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SAD and Lightbox Therapy

Irregular Sleep-Wake Rhythm? Shift work Sleep Disorder? Jet lag? Disturbed and broken sleep? Winter blues?

Light Box Therapy can work well for SAD and Circadian Rhythm Problems

In the UK, the maximum 16 hours and 50 minutes of sunlight - on the longest day in June (the summer solstice) - dwindles to just seven hours and 40 minutes six months later in December (the winter solstice).

On the last Sunday in October at 2am the UK reverts to Greenwich Mean Time (GMT) by going back one hour, to 1am. This marks the official end of British summertime. It’s also the time when, in a recent survey, 40 per cent of people said the “winter blues” officially kick in. The same group suggested they only expect to see around three-and-a-half hours of daylight on weekdays, but slightly more at the weekend (3hrs 45mins).

If you struggle to sleep well at night, especially with insomnia or a circadian rhythm disorder, keeping to a regular wake-up time coupled with exposure to morning sunlight can be an extremely helpful combination. It is also useful in cases where difficulties with mood as the result of seasonal changes in the length of the day lead to symptoms of winter depression or seasonal affective disorder (SAD).

Ideally, your exposure to sunlight should be within the first hour of getting out of bed and the best sunlight exposure is that taken out of doors directly into the eyes for 30-45 minutes Take a walk or sit outside to have breakfast or read the newspaper, but make sure the light is hitting your eyes directly. Do not wear sunglasses. Even if the day is overcast, the sunlight will filter through the clouds or even the rain and continue to have its effect.

This advice is fine in Britain’s summer months, but less practicable in the darker mornings of winter. This is when doctors recommend the use of a Light Box. These provide an intensity of soft white light of about 10,000 lux or less toward the red end of the colour spectrum. This compares with sun's light intensity of 100,000 lux.

Light Box Therapy, sometimes called phototherapy, can help you sleep better and feel significantly more alert during the day.

Symptoms that are particularly responsive to light box therapy include: - Insomnia - Excessive morning sleepiness or hypersomnia - Winter or seasonal depression - Lethargy

If you feel that you have symptoms or a condition that might be responsive to light box phototherapy, you may wish to consult with your doctor before selecting a light box.

How to Use a Light Box for Phototherapy

During phototherapy treatment with a light box, your eyes should remain open. It is best if the light is incidental to your sight. The benefits of a light box occur at the periphery of our vision so instead of staring directly into the light box, set it off to the side and look towards something else. You may want to watch television, use your computer, or read while you are using the light.

Light exposure can be varied depending on the condition. Start with one 10-15 minute session of light exposure per day upon waking and gradually increase this exposure to 30-45 minutes per day, depending on your response. Some light boxes come with a timer to help manage your sessions. Most people use the light box for 15-30 minutes daily upon awakening and typically see a response over several weeks.

Circadian Disorders

For those with a misaligned sleep schedule from a circadian rhythm disorder, the use of a light box may be helpful to shift your sleep to the desired time.

  • Delayed Sleep Phase Syndrome: This is where you are falling asleep too late and are sleeping in or excessively sleepy in the morning. This conditions affects about 10% of people and often begins in teenagers. You should use the light box in the morning.

  • Advanced Sleep Phase Syndrome: If you are falling asleep too early and wake before you would like, the light box can be used in the evening.

If effective, these treatments will be lifelong.

Seasonal Affective Disorder (Winter Depression)

For those with Seasonal Affective Disorder (Winter Depression) or Sub-Syndrome SAD best results are from morning use. Light box therapy should be continued until natural exposure to sunlight is available sometime in Spring.

If it is effective, individuals with SAD will require lifelong treatment during the winter months.

Light therapy has very few side effects and is usually well-tolerated. If your symptoms are persistent, you may wish to increase the exposure to twice per day but it is typically recommended that you do not exceed 90 minutes per day.

Sources:

American Academy of Sleep Medicine. "International classification of sleep disorders: Diagnostic and coding manual." 2nd ed. 2005.

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders." 4th ed. American Psychiatric Association, Washington DC, 2000.

Chesson, AJ, et al. "Practice parameters for the use of light therapy in the treatment of sleep disorders." Standards of Practice Committee, American Academy of Sleep Medicine. Sleep. 1999; 22:641.

Eagles, JM. "Seasonal affective disorder." Br J Psychiatry. 2003; 182:174.

Eastman, CI et al. "Bright light treatment of winter depression: a placebo-controlled trial." Arch Gen Psychiatry. 1998; 55:883.

Golden, RN et al. "The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence." Am J Psychiatry. 2005; 162:656.

Partonen, T., et al. "Seasonal affective disorder." Lancet 1998; 352:1369.

Terman M et al. "A controlled trial of timed bright light and negative air ionization for treatment of winter depression." Arch Gen Psychiatry. 1998; 55-875

See a range of Light Boxes, Simulated Daylight LightBulbs and Wake-up Lights here.

The information AllergyBestBuys provides should not be considered medical advice, nor is it intended to replace consultation with a qualified physician

 

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