Light Therapy + CBT for Teen Sleep Deprivation

Overseen By Jamie Zeitzer, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Must not be taking: Sleep medications

Disqualifiers: Prone sleeping position

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

Compensation: Varies

Number of Visits: Unknown

Duration: 20 weeks

160 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if combining light therapy with cognitive behavioral therapy (CBT) can improve sleep, mood, and thinking skills in teenagers. Participants will receive either real light therapy with CBT or a sham (inactive) light with CBT. Teens aged 14-18 who are full-time high school students and can adjust their bedtime might be suitable candidates. As an unphased trial, this study provides a unique opportunity for teens to explore innovative treatments that could enhance their sleep and overall well-being.

Will I have to stop taking my current medications?

If you are currently taking any medications specifically for sleep disorders, you will need to stop taking them to participate in this trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that combining light therapy with cognitive behavioral therapy (CBT) can help teens sleep longer. This combination can increase sleep by about 43 to 45 minutes each night, offering a promising improvement for better sleep habits.

Light therapy, which uses flashes of light to reset the body's internal clock, is generally safe. Studies have not reported any major safety issues. CBT, a type of talk therapy, is also safe and helps change unhelpful thoughts and behaviors.

Overall, both treatments have been safely used in teens, with no significant reports of negative effects in the research. This makes them a potentially safe option for teens who have trouble sleeping. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about combining light therapy with cognitive behavioral therapy (CBT) for teen sleep deprivation because it offers a two-pronged approach unlike most current treatments. While CBT helps address behavioral patterns affecting sleep, light therapy directly targets the body's natural sleep-wake cycle by using timed light flashes to simulate a natural wake-up signal. This combination could potentially help reset the body's internal clock more effectively and quickly than traditional sleep aids or behavioral interventions alone.

What evidence suggests that this trial's treatments could be effective for increasing sleep time in adolescents?

This trial will compare the effects of light therapy combined with cognitive behavioral therapy (CBT) to sham light therapy combined with CBT. Research has shown that combining light therapy with CBT can significantly improve sleep in teenagers. Specifically, studies have found that this combination can help teens sleep about 45 minutes more each night. Light therapy adjusts the body's internal clock, making it easier for teens to fall asleep earlier and sleep longer. CBT changes sleep habits and thoughts about sleep to enhance sleep quality. These findings offer promising solutions for addressing sleep deprivation in adolescents. ^{1 3 5 6 7}

Are You a Good Fit for This Trial?

This trial is for teens aged 14-18 who are full-time students in grades 9-12. They should be willing and able to go to bed earlier, and plan on sleeping at home most of the time during the study. Teens taking sleep medications or those who only sleep face-down cannot participate.

Inclusion Criteria

Planning on sleeping at home in their bedroom for at least 75% of the study

I am either male or female.

I am between 14 and 18 years old and currently in high school.

Exclusion Criteria

I am taking medication for sleep problems.

You only sleep on your stomach.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a combination of light therapy and cognitive behavioral therapy to increase total sleep time

20 weeks

Weekly sessions (in-person or virtual)

Follow-up

Participants are monitored for changes in mood and cognitive performance after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• CBT
• Light
• Sham Light

Trial Overview The trial tests if a new lighting intervention combined with behavioral therapy (CBT) can help teens sleep longer. It checks whether this approach not only increases total sleep time but also improves mood and cognitive performance over an extended period.

How Is the Trial Designed?

Group I: Light + Cognitive Behavioral Therapy (CBT) Experimental Treatment 2 Interventions

1 hour of light flashes (typical wake time - 75 min → typical wake time - 15 min) and cognitive behavioral therapy

Group II: Sham light + CBT Active Control 2 Interventions

1 hour of sham light flashes (one flash) and cognitive behavioral therapy

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

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]

This pilot study will evaluate the effects of 2 weeks of morning bright-light therapy on juvenile depression and severe mood dysregulation in 60 patients aged 12 to 18, aiming to address both depressive symptoms and sleep-wake rhythm disturbances.

The study will compare the effects of active light therapy (10,000 lux) versus inactive light (100 lux) over 10 sessions, measuring outcomes such as depression severity, sleep quality, and melatonin levels to assess the therapy's efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Morning light therapy for juvenile depression and severe mood dysregulation: study protocol for a randomized controlled trial. Bogen, S., Legenbauer, T., Bogen, T., et al.[2021]

In a study involving 20 healthy participants, a new bright light therapy (BLT) cabin showed no reports of headaches, which are a common side effect of conventional BLT devices.

While some participants experienced blurring of vision (21.1% prevalence), the absence of headaches suggests that this new technology may improve patient adherence to treatment for seasonal depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bright light therapy: Minimizing light induced side effects with an innovative light setup. Leichtfried, V., Kantner-Rumplmair, W., Bartenbach, C., et al.[2014]

In a study involving 33 inpatients, the combination of total sleep deprivation (TSD) for one night followed by bright light therapy (BLT) did not show significant improvements in depression symptoms compared to a control group that received sleep hygiene advice.

