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While the role of genetic mutations in\n                    <jats:italic>PKD1<\/jats:italic>\n                    ,\n                    <jats:italic>PKD2<\/jats:italic>\n                    , and other minor genes is well established, the influence of circadian rhythms and sleep disturbances on disease progression remains underexplored. The circadian timing system, coordinated by the central clock in the suprachiasmatic nucleus and synchronized with peripheral clocks in the kidneys, regulates key physiological processes, including glomerular filtration rate (GFR), sodium handling, blood pressure, and hormone secretion. In ADPKD, circadian disruption driven by intrinsic molecular alterations and exacerbated by sleep disorders contributes to sympathetic nervous system activation, renin-angiotensin-aldosterone system (RAAS) dysregulation, and elevated vasopressin levels, all of which accelerate cyst growth and hypertension. Mechanistic links also involve the activation of the mTOR pathway, impaired fatty acid oxidation, and altered gut microbiota composition. These disturbances impair kidney function and increase the risk of cardiovascular disease. Chronotherapy and targeted sleep hygiene interventions offer promising adjunctive strategies for mitigating circadian misalignment in ADPKD. Timed administration of antihypertensives, diuretics, and disease-modifying agents, such as tolvaptan, along with melatonin supplementation, structured light exposure, and optimized physical activity patterns, may enhance therapeutic efficacy and improve quality of life (QoL). Future research should prioritize longitudinal and interventional studies incorporating circadian biomarkers to evaluate the impact of aligning therapeutic interventions with biological rhythms on kidney and cardiovascular outcomes in ADPKD.\n                  <\/jats:p>","DOI":"10.1007\/s10157-026-02970-2","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T12:09:00Z","timestamp":1792238940000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Circadian rhythms and sleep disturbances: a conceptual perspective with implications for autosomal dominant polycystic kidney disease"],"prefix":"10.1007","author":[{"given":"Niloufar","family":"Ebrahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5204-1152","authenticated-orcid":false,"given":"Amir","family":"Abdipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic F.","family":"Rahbari-Oskoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"2970_CR1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.0310","author":"FT Chebib","year":"2025","unstructured":"Chebib FT, Hanna C, Harris PC, et al. 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Rahbari-Oskoui reports the following relationships: employment with Emory University School of Medicine; consultancy roles with UpToDate, Otsuka, and Regulus; research funding from the National Institutes of Health (NIH), Sanofi, Duke University (subcontract with Oxford), Alnylam, and Vertex; honoraria from Otsuka; and author royalties from UpToDate. Dr. Rahbari-Oskoui serves as Associate Editor for BMC Nephrology and as an Editorial Board Member for the Journal of Cardiology and Vascular Medicine. He is also the Director of the PKD Center of Excellence at Emory and Medical Director of Emory Dialysis on North Decatur. Additional roles include Steering Committee Member for a PKD clinical trial with Vertex and Advisory Board Member for AstraZeneca and Regulus related to PKD therapeutic development. He has also participated in the Unbranded Speaker Bureau for Otsuka, delivering disease awareness programs in ADPKD without reference to commercial products.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}