Chronotherapy for Treatment of Insomnia

If you are having trouble falling asleep at your desired bedtime, a common symptom of insomnia, what role could a treatment called chronotherapy have? How is chronotherapy done? Where is the best place to undergo chronotherapy?

Chronotherapy is a helpful therapy for those who have difficulty initiating sleep. Insomnia may have many causes; sometimes it is due to a problem with the timing of the desire for sleep. There are many biological processes, including sleep patterns, that follow a circadian rhythm.Problems with this can lead to one of the circadian rhythm sleep disorders, most commonly delayed or advanced sleep phase syndrome.

Man lying awake in bed
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Reset the Timing of Sleep

As a means to reset the timing of sleep, chronotherapy can be very effective. As mentioned above, it involves the delay of sleep by several hours on successive days. What may not be clear, however, is that this delay continues day after day, with the sleep period moving around the 24-hour clock. This may be illustrated with an example: If you have delayed sleep phase syndrome, you may find yourself falling asleep at 3 a.m. when you really wish to be in bed by 11 p.m. instead. You may follow the following schedule as you adjust your sleep timing with chronotherapy:

  • Day 1: Bedtime 6 a.m.
  • Day 2: Bedtime 9 a.m.
  • Day 3: Bedtime 12 noon
  • Day 4: Bedtime 3 p.m.
  • Day 5: Bedtime 6 p.m.
  • Day 6: Bedtime 9 p.m.
  • Day 7 and thereafter: Bedtime 11 p.m.

Such a regimen must be strictly adhered to, and often it is necessary to undertake the chronotherapy treatment in a controlled setting, such as in a hospital. In some cases it may be necessary to make adjustments in smaller intervals, advancing your bedtime by only one to two hours. Slight variations or lapses in the schedule will leave you returning to your old ways. Once the new timing of the sleep period is established, it should be strictly observed.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bianchi M. Chronic insomnia. Semin Neurol. 2017;37(04):433-438. doi: 10.1055/s-0037-1605344

  2. National Institute of General Medcial Sciences. Circadian Rhythms.

  3. Cardinali DP, Brown GM, Pandi-Perumal SR. Chronotherapy. Handbook of Clinical Neurology. Vol 179. Elsevier; 2021:357-370. doi: 10.1016/B978-0-12-819975-6.00023-6

  4. Nesbitt AD. Delayed sleep-wake phase disorder. Journal of Thoracic Disease. 2018;10(1). doi: 10.21037/jtd.2018.01.11

Additional Reading

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.