Physical and rehabilitation medicine, medical rehabilitationPhysical and rehabilitation medicine, medical rehabilitation2658-68432949-1436Eco-Vector6322510.36425/rehab63225Review ArticleCircadian Rhythms and Chronic ConsciousnessKanarskiiMihail M.<p>Junior Research Associate</p>kanarMM@yandex.ruhttps://orcid.org/0000-0002-7635-1048SternMarina V.<p>MD, Cand. Sci. (Med.)</p>mstern@fnkcrr.ruVorobievaIrina S.ivorobieva@fnkcrr.ruGorshkovKirill M.kgorshkov@fnkcrr.ruKrylovaTatiana N.krylova@fnkcrr.ruGorlachevMikhail M.mgorlachev@fnkcrr.ruhttps://orcid.org/0000-0002-7277-5193GudojnikovaVictoria V.vgudojnikova@fnkcrr.ruKopylovPavel M.pkopylov@fnkcrr.ruMirzaevFaruh B.fmirzaev@fnkcrr.ruBorisovIlya V.<p>Junior Research Associate</p>realzel@gmail.comhttps://orcid.org/0000-0002-5707-118XNekrasovaYulia Yu.<p>Cand. Sci. (Tech), Research Associate</p>nekrasova84@yandex.ruhttps://orcid.org/0000-0002-4435-8501Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology29112021343403471203202112032021Copyright © 2021, Kanarskii M.M., Stern M.V., Vorobieva I.S., Gorshkov K.M., Krylova T.N., Gorlachev M.M., Gudojnikova V.V., Kopylov P.M., Mirzaev F. ., Borisov I.V., Nekrasova Y.Y.2021<p>Among the possible points of therapeutic action and predicting the outcome in patients in a vegetative state and minimally conscious state, the analysis of circadian rhythms, such as the sleep-wake cycle, melatonin secretion, temperature trends, heart rate, and blood pressure, attracts more and more attention. In this review, we analyzed studies on circadian rhythms in patients with chronic disorders of consciousness, assessed the possible limitations of standard methods, proposed a concept for the development of an assessment of the sleep-wake cycle, and assessed the role of exogenous factors that are likely to be involved in the disturbance of circadian rhythms in intensive care units. Based on the results of the study, we came to the conclusion that for the full realization of the rehabilitation potential, it is necessary to develop methods for assessing circadian rhythms based on a multicomponent approach, including 24-hour monitoring using actigraphy for more accurate identification of the rest-activity cycle, video monitoring of the orofascial area to increase the reliability of oculographic assessment and revealing hidden patterns, analysis of the temperature curve, the level of melatonin, TSH, cortisol, as well as exogenous factors. 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