A Randomized Controlled Trial with Bright Light and Melatonin for the Treatment of Delayed Sleep Phase Disorder

Oct 18, 2013Journal of biological rhythms

Bright light and melatonin for delayed sleep phase disorder: effects on sleepiness and thinking in a controlled trial

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Abstract

Bright light and melatonin treatment may improve subjective daytime sleepiness, fatigue, and cognitive function in individuals with delayed sleep phase disorder.

All treatment conditions, including bright light and melatonin, were similarly effective in reducing subjective daytime sleepiness and fatigue over a 2-week period.
Objective measures of sleepiness showed no improvement following the 2-week intervention.
Long-term treatment with combined bright light and melatonin led to sustained improvements in subjective sleepiness, fatigue, and cognitive function over 3 months.
Participants receiving no treatment returned to baseline levels on most outcome measures after the long-term period.
Gradual advancement of rise times appears to have positive short-term effects on sleepiness and cognitive performance in patients with delayed sleep phase disorder.

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Delayed sleep phase disorder (DSPD) is a circadian rhythm sleep disorder. Patients with DSPD have problems initiating sleep if they go to bed at a conventional time, and they often have problems waking at desired times. If they rise early in the morning, they usually experience severe sleepiness during morning hours. In the present study, we investigated the short- and long-term effects on measures of subjective and objective sleepiness and cognitive function of bright light and melatonin treatment alongside gradually advanced rise times in adolescents and young adults. Four treatment conditions were used in the short-term intervention (2 weeks): dim light (placebo) + placebo capsule, bright light + placebo capsule, dim light (placebo) + melatonin capsule, and bright light + melatonin capsule. This was followed by a long-term intervention (3 months) including 2 conditions: no treatment and combined bright light + melatonin treatment. Effects of treatment on sleepiness and fatigue were the primary outcome measures, and effects on cognitive function were secondary outcome measures. On a gradual advancement of the rise time schedule, all treatment conditions (bright light, melatonin, combination, and placebo) were almost equally effective in improving subjective daytime sleepiness, fatigue, and cognitive function in the 2-week study. The 2-week intervention showed no effect on objective sleepiness. Long-term treatment increased some of the positive effects seen after 2 weeks. The combined bright light and melatonin treatment improved subjective daytime sleepiness, fatigue, and cognitive function in the 3-month study. The no-treatment group returned to baseline values on most variables. In conclusion, a gradual advancement of rise times seems to produce positive effects on subjective sleepiness, fatigue, and cognitive performance during short-term treatment of patients with DSPD. However, the benefits from gradually advanced rise times seem to wear off, suggesting that the continuation of bright light and melatonin treatment is beneficial to maintain positive effects over time.

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A Randomized Controlled Trial with Bright Light and Melatonin for the Treatment of Delayed Sleep Phase Disorder

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