Effect of Light Flashes vs Sham Therapy During Sleep With Adjunct Cognitive Behavioral Therapy on Sleep Quality Among Adolescents: A Randomized Clinical Trial
| Autor: | Lolly Starr-Glass, Jamie M. Zeitzer, Holly Batchelder, Meital Mashash, Katherine A. Kaplan, Rayma Williams |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Light therapy
Male medicine.medical_specialty Evening Adolescent medicine.medical_treatment Vision Disorders Bedtime law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Double-Blind Method law Sleep Disorders Circadian Rhythm 030225 pediatrics medicine Humans Original Investigation Psychiatry Cognitive Behavioral Therapy business.industry Research General Medicine Phototherapy Combined Modality Therapy 3. Good health Featured Cognitive behavioral therapy Sleep deprivation Online Only Treatment Outcome Research Design Physical therapy Female Sleep (system call) medicine.symptom Sleep onset business Sleep 030217 neurology & neurosurgery |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question Can adjustment of circadian timing through light flash therapy during sleep increase total sleep time in teenagers? Findings In this double-blind, placebo-controlled, randomized clinical trial of 102 adolescents, light flash therapy alone was ineffective. When delivered in combination with a cognitive behavioral therapy meant to encourage an earlier bedtime, the combination of light flash therapy and cognitive behavioral therapy significantly and stably increased total sleep time by nearly 45 minutes per night. Meaning Combination light flash therapy and cognitive behavioral therapy is an effective tool to increase sleep time and combat sleep loss in teenagers. Importance Owing to biological, behavioral, and societal factors, sleep duration in teenagers is often severely truncated, leading to pervasive sleep deprivation. Objective To determine whether a novel intervention, using both light exposure during sleep and cognitive behavioral therapy (CBT), would increase total sleep time in teenagers by enabling them to go to sleep earlier than usual. Design, Setting, and Participants This double-blind, placebo-controlled, randomized clinical trial, conducted between November 1, 2013, and May 31, 2016, among 102 adolescents enrolled full-time in grades 9 to 12, who expressed difficulty going to bed earlier and waking up early enough, was composed of 2 phases. In phase 1, participants were assigned to receive either 3 weeks of light or sham therapy and were asked to try to go to sleep earlier. In phase 2, participants received 4 brief CBT sessions in addition to a modified light or sham therapy. All analyses were performed on an intent-to-treat basis. Interventions Light therapy consisted of receiving a 3-millisecond light flash every 20 seconds during the final 3 hours of sleep (phase 1) or final 2 hours of sleep (phase 2). Sham therapy used an identical device, but delivered 1 minute of light pulses (appearing in 20-second intervals, for a total of 3 pulses) per hour during the final 3 hours of sleep (phase 1) or 2 hours of sleep (phase 2). Light therapy occurred every night during the 4-week intervention. Cognitive behavioral therapy consisted of four 50-minute in-person sessions once per week. Main Outcomes and Measures Primary outcome measures included diary-based sleep times, momentary ratings of evening sleepiness, and subjective measures of sleepiness and sleep quality. Results Among the 102 participants (54 female [52.9%]; mean [SD] age, 15.6 [1.1] years), 72 were enrolled in phase 1 and 30 were enrolled in phase 2. Mixed-effects models revealed that light therapy alone was inadequate in changing the timing of sleep. However, compared with sham therapy plus CBT alone, light therapy plus CBT significantly moved sleep onset a mean (SD) of 50.1 (27.5) minutes earlier and increased nightly total sleep time by a mean (SD) of 43.3 (35.0) minutes. Light therapy plus CBT also resulted in a 7-fold greater increase in bedtime compliance than that observed among participants receiving sham plus CBT (mean [SD], 2.21 [3.91] vs 0.29 [0.76]), as well as a mean 0.55-point increase in subjective evening sleepiness as compared with a mean 0.48-point decrease in participants receiving sham plus CBT as measured on a 7-point sleepiness scale. Conclusions and Relevance This study found that light exposure during sleep, in combination with a brief, motivation-focused CBT intervention, was able to consistently move bedtimes earlier and increase total sleep time in teenagers. This type of passive light intervention in teenagers may lead to novel therapeutic applications. Trial Registration ClinicalTrials.gov identifier: NCT01406691 This randomized clinical trial examines whether a novel intervention, using both light exposure during sleep and cognitive behavioral therapy, increases total sleep time in teenagers by enabling them to go to sleep earlier than usual. |
| Databáze: | OpenAIRE |
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