Despite the lack of effectiveness in rapidly relieving depression, the TSD and BLT treatment was found to be feasible and well-accepted by participants, with low dropout rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial. Ioannou, M., Szabó, Z., Widmark-Jensen, M., et al.[2021]

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]

The TranS-C cognitive behavioral sleep intervention significantly reduced the severity of Major Depressive Disorder (MDD) in adolescents with evening circadian preference, showing lasting effects up to 12 months after treatment.

Improved alignment between circadian biology and sleep-wake behavior was identified as a key mechanism for the reduction in depression symptoms, suggesting that addressing sleep patterns can be crucial in treating depression in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Report from a randomized control trial: improved alignment between circadian biology and sleep-wake behavior as a mechanism of depression symptom improvement in evening-type adolescents with depressive symptoms. Asarnow, LD., Soehner, A., Dolsen, E., et al.[2023]

A preliminary study involving 8 adolescent cancer survivors tested a nurse-guided bright white light (BWL) therapy intervention, showing it was feasible for participants to manage BWL at home with minimal side effects.

Participants used BWL for an average of 15 minutes daily over 28 days, with most reporting mild adverse events, indicating that this approach could potentially support circadian health in this population, though further research with larger groups is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Morning Bright Light Therapy Intervention to Improve Circadian Health in Adolescent Cancer Survivors: Methods and Preliminary Feasibility. Rogers, VE., Mowbray, C., Rahmaty, Z., et al.[2021]

In a study involving 62 juvenile inpatients with moderate to severe depression, both wake therapy followed by bright light therapy and bright light therapy alone led to decreased depressive symptoms and improved sleep quality.

Bright light therapy alone showed continued improvement in depressive symptoms two weeks after treatment, while the one-night wake therapy did not provide lasting benefits, highlighting the potential of bright light therapy as a more effective long-term intervention for juvenile depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chronotherapeutic treatments for depression in youth. Gest, S., Holtmann, M., Bogen, S., et al.[2018]

A study involving healthy young adults found that a single 30-minute session of bright light therapy (10,000 lux) did not lead to significantly more side effects compared to dim red light exposure, suggesting it is safe for short-term use in this population.

While both groups reported slight increases in eye strain and blurred vision, these effects were not significantly higher in the bright light therapy group, indicating that adverse effects may be less common in non-clinical populations than previously thought.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The acute side effects of bright light therapy: a placebo-controlled investigation. Botanov, Y., Ilardi, SS.[2023]

In a study of 26 patients with unipolar or bipolar depression, combined chronotherapy (sleep deprivation and light therapy) led to significant reductions in depression severity, with IDS-C scores dropping from an average of 39.3 before treatment to 28.4 at week 2 and 28.6 at week 4.

The overall response rate to this treatment was 34.6%, and the remission rate was 19.2%, suggesting that combined chronotherapy can provide rapid and lasting benefits for patients, including those with treatment-resistant depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Combined sleep deprivation and light therapy: Clinical treatment outcomes in patients with complex unipolar and bipolar depression. Sikkens, D., Riemersma-Van der Lek, RF., Meesters, Y., et al.[2019]

In a study of 40 inpatients with major depressive disorder, those who responded positively to total sleep deprivation (TSD) showed significantly better improvement with subsequent light therapy compared to those who did not respond to TSD.

The study suggests that a positive response to TSD may predict a beneficial outcome from light therapy, although no significant difference was found between the effects of bright white light and dim red light during treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sleep deprivation as a predictor of response to light therapy in major depression. Fritzsche, M., Heller, R., Hill, H., et al.[2019]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6763980/

Effect of Light Flashes vs Sham Therapy During Sleep With ... The combination of light flash therapy and cognitive behavioral therapy significantly and stably increased total sleep time by nearly 45 minutes per night.

2. med.stanford.edu med.stanford.edu/news/all-news/2019/09/teens-sleep-43-more-minutes-per-night-after-combo-of-two-treatme.html

Teens sleep 43 more minutes per night after combo of two ... Stanford researchers increased how long teens slept with light therapy, used to reset their circadian clocks, combined with cognitive behavioral therapy.

3. withpower.com withpower.com/trial/phase-sleep-deprivation-6-2022-c5eb3

Light Therapy + CBT for Teen Sleep Deprivation Research shows that bright light therapy can help improve sleep patterns in adolescents by encouraging earlier sleep onset and longer sleep periods.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10693907/

Electric Lighting, Adolescent Sleep and Circadian Outcomes ... Effect of Light Flashes vs Sham Therapy During Sleep With Adjunct Cognitive Behavioral Therapy on Sleep Quality Among Adolescents: A Randomized Clinical Trial.

5. clinicaltrials.gov clinicaltrials.gov/study/NCT05555186

The Effects of Bright Light Therapy on Adolescent's Sleep ... Indeed, bright light therapy (BLT) has been shown to be a promising treatment to improve sleep and decrease depressive symptoms among different patient groups.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12575478/

Piloting a brief digital behavioral intervention for adolescent ... The current study examined the combined effect of light flash therapy during sleep with an online behavioral intervention on adolescent sleep ...

7. clinicaltrials.gov clinicaltrials.gov/ct2/show/NCT06036420

Flashed Light Therapy for Adolescents with ADHD and ... Effect of Light Flashes vs Sham Therapy During Sleep With Adjunct Cognitive Behavioral Therapy on Sleep Quality Among Adolescents: A Randomized Clinical Trial.