Morning Bright Light for Adolescent Sleep Patterns

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Rush University Medical Center

Must not be taking: Melatonin, OTC sleep aids

Disqualifiers: Psychotic, Bipolar, Neurological, Sleep, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how morning bright light exposure (also known as Bright Light Therapy or Phototherapy) might assist teenagers with late sleep patterns caused by shifts in their internal body clocks. The research aims to determine if adjusting sleep times and evening light exposure can enhance the effectiveness of morning light in helping teens fall asleep earlier. It involves different groups experiencing varying levels of sleep restriction to find the optimal balance for shifting sleep schedules. Teens aged 14-17 who are fully vaccinated for COVID-19 and can speak English might be suitable candidates if they do not have chronic medical conditions or use certain medications. As an unphased trial, this study offers a unique opportunity for teens to contribute to understanding how light exposure can improve sleep patterns.

Will I have to stop taking my current medications?

Yes, you will need to stop taking any prescribed medications (except birth control pills) and over-the-counter medications that can affect sleep or melatonin.

What prior data suggests that morning bright light therapy is safe for adolescents?

Research has shown that bright light therapy, often used in the morning, is generally safe for people, including teens and children. Studies have found that it can improve sleep patterns without causing major side effects. Most people tolerate this treatment well, and there are no reports of serious problems from morning bright light exposure. This therapy typically involves sitting near a light box for about 30 minutes each morning. While bright light therapy is effective for sleep issues, it does not always outperform other treatments, such as a placebo, in every situation. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using morning bright light to help improve adolescent sleep patterns because it offers a natural, non-pharmacological approach to managing sleep issues. Unlike traditional treatments like melatonin supplements or behavioral therapy, morning bright light aims to reset the body's internal clock by exposing teens to natural light at a specific time. This method could help align sleep schedules more effectively with the natural day-night cycle, potentially offering a quicker and more holistic way to improve sleep quality without medication.

What evidence suggests that morning bright light therapy could be effective for improving adolescent sleep patterns?

This trial will compare the effects of different sleep restriction schedules on adolescent sleep patterns. Research has shown that exposure to bright light in the morning can reset the body's internal clock, helping teenagers fall asleep earlier. Studies have found that this can improve sleep timing, reduce the time it takes to fall asleep, and increase overall sleep duration. Teenagers have reported feeling more alert and in a better mood during the day after using bright light therapy. However, insufficient sleep or excessive evening light exposure may reduce the benefits of morning bright light. Early findings suggest that limiting evening light and ensuring adequate sleep can enhance the positive effects of morning bright light therapy. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for teens aged 14-17 who speak English and are fully vaccinated against COVID-19. It's not for those with unusual sleep patterns, current illness, certain medication use (except birth control), severe mood symptoms, color blindness, recent eye surgery, drug or alcohol use, significant mental or physical health issues, recent travel across time zones, or melatonin/OTC sleep med usage.

Inclusion Criteria

Participants are fully vaccinated for COVID-19

Participants and parents have sufficient knowledge of the English language

I am between 14 and 17 years old.

Exclusion Criteria

I experience severe symptoms before my period that affect my daily life.

Color blind as determined by the Ishihara color blindness test, or eye surgery to correct for lens curvature

Positive test for alcohol at the beginning of the 7-day lab stay

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline

Participants undergo a baseline week with 10-hour sleep opportunities to establish initial sleep patterns

1 week

Experimental Manipulation

Participants are assigned to different levels of sleep restriction and evening light exposure, followed by morning bright light exposure

2 weeks

Daily monitoring in the laboratory

Follow-up

Participants are monitored for changes in circadian phase and sleep patterns after the experimental manipulation

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Morning bright light

Trial Overview The study tests if morning bright light can help teenagers wake up earlier by adjusting their body clocks. It looks at how sleep restriction and evening household light affect this process. The goal is to find the right balance of these factors to improve teens' sleep schedules.

How Is the Trial Designed?

