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Sleep Med Clin. 2009 Jun 1;4(2):143-163.

Influence of the Circadian System on Disease Severity.

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  • 1Clinical Fellow, Division of Sleep Medicine, Brigham & Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA. Tel. 617-732 5778, Fax 617-279 0683, email:


The severity of many diseases varies across the day and night. For example, adverse cardiovascular incidents peak in the morning, asthma is often worse at night and temporal lobe epileptic seizures are most prevalent in the afternoon. These patterns may be due to the day/night rhythm in environment and behavior, and/or endogenous circadian rhythms in physiology. Furthermore, chronic misalignment between the endogenous circadian timing system and the behavioral cycles could be a cause of increased risk of diabetes, obesity, cardiovascular disease and certain cancers in shift workers. Here we describe the magnitude, relevance and potential biological basis of such daily changes in disease severity and of circadian/behavioral misalignment, and present how these insights may help in the development of appropriate chronotherapy.

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