10 November 2014

Sleep Hygiene Tip of the Week || SHED SOME LIGHT: Teens can benefit from "happy lights"

One of the biggest circadian rhythm problems relates to Delayed Sleep Phase Disorder (DSPS), in which teenagers, due to the developmental nature of their changing brains, tend to fall asleep later and require sleeping later in the morning.

It's a challenge because teens have been shown to be at risk for sleep deprivation because of late bedtimes mixed with school start times which are too early. Also, those kids who are active in sports or jobs which have challenging hours may also struggle to get more than 5 hours a sleep a night because they have practices or shifts that cut into their homework and sleep schedules.

Society, on the one hand, demands that we keep our kids busy, but the price they often pay to stay out of trouble is sleep deprivation, which can contribute to other kinds of trouble: poor grades, motor vehicle accidents, mood disorders.

So how are we to get adolescents out of bed in the morning with so much stacked against them? Using phototherapy can help.

In one randomized parallel clinical trial, the use of bright light (compared to dim light) as part of a sleep phase adjustment protocol was shown to improve morning sleepiness in the subjects. Bright light was defined as measuring at 2700 lux, while dim light was measured as 0.1 lux. Phototherapy in this study was delivered via a special mask.

The sleep phase adjustment protocol in this experiment was designed for nine weeks: one week to establish a baseline sleep schedule for each subject, then four weeks of chronotherapy treatment which included one-hour shifts in bedtimes per week with no naps or bright light after 5pm, followed by four weeks of followup.

Not only did bright light help improve morning sleepiness, but the overall treatment protocol for DSPS in this study ultimately suggested that complete adjustment therapies using chronotherapy without bright light treatments were not as effective.

If you have a teenager who struggles to get out of bed in the morning, and there are no other options for them (such as delayed school start time), it might be a good idea to visit the doctor to discuss the possibility of a sleep phase adjustment using both phototherapy and chronotherapy. A doctor will, at this time, want to rule out other causes for daytime sleepiness, such as narcolepsy or sleep apnea. If the doctor determines that your teen has DSPS, they will wish to work with you and them on a behavior therapy that the teen must follow to reset their rhythms; it requires strict adherence to a bedtime protocol, careful use of lighting, and a sleep diary, among other things. It has been shown to be helpful and doesn't usually require medication.
This Verilux product, the Rise & Shine Serenity series,
gives timed light that mimics natural sunrise and sunset times.
It may be useful in resetting circadian rhythms in teens
suffering from DSPS.
Image courtesy Verilux.

In addition, the investment of a so-called "happy light" can be very useful. Full-spectrum lighting systems which adjust light brightness in the teen's bedroom on a gentle timed schedule can gradually help them to adjust to nature's circadian rhythms and light cues.

Some of these come equipped with alarms, as well. Verilux offers two different systems which may work well for you. Avoid bright lighting with ultraviolet rays; most full-spectrum systems do not include it for safety reasons.