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Light Therapy For Better Sleep
Light Therapy For Better Sleep
sleepreviewmag.com/2015/05/light-therapy-better-sleep/
The benefits of lighting that helps us sleep, improves our mood, reduces depression, or
makes us feel more alert on the job are, simply put, priceless. An expert from the Lighting
Research Center at Rensselaer Polytechnic Institute explains how to make light therapy
successful in clinical settings.
By Mariana G. Figueiro, PhD
Light is not just for vision. Humans have a biological clock located in the suprachiasmatic nuclei that generates
and regulates circadian rhythms, which are biological rhythms that repeat approximately every 24 hours. These
include cycles such as sleep-wake, body temperature, hormone production, and alertness. Light is the main
input to synchronize the biological clock to the solar day. If we are not exposed to a sufficient amount of light of
the right spectrum, for a sufficient amount of time, and with the right timing, our biological clock becomes
desynchronized with the solar day and we may experience decrements in physiological functions,
neurobehavioral performance, and sleep.1,2
A person is more likely to experience a good night of sleep when the circadian and homeostatic systems, both of
which influence the sleep-wake cycle, are aligned. Sleep homeostasis increases with time awake, contributing to
high sleep pressure at night. The circadian system sends an alerting signal to the body during the day,
counteracting the increase of sleep pressure with time awake, and a sleeping signal during the night, promoting
a consolidated night of sleep.
Another very well-known circadian rhythm is the cycle of melatonin production. Melatonin is a hormone produced
by the pineal gland at night and under conditions of darkness. For diurnal species, such as humans, melatonin
signals that it is time to sleep. The timing of melatonin onset in the evening, referred to as dim light melatonin
onset (DLMO), occurs approximately 2 hours prior to natural bedtimes, and is used as a marker of the circadian
clock. Evening exposure to sufficient light will delay the onset of melatonin, delaying bedtimes.
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Potential Applications
Keeping in mind that lighting characteristics affecting the circadian system are different than those affecting
vision, and, more importantly, that the successful application of light as therapy requires continuous monitoring of
ones light exposure during waking hours, the therapeutic value of circadian light (and dark) on special
populations has been demonstrated in laboratory and field studies.
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two ways: phase shifting and acute effects. Phase shifting effects allow permanent night shift workers to cope
with being awake at night by providing entrainment to the
night shift. However, light exposure control throughout the
24-hour day is needed, making it harder for workers to
comply with the new light regimen.
Light can increase alertness in shift workers who are still
entrained to a day shift schedule and are coping with night
shift work. In most studies to date, the alerting effects of light
have been linked to its ability to suppress melatonin, and the
suppression of melatonin by light at night has been
implicated as an endocrine disruptor and linked to an
increased risk of certain types of cancers observed in those
working rotating shifts for 20 to 30 years or more.20,21 In a
series of recent studies, however, we demonstrated that
exposures to both short-wavelength (blue) and longwavelength (red) lights in the middle of the night increased
objective and subjective alertness, reduced subjective
sleepiness, and improved certain types of performance
Sleep in Adolescents
Teenagers tend to go to sleep late and wake up late. This pattern
interferes with their normal functioning because teenagers do not sleep
for as many hours as those going to sleep at more normal hours. Light
exposure after minimum core body temperature (in the morning) and
light restriction in the evening have been shown to advance the phase
of the master clock.27 Some evidence has emerged suggesting that the
endogenous circadian period is longer, sleep pressure accumulates slower, and the sensitivity to light by the
circadian system is greater in adolescents than in adults, especially for those suffering from delayed sleep phase
disorder. In fact, recent data from our lab show that adolescents (ages 15-17 years) are more sensitive to
evening light from self-luminous devices than those in their twenties.28 Both of these phenomena would
functionally delay the timing of the adolescent circadian clock, thereby contributing to later bed and rise times.
Rigid school schedules require teens to be in class all morning, yet schools may not provide adequate light or
daylight to stimulate their circadian system, especially in dark winter months. As teenagers spend more time
indoors, they may miss out on essential morning light needed to stimulate their circadian system and promote
entrainment to the 24-hour solar day.29 In late spring, if teenagers spend more time outdoors after school, the
brains clock may be delayed by the evening daylight exposure.30 Late spring mornings may also pose a
concern because of the very early sunrises. Students who are phase delayed, and thus reach their minimum
core body temperature at later clock hours in the morning, may run the risk of receiving too much daylight in the
delay portion of the phase response curve while traveling to school in the very early morning.
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A lighting intervention designed to deliver light starting mid-morning (eg, after 9 AM) until the end of the school
day and provisions to reduce evening light exposures, such as the use of orange-tinted glasses and the control
of exposure to self-luminous devices, may help shift the timing of sleep in teenagers. Successful light therapy in
this population will likely involve both school administrators and family members.
Mariana G. Figueiro, PhD, is light and health program director at the Lighting
Research Center and professor at Rensselaer Polytechnic Institute. She is the
author of more than 60 scientific articles in her field of research, along with the
AARP-sponsored publication, Lighting the Way: a Key to Independence, which
provides guidelines for the design of lighting to meet the needs of older adults.
References
1. Leproult R, et al. Circadian misalignment augments markers of insulin resistance
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and inflammation, independently of sleep loss. Diabetes. 2014;63:1860-9.
2. Van Cauter E, et al. Metabolic consequences of sleep and sleep loss. Sleep
Med. 2008;9:S23-8.
3. Lewy A, et al. Light suppresses melatonin secretion in humans. Science. 1980;210:1267-9.
4. Zeitzer JM, et al. Sensitivity of the human circadian pacemaker to nocturnal light: melatonin phase resetting
and suppression. J Physiol. 2000;526:695-702.
5. Brainard GC, et al. Action spectrum for melatonin regulation in humans: evidence for a novel circadian
photoreceptor. J Neurosci. 2001;21:6405-12.
6. Thapan K, et al. An action spectrum for melatonin suppression: evidence for a novel non-rod, non-cone
photoreceptor system in humans. J Physiol. 2001;535:261-7.
7. Rea MS, et al. A model of phototransduction by the human circadian system. Brain Res Rev. 2005;50:213-28.
8. Khalsa SB, et al. A phase response curve to single bright light pulses in human subjects. J Physiol.
2003;549:945-52.
9. Rea MS, et al. A new approach to understanding the impact of circadian disruption on human health. J
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