleep-wake cycle, to treat unipolar and bipolar depressions.

Dark therapy. This strange-sounding intervention harnesses the use of timed and extended periods of darkness to treat the manic phase and rapid-cycling forms of bipolar disorders. This treatment can employ actual darkness but more commonly relies on the use of blue-blocking glasses to achieve ‘virtual darkness.’

Melatonin. Melatonin is the bodies’ darkness hormone, being produced by the pineal gland only during periods when light is absent. Like many chronotherapeutic interventions, properly- timed and dosed melatonin can change the timing of one’s internal body clock and, in so doing, correct timing misalignments that have given rise to sleep or mood disturbances.

Interpersonal social rhythm therapy (IPSRT). IPSRT is a psychosocial treatment that attempts to prevent relapse in bipolar disorders by improving the regularity of one’s daily activity, social, sleep, eating and exercise timing.

Cognitive behavioral therapy of insomnia, adapted for bipolar disorders (CBTI-BP). This treatment uses a mixture of cognitive and behavioral strategies to identify and resolve any worry-related components of insomnia. It also uses a technique of relative sleep restriction to improve sleep efficiency.