Group I: 4.5 hours of sleep restriction Experimental Treatment 1 Intervention

Bedtime will be 4.5 hours later than baseline.

Group II: 3 hours of sleep restriction Experimental Treatment 1 Intervention

Bedtime will be 3 hours later than baseline.

Group III: 1.5 hours of sleep restriction Experimental Treatment 1 Intervention

Bedtime will be 1.5 hours later than baseline.

Group IV: 0 hours of sleep restriction Active Control 1 Intervention

Bedtime will be the same as baseline.

Morning bright light is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Bright Light Therapy for:

• Circadian rhythm disorders
• Seasonal affective disorder
• Sleep phase delay

Approved in European Union as Light Box Therapy for:

• Circadian rhythm disorders
• Seasonal affective disorder
• Sleep phase delay

Approved in Canada as Phototherapy for:

• Circadian rhythm disorders
• Seasonal affective disorder
• Sleep phase delay

Who Is Running the Clinical Trial?

Rush University Medical Center

Lead Sponsor

Trials

448

Recruited

247,000+

Published Research Related to This Trial

A school-based motivational sleep education program combined with bright light therapy (BLT) and/or parental involvement significantly improved sleep knowledge, sleep onset latency, total sleep time, and mood among 193 adolescents over a 4-week period.

All intervention groups showed similar benefits compared to the control group, particularly for students with delayed sleep timing, suggesting that these educational strategies can effectively enhance sleep health in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of novel school-based interventions for adolescent sleep problems: does parental involvement and bright light improve outcomes? Bonnar, D., Gradisar, M., Moseley, L., et al.[2019]

A study involving 37 adolescents showed that exposure to bright light for 2.5 hours on weekend mornings can significantly advance their circadian rhythms by about 1 hour, helping them fall asleep earlier.

This method of using morning bright light treatment is a feasible approach to improve sleep patterns in adolescents who typically have late bedtimes and insufficient sleep during school nights.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Circadian Phase Advances in Response to Weekend Morning Light in Adolescents With Short Sleep and Late Bedtimes on School Nights. Misiunaite, I., Eastman, CI., Crowley, SJ.[2020]

A study involving 3201 secondary education students found that adolescents with a preference for staying up late (eveningness orientation) experienced significant sleep problems, including difficulties with sleep timing and quality.

The research suggests that adjusting school start times to be later and providing education on sleep hygiene could help align adolescents' natural sleep patterns with their school schedules, potentially improving their overall sleep health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Morningness-eveningness correlates with sleep time, quality, and hygiene in secondary school students: a multilevel analysis. Vollmer, C., Jankowski, KS., Díaz-Morales, JF., et al.[2018]

A randomized controlled trial involving 49 adolescents with delayed sleep phase disorder (DSPD) showed that combining cognitive-behavior therapy (CBT) with bright light therapy (BLT) significantly improved sleep-related issues, with moderate-to-large effects observed immediately after treatment.

At a 6-month follow-up, the CBT plus BLT group maintained improvements in sleep patterns and daytime functioning, with only 13% still meeting DSPD criteria, indicating the long-term efficacy of this combined treatment approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of cognitive-behavior therapy plus bright light therapy for adolescent delayed sleep phase disorder. Gradisar, M., Dohnt, H., Gardner, G., et al.[2021]

In a study involving 28 adolescents aged 14 to 17 with mild depressive disorder, bright light therapy (2,500 Lux) significantly improved depressive symptoms compared to a placebo (50 Lux), demonstrating its efficacy as a treatment option.

The study found no significant adverse reactions to bright light therapy, indicating it is a safe intervention for treating depression in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bright light treatment as mono-therapy of non-seasonal depression for 28 adolescents. Niederhofer, H., von Klitzing, K.[2021]

Bright Light Therapy (BLT) is a promising and tolerable treatment for adolescent depression, showing few side effects, but there is a significant lack of well-powered studies to confirm its efficacy in this age group.

