Scope

Chronotherapy encompasses a set of environmentally based treatments anchored to the body's interior clock, or circadian rhythm ( "therapy by the clock"     Olivia Judson in the New York Times).  Treatment takes place at home, and may involve bright light therapy, dawn and dusk simulation, microdose melatonin, blue light protection, home and workplace lighting, as well as meal, physical activity, sleep and wake timing.

     As Dr. Michael Terman, director of the consortium, commented in Psychiatric Times, "Light therapy is both underused and abused". Therefore, success often requires expert guidance. Comprehensive chronotherapy involves a multifaceted evaluation of environmental, medical and life factors that might underlie circadian disturbances. This analysis forms the basis for treatment recommendations. Patients are closely monitored for interactions between chronotherapy and psychotropic medications, such as sedatives, antidepressants, antipsychotics, and stimulants.  Often, the need for medication is reduced as chronotherapy exerts its effect.

     In parallel with medication interactions, comprehensive chronotherapy recognizes that emotional issues may be a critical factor in resolving circadian rhythm disturbances.  Therefore, the group offers coordinated psychotherapy for both individuals and couples when it could provide a key to treatment success.

     Three mental health specialists, Drs. Michael Terman, Niles Drake, and Margaret Mandel form the core group of the program, which originated at Columbia University Medical Center. There, Dr. Terman conducted clinical trials on light therapy beginning in the 1980's with grants from the National Institute of Mental Health.  The Sleep Research Society Foundation supported additional investigation into the circadian timing and microdosing of melatonin administration.  Based on this research, Dr. Terman developed a set of treatments that can be tailored to the individual patient.