Benzodiazepines. Short-acting benzodiazepines, such as Xanax, are often chosen in the early treatment of a circadian rhythm disorder and are used in conjunction with behavioral therapy. Long-term use of these medications is not recommended due to potential side effects, such as the rebound phenomenon (the original problem returns at a higher level), and the risk of developing a dependence on these drugs.

Non-benzodiazepine Hypnotics. These medications, such as Ambien, Sonata and Lunesta, are gaining popularity because they do not have a significant effect on the regular sleep cycle and are not associated with the rebound phenomenon seen with benzodiazepines. Ambien and Sonata are good short-term options for treating sleep problems, while Lunesta, a newer sleep medicine, is approved for long-term use.

Enhancing environmental cues

This is a part of the treatment of circadian rhythm disorders once a regular pattern of sleep-wake cycle has been established. It is also very important to provide as many circadian signals or ‘zeitgebers’ as possible.

Patients are encouraged to keep a dark quiet room during sleep and a well-lit room upon awakening

Lower night time temperatures (8° lower than daytime temperature) darker evening and dark nights, with very bright morning and daytime light are all helpful

Avoid bright light exposure in the evening

Enforce regular mealtimes and other activities