Current evidence suggests that while BLT is effective for adults, more research is needed to establish its effectiveness, feasibility, and acceptability specifically for adolescents with depressive disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Light Therapy for Adolescent Depression: A Scoping Review. Ballard, R., Parkhurst, J., Julian, K., et al.[2023]

Light therapy significantly improved sleep onset and nighttime sleep in a small group of 28 children aged around 10 years, reducing the time it took for them to fall asleep by approximately 10 minutes.

The study suggests that the positive effects of light therapy observed in adolescents may also apply to children, although further research is needed to confirm these findings and better understand the circadian effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effect of light therapy on the night sleep of children with sleep problems]. Wessolowski, N., Barkmann, C., Stuhrmann, LY., et al.[2020]

A study involving 26 healthy adolescents (ages 13-18) found that using a bright light therapy device for 30 minutes each morning significantly improved alertness, attention, and math performance, particularly when the device was used consistently (57% of the recommended time).

Bright light therapy was associated with increased brain activity in areas related to attention and improved sleep cycle consistency, although it did not significantly affect sleep onset or duration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bright light therapy and early morning attention, mathematical performance, electroencephalography and brain connectivity in adolescents with morning sleepiness. Teicher, MH., Bolger, E., Garcia, LCH., et al.[2023]

In a study of 31 older adults with early morning awakening, bright light therapy (10,000 lux) showed a significant effect on the time spent in bed after final morning awakening, but had limited overall impact on sleep quality as measured by actigraphy.

Despite the mixed results, the study suggests that bright light therapy remains a potential treatment option for early morning awakening, although factors like light exposure timing and compliance may need to be addressed for better efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bright light treatment has limited effect in subjects over 55 years with mild early morning awakening. Pallesen, S., Nordhus, IH., Skelton, SH., et al.[2006]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1389945718300364

A randomised controlled trial of bright light therapy and ... Adolescents had improved sleep timing, SOL and daytime functioning post-treatment. •. There were no significant differences in outcomes between treatment groups ...

2. withpower.com withpower.com/trial/phase-5-2021-fb15e

Morning Bright Light for Adolescent Sleep Patterns Morning bright light exposure from light boxes can shift rhythms earlier (phase advance) to facilitate earlier sleep onset, and reduce circadian misalignment ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10885037/

Bright Light Therapy for Major Depressive Disorder in ... Results: Of the nine enrolled adolescents, the rate of daily use of the light therapy box was 100% at week 2, 78% at week 4 (n = 7), and 67% at ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT04921215?cond=Chronobiology&viewType=Table&rank=7

NCT04921215 | Teen Sleep and Light Study Studies of adults, however, indicate that restricted sleep and exposure to evening light due to late bedtimes make morning bright light less effective in ...

5. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/29680419/

A randomised controlled trial of bright light therapy and ... Improvements in sleep timing (d = 0.53-0.61), sleep onset latency (d = 0.57), total sleep time (d = 0.51), and daytime functioning (d = 0.52-1.02) were ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6746555/

Bright Light Therapy: Seasonal Affective Disorder and Beyond In general, BLT is performed early in the morning using a device known as a light box. ... Combined total sleep deprivation and light therapy in the treatment of ...

7. jamanetwork.com jamanetwork.com/journals/jamapsychiatry/fullarticle/2816353

Bright Light Therapy as Add-On to Inpatient Treatment in ... The findings in this study did not indicate superiority of bright light therapy over placebo red light therapy in a large sample of adolescent inpatients.

8. nature.com nature.com/articles/s41598-019-54311-x

Light therapy with boxes or glasses to counteract effects of ... We aimed to determine whether early light administration can counteract sleep deprivation effects, and to compare LED-glasses with a traditional light therapy ...

9. psychiatry.org psychiatry.org/news-room/apa-blogs/bright-light-therapy-beyond-seasonal-depression

Bright Light Therapy: Growing Evidence Beyond Seasonal ... Bright light therapy usually involves sitting near a light box or lamp during a 30-minute session each morning. A typical therapy light ...