Precision medicine in circadian rhythm sleep-wake disorders: current state and future perspectives

Per Med. 2017 Mar;14(2):171-182. doi: 10.2217/pme-2016-0079. Epub 2017 Jan 24.

Abstract

In circadian rhythm sleep-wake disorders precision medicine is less developed than in other medical disciplines mainly because homeostatic sleep and circadian timing have a very complex phenotype with multiple genetic regulation mechanisms. However, biomarkers, phenotyping and psychosocial characteristics are increasingly used. Devices for polysomnography, actigraphy and sleep-tracking applications in mobile phones and other consumer devices with eHealth technologies are increasingly used. Also sleep-related questionnaires and the assessment of co-morbidities influencing sleep in circadian rhythm sleep-wake disorders are major contributors to precision sleep medicine. To further strengthen the (pharmaco-)genetic and biomarker pillar, technology needs to be evolved further. Routinely measuring treatment results using patient-reported outcome measures and clinical neurophysiological instruments will boost precision sleep medicine.

Keywords: DLMO; biomarker; genetics; melatonin; personalized medicine; precision medicine; sleep.

Publication types

  • Review

MeSH terms

  • Circadian Rhythm / genetics*
  • Circadian Rhythm / physiology*
  • Humans
  • Melatonin / therapeutic use
  • Polysomnography / methods
  • Precision Medicine / methods
  • Sleep / physiology
  • Sleep Disorders, Circadian Rhythm / drug therapy
  • Sleep Disorders, Circadian Rhythm / genetics
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / genetics*

Substances

  • Melatonin