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Light Treatment for Sleep Disorders: Consensus Report

IV. Sleep Phase and Duration Disturbances

Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 722 West 168th Street, New York, NY 10032

Alfred J. Lewy

Department of Psychiatry, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97201

Derk-Jan Dijk

Institute of Pharmacology, University of Zürich, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland

Ziad Boulos

Institute for Circadian Physiology, 1 Alewife Center, Cambridge, MA 02140

Charmane I. Eastman

Biological Rhythms Research Laboratory, Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Parkway, Chicago, IL 60612

Scott S. Campbell

Laboratory of Human Chronobiology, New York Hospital, Cornell University Medical College, 21 Bloomingdale Road, White Plains, NY 10605

Advanced and delayed sleep phase disorders, and the hypersomnia that can accompany winter depression, have been treated successfully by appropriately timed artificial bright light exposure. Under entrainment to the 24-h day-night cycle, the sleep-wake pattern may assume various phase relationships to the circadian pacemaker, as indexed, for example, by abnormally long or short intervals between the onset of melatonin production or the core body temperature minimum and wake-up time. Advanced and delayed sleep phase syndromes and non-24-h sleep-wake syndrome have been variously ascribed to abnormal intrinsic circadian periodicity, deficiency of the entrainment mechanism, or—most simply—patterns of daily light exposure insufficient for adequate phase resetting. The timing of sleep is influenced by underlying circadian phase, but psychosocial constraints also play a major role. Exposure to light early or late in the subjective night has been used therapeutically to produce corrective phase delays or advances, respectively, in both the sleep pattern and circadian rhythms. Supplemental light exposure in fall and winter can reduce the hypersomnia of winter depression, although the therapeutic effect may be less dependent on timing.

Key Words: sleep • circadian rhythms • light • phototherapy • delayed sleep phase syndrome • advanced sleep phase syndrome • non-24-h sleep-wake syndrome • hypersomnia • seasonal affective disorder

Journal of Biological Rhythms, Vol. 10, No. 2, 135-147 (1995)
DOI: 10.1177/074873049501000206


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