Figure 2. A multimodal approach to address circadian disruption and its effect on health.

Diagnostic approaches, including current tools, rely primarily on self-reported and behavioral measures and require time-intensive multiple sampling of biomarkers to obtain a 24-hour profile. However, tools in development seek to assess circadian phase using a single time sample of multiple rhythms. Circadian-based therapies, such as timed bright light exposure and exogenous melatonin, are commonly used to align the phase of external/behavioral rhythms with endogenous central and peripheral clocks. In addition, time-restricted feeding can enhance alignment among peripheral clocks and improve metabolic health. In development are multimodal approaches to target central and peripheral clocks with dynamic circadian lighting, time-restricted feeding and drugs to align and stabilize circadian entrainment, and chronopharmacotherapy to optimize efficacy and tolerability of medications. CRSWD, circadian rhythm sleep wake disorder.