Andrew Darrell Krystal

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

View All News

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

Toward Individualized Deep Brain Stimulation: A Stereoelectroencephalography-Based Workflow for Neurostimulation Target Identification.

Journal Article Neuromodulation · December 13, 2025 OBJECTIVES: Deep brain stimulation (DBS) is increasingly being used to treat a variety of neuropsychiatric conditions, many of which exhibit idiosyncratic symptom presentations and neural correlates across individuals. Thus, we have used inpatient stereoel ... 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

View All Publications

Education, Training & Certifications

Duke University · 1987 M.D.

Andrew Darrell Krystal

Overview

Current Appointments & Affiliations

In the News

Recent Publications

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

Toward Individualized Deep Brain Stimulation: A Stereoelectroencephalography-Based Workflow for Neurostimulation Target Identification.

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

Recent Grants

Obstructive Sleep Apnea Screening in Pregnant Women with Chronic Hypertension

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

Modified KOR Phase 2A Study

Education, Training & Certifications