Sleep and circadian rhythms profoundly influence the crucial functions of nearly every cell and organ in the body. Understanding how this internal body clock regulates the timing of sleep and wakefulness — as well as myriad other essential physiological functions — presents unique opportunities. With the many tools and approaches available today, researchers now have the potential to develop interventions that impact a broad range of health concerns, from mental well-being and resilience to disease, to social determinants of health and public safety.

The 2021 NIH Sleep Research Plan is based on a set of research needs and opportunities identified with input from researchers, public representatives, NIH workshop participants, and programmatic staff. The scientific recommendations discussed herein are based on discussions with the Sleep Disorders Research Advisory Board (SDRAB), members of the public attending SDRAB meetings, and representatives of NIH extramural programs participating in the NIH Sleep Research Coordinating Committee (SRCC). 

Generating high-value scientific knowledge in sleep and circadian research — from basic mechanistic biology to clinical translation — will lead to new avenues for curing disease and promoting health, well-being, and safety. Taking advantage of opportunities in these still-developing sleep and circadian disciplines will require innovative strategies that will result from effective training of a diverse, interdisciplinary scientific workforce.  

This plan presents a vision that advances the mission of the National Center on Sleep Disorders Research and builds on almost three decades of unparalleled success by sleep and circadian researchers. The five strategic goals, research priorities, and tactics, all demonstrate how the sleep and circadian sciences can advance medicine and promote public health.  Additionally, the nine critical opportunities highlight the potential to broaden the landscape of biomedical sciences in the context of sleep and circadian research.

The plan incorporates crosscutting NIH priorities that address minority health and health disparities, sex as a biological variable, inclusion across the lifespan, the opioid epidemic, and how the loss of sleep health may exacerbate the risk and outcome of infectious diseases such as COVID-19. The plan also covers the development of personalized treatments for sleep and circadian disorders. That said, the opportunities identified in this research plan are not meant to be inclusive of every important research topic in sleep and circadian biology, and they do not preclude the scientific exploration of any other significant topic in this field.

The 2017 Nobel Prize in Physiology or Medicine was awarded for the discovery of the molecular mechanisms that control circadian rhythms in biological systems. This recognition reflects the convergence of advances in data science, trans-omics, computational biology, and functional brain imaging. All these have accelerated biomedical research efforts and increased our understanding of the molecular mechanisms of circadian rhythms and sleep in preclinical (animal) models. The accumulation of preclinical knowledge and methodological opportunities uniquely positions the field of sleep and circadian rhythms to translate these discoveries in ways that promote human health, prevent disease, and generate treatments and cures for patients. This new understanding of the biology of sleep and circadian rhythms presents enormous opportunities for further exploring the cellular and molecular biology of sleep, which in turn will help us to understand and target the pathobiological states that emanate from such systems. Given the cross-cutting and interdisciplinary nature of sleep and circadian rhythms, the investment of time and resources into sleep and circadian rhythms research will yield large rewards for the health and well-being of individuals and populations.