Scholars@Duke
Andrew Darrell Krystal

Andrew Darrell Krystal

Professor Emeritus of Psychiatry and Behavioral Sciences
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
andrew.krystal@duke.edu
Box 3309 Med Ctr, Durham, NC 27710
54221 Hosp South, Durham, NC 27710

Overview

My research is focused on better understanding the pathophysiology of sleep disorders and mood disorders and developing improved treatments for these conditions. My primary research tools are: electroencepahlography (EEG), polysomnography (PSG), computer signal analysis and modeling, functional magnetic resonance imaging (fMRI), and positron emission tomograophy (PET). Nearly all of my projects have been carried out with humans, however, projects are ongoing with gene knock-out models in mice, and lemurs in collaboration with the Duke Primate Center. A few representative current studies are: 1) Defining physiologic (EEG, PSG, PET, fMRI) correlates of sleep complaints and subtyping insomnia on the basis of the associated pathophysiology, 2) Studying the relationship of EEG data recorded during non-REM sleep, daytime function, and insomnia treatment response, 3) Developing new pharmacologic and non-pharmacologic treatments for insomnia, 4) Studying the relationship of natural sleep and hibernation-like phenomena (torpor), 5) Predicting depression treatment response on the basis of pre-treatment EEG and structural MRI data.

Current Appointments & Affiliations

Professor Emeritus of Psychiatry and Behavioral Sciences · 2017 - Present Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences, Psychiatry & Behavioral Sciences

In the News

Published July 21, 2016
Duke to Participate in Early Clinical Trials for Emerging Neurological Therapies
Published January 21, 2016
Type A to ZZZ: The agony of industry insomnia
Published May 8, 2014
Dr. Andrew Krystal comments: Psychiatry's scientific reboot gets under way

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Recent Publications

Integrating expert knowledge into large language models improves performance for psychiatric reasoning and diagnosis.

Journal Article Psychiatry Res · January 2026 BACKGROUND AND METHODS: The authors sought to evaluate the performance of common large language models (LLMs) in psychiatric diagnosis, and the impact of integrating expert-derived reasoning on their performance. Clinical case vignettes and associated diag ... Full text Link to item Cite

The Effectiveness of Digital Cognitive Behavioral Therapy to Treat Insomnia Disorder in US Adults: Nationwide Decentralized Randomized Controlled Trial.

Journal Article JMIR Ment Health · December 4, 2025 BACKGROUND: Cognitive behavioral therapy (CBT) is recommended as the first-line treatment for insomnia; however, few patients have access to it. A new class of Food and Drug Administration (FDA)-regulated digital CBT treatments has the potential to address ... Full text Link to item Cite

Computationally Informed Insights Into Anhedonia and Treatment by Kappa Opioid Receptor Antagonism.

Journal Article Biol Psychiatry Cogn Neurosci Neuroimaging · November 2025 BACKGROUND: Anhedonia, the loss of pleasure, is prevalent and impairing. Parsing its computational basis promises to explain its transdiagnostic character. One manifestation of anhedonia, reward insensitivity, may be linked to limited memory. Furthermore, ... Full text Link to item Cite
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Recent Grants

Obstructive Sleep Apnea Screening in Pregnant Women with Chronic Hypertension

ResearchSignificant Contributor · Awarded by Society for Obstetric Anesthesia and Perinatology · 2017 - 2020

KOR Phase 2A Study - Mod 3 (Advanced Understanding)

Clinical TrialPrincipal Investigator · Awarded by National Institutes of Health · 2014 - 2017

Modified KOR Phase 2A Study

Clinical TrialPrincipal Investigator · Awarded by National Institutes of Health · 2014 - 2017

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Education, Training & Certifications

Duke University · 1987 M.D.