The role of the circadian system is forecasting the daily and yearly change of environment. Circadian rhythm sleep-wake disorder (CRSWD) is defined as physical and social impairment caused by misalignment between circadian rhythm and desirable social schedule. CRSWDs are induced by medical or environmental factors as well as dysfunctions of circadian system. Clinicians should be aware that sleep-inducing medications, restless legs syndrome, delirium and less obedience to social schedule are frequent cause of CRSWD among elderly. Bright light therapy and orally administered small dose of melatonin or melatonin agonist at proper circadian phase are recommended treatments. Sleep-inducing medications should not be considered as CRSWD treatments, especially to elderly.