The science of circadian rhythms touches many subspecialties of medicine but perhaps none so inextricably as sleep. So when the 2017 Nobel Prize for Physiology or Medicine was bestowed upon 3 researchers for identifying key mechanistic principles for the biological clock, advocates for the importance of sleep—seeing firsthand how sleep is often overlooked, especially in today’s fear-of-missing-out culture—celebrated the significance of the prestigious international recognition.

Using fruit flies as a model organism, US-based Nobel laureates Jeffrey C. Hall, Michael Rosbash, and Michael W. Young isolated a gene that controls the normal daily biological rhythm. This gene encodes a protein that accumulates in the cell during the night, they showed, and is then degraded during the day. Later, they identified more protein components of this machinery, exposing the mechanism governing the self-sustaining clockwork inside the cell.

Having their discoveries heralded as work that “conferred the greatest benefit on mankind” is simultaneously well-deserved and pleasantly surprising. When the scientists began their research a little over 30 years ago, not many others recognized the significance of these daily internal rhythms or their implications beyond jet lag or when flowers open and close. The prize highlights how far circadian rhythms research has come and its potential to go so much further in the future.

Research in circadian rhythms has already made a real-world positive impact on sleep by providing data showing that when a person sleeps is important, impacting both quantity and quality of sleep. Today, sleep advocates around the country use this data to convince school districts to shift start times for middle and high schoolers to 8:30 am or later. The knowledge that adolescent circadian physiology is different than that of adults and of elementary schoolers is crucial to this advocacy.

Gaining a greater understanding of the genetic underpinnings behind sleep disorders will have significant clinical impact in the future. Indeed, Young’s lab is currently working to assess how rhythmic gene and protein activities are established in cells derived from patients with sleep and depressive disorders. Among other discoveries, this work recently identified a common mutation that slows the human biological clock. People with the “night owl” variant of this gene have a long circadian cycle, making it challenging for them to stay on a normal 24-hour cycle. In an interview with Medscape in which Young was asked what aspect of his work was likely to be most relevant to human medicine, Young responded, “We are doing some work with human cultured cells, working with patients and culturing cells, to look at sleep disorders. It is very clear that a lot is going to be learned about…the inheritability of sleep disorders.”1

In the future, thanks to continuing circadian rhythms research built on the Nobel Prize-winning work, pharmaceutical companies could target circadian rhythm mechanisms directly when treating sleep disorders. We may see new drugs for disruptions like shift work sleep disorder and advanced and delayed sleep phase syndromes. Sleep clinicians would benefit from having more ways to treat patients that address a root cause of the disorder.

Sleep Review applauds Hall, Rosbash, and Young for their important work, especially for persevering in the early days when its significance was yet to be known. A win for circadian rhythms is a win for sleep.

Sree Roy is editor of Sleep Review. Email sroy[at]

1. Gozlan M. 2017 Nobel Prize Winner Michael W. Young: An Interview – Medscape. 2017 Nov 17.