Circadian principles: Behavioral health implications

Abstract

In the context of inter-disciplinary and collaborative practice models, this article introduces behavioral health clinicians to circadian concepts such as chronotype, phase-response curve and entrainment as they impact self-regulation, behavior, and neuro-cognitive performance. A review of selected research studies and theoretical commentary represents the basis for describing chronobiologic principles and their pertinence to everyday mental health practice. Despite scholarly references to methodologic limitations in the research, environmental and clinical applications of chronobiologic knowledge/techniques, including but not limited to bright light therapy, for managing mood and the sleep-wake balance, continue to be documented in the scientific literature with subjective as well as measurable benefit in practice and community settings. In the developed world, urban environments expose individuals to excessive and ill- timed artificial illumination across the 24-hr period, leading to varying degrees of circadian shifting. Seasonal rhythms related to natural light availability, reflect additional, recurring disruptions in sleep-wake patterning and impacts on behavior. Circadian management principles, mindful of external and internal clock time, and strategically integrated with psychological services, provide further clues to understanding downstream fluctuations in levels of alertness, neuro-cognitive performance, mood and sleep quality and inform risk management practices.