Articlebronze2005

The Treatment of Early-Morning Awakening Insomnia With 2 Evenings of Bright Light

Leon Colburn Lack · Helen Wright · Kristyn Kemp · Samantha Gibbon

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Abstract

STUDY OBJECTIVE: To assess the effectiveness of brief bright-light therapy for the treatment of early-morning awakening insomnia. PARTICIPANTS: Twenty-four healthy adults with early-morning awakening insomnia were assigned to either the bright-light condition (2,500-lux white light) or the control (dim red light) condition. MEASUREMENTS AND RESULTS: The circadian phase of rectal temperature and urinary melatonin rhythms were assessed with 26-hour constant routines before and after 2 evenings of light therapy. Sleep and daytime functioning were monitored using sleep diaries, activity monitors, and mood scales before light therapy and for 4 weeks during the follow-up period. While there were no significant circadian phase changes in the dim-light control group, the bright-light group had significant 2-hour phase delays of circadian temperature and melatonin rhythm. Compared to pretreatment measures, over the 4-week follow-up period, the bright-light group had a greater reduction of time awake after sleep onset, showed a trend toward waking later, and had a greater increase of total sleep time. Participants in the bright-light condition also tended to report greater reductions of negative daytime symptoms, including significantly fewer days of feeling depressed at the 4-week follow-up, as compared with the control group. CONCLUSION: Two evenings of bright-light exposure phase delayed the circadian rhythms of early-morning awakening insomniacs. It also improved diary and actigraphy sleep measures and improved some indexes of daytime functioning for up to 1 month after light exposure. The study suggests that a brief course of evening bright-light therapy can be an effective treatment for early-morning awakening insomniacs who have relatively phase advanced circadian rhythms.

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References

2003The Role of Actigraphy in the Study of Sleep and Circadian Rhythms 2003Practice Parameters for the Role of Actigraphy in the Study of Sleep and Circadian Rhythms: An Update for 2002 1993Alleviation of Sleep Maintenance Insomnia with Timed Exposure to Bright Light 1993The Effect of Evening Bright Light in Delaying the Circadian Rhythms and Lengthening the Sleep of Early Morning Awakening Insomniacs

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2014Position statement on pediatric sleep for psychiatrists.2017Circadian Phase and Phase Angle Disorders in Primary Insomnia 2007Sleep and aging: 2. Management of sleep disorders in older people 2009Scheduled Bright Light for Treatment of Insomnia in Older Adults 2008Sleep and Its Disorders in Seniors 2007Treating chronobiological components of chronic insomnia 2023Light therapy in insomnia disorder: A systematic review and meta‐analysis 2015Nonpharmacologic Management of Chronic Insomnia.

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