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

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to determine whether a combination of a novel lighting intervention and a behavioral intervention are able to increase total sleep time in adolescents. The main questions this trial aims to answer are whether this combination therapy is able to meaningfully increase total sleep time in adolescents, and do so over a sustained period of time, and whether such a changes is associated with concomitant changes in mood and cognitive performance.

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.

What data supports the effectiveness of this treatment 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. Additionally, cognitive-behavioral therapy combined with bright light therapy has been effective for adolescents with delayed sleep phase disorder, suggesting potential benefits for sleep deprivation. ^{1 2 3 4 5}

Is light therapy safe for humans?

Bright light therapy is generally safe for humans, with some studies reporting mild side effects like eye strain, irritability, and nausea. However, these side effects are not common, and the therapy is well-tolerated by most people. ^{1 6 7 8 9}

How does the Light Therapy + CBT treatment for teen sleep deprivation differ from other treatments?

The Light Therapy + CBT treatment is unique because it combines bright light therapy, which helps regulate the sleep-wake cycle, with cognitive behavioral therapy (CBT), which addresses the thoughts and behaviors affecting sleep. This dual approach targets both the biological and psychological aspects of sleep deprivation, unlike other treatments that may focus on just one aspect. ^{1 7 10 11 12}

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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 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]

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 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 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 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 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]

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 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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Bright light treatment as mono-therapy of non-seasonal depression for 28 adolescents. [2021]

2. England 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. [2023]

3. Switzerland pubmed.ncbi.nlm.nih.gov

[Effect of light therapy on the night sleep of children with sleep problems]. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of cognitive-behavior therapy plus bright light therapy for adolescent delayed sleep phase disorder. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

A Morning Bright Light Therapy Intervention to Improve Circadian Health in Adolescent Cancer Survivors: Methods and Preliminary Feasibility. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Bright light therapy: Minimizing light induced side effects with an innovative light setup. [2014]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Combined sleep deprivation and light therapy: Clinical treatment outcomes in patients with complex unipolar and bipolar depression. [2019]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

The acute side effects of bright light therapy: a placebo-controlled investigation. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Morning light therapy for juvenile depression and severe mood dysregulation: study protocol for a randomized controlled trial. [2021]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Sleep deprivation as a predictor of response to light therapy in major depression. [2019]

12. Germany pubmed.ncbi.nlm.nih.gov

Chronotherapeutic treatments for depression in youth. [2018]