Colin Snow
Delayed sleep phase syndrome (DSPS) is a condition that affects an individual's ability to fall asleep and wake up, with a delay of more than two hours past their intended bedtime. This syndrome is commonly treated with light therapy, which involves controlled and intentional exposure to specific kinds of light, such as artificial light or natural sunlight, to regulate the body's circadian rhythm. The treatment requires patients to sit in front of a light box for 20 to 40 minutes, preferably within an hour of waking up. This process helps suppress melatonin production, signalling to the body that it is time to wake up.
| Characteristics | Values |
|---|---|
| Treatment methods | Chronotherapy and light therapy |
| Light therapy | Exposure to artificial light to regulate the body’s circadian rhythm |
| Mechanism | Mimicking natural sunlight |
| Benefits | Improves the timing and quality of sleep |
| Effectiveness | Affects the body’s production of melatonin |
| Exposure time | 20-40 minutes |
| Light intensity | 10,000 lux |
| Light source | Natural outdoor light, full spectrum lamp, or portable visor |
| Exposure duration | 30-90 minutes |
| Timing | Morning, within an hour of waking up |
| Evening use | Avoid blue spectrum light |
| Bright light avoidance | Use dim lights in the evening |
| Alternative approach | 30 minutes of sun exposure outdoors after waking up |
| Other recommendations | Reduce light exposure from electronic devices in the evening |
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What You'll Learn
Morning light exposure
The light therapy aims to reset the body's circadian rhythm or internal clock by suppressing melatonin production, which is responsible for regulating the sleep-wake cycle. By exposing the eyes to intense yet safe levels of light, the body is signalled that it is time to wake up, thus gradually shifting the sleep schedule to a socially acceptable time.
For those unable to access natural light, artificial light sources such as a full-spectrum lamp or a portable visor at lower light intensity can be used. These artificial light sources should produce around 10,000 lux of light, and individuals can engage in other activities during the light therapy session.
It is important to note that the timing of light exposure is critical to the success of the treatment. The light must reach the retina as soon as possible after spontaneous awakening to achieve the desired effect. Some individuals have also reported success with lights that turn on shortly before awakening, simulating dawn.
Additionally, bright light avoidance in the evening is complementary to morning light exposure. Reducing exposure to electronic devices and blue spectrum light in the hours before bedtime is essential for evening melatonin production and promoting sleep.
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Evening light avoidance
To avoid evening light, individuals can turn off electronic devices at least an hour before bedtime. Additionally, closing curtains or blinds to block out external light sources, and wearing an eye mask while sleeping, can further reduce light exposure. These measures complement the morning aspect of light therapy, where individuals are encouraged to expose themselves to bright light soon after waking up, either through natural sunlight or artificial light therapy lamps.
It is important to note that the success of light therapy for DSPS depends on various factors, including the brightness, timing, frequency, and duration of light exposure. Consulting a sleep specialist is crucial to determine the correct approach, as they can provide guidance on light exposure scheduling, intensities, and other considerations for effective treatment.
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Natural vs artificial light sources
Natural light therapy involves exposing yourself to bright light first thing in the morning. You could grab a cup of coffee and sit outside, or go for a short walk. A common recommendation is 20 minutes, but a doctor will know best.
Artificial light therapy involves the use of artificial light sources, such as a full-spectrum lamp at 10,000 lux or a portable visor with lower light intensity. This can be used when natural light is not available. Morning light exposure is more effective for treating delayed sleep phase syndrome, with a recommended exposure duration of 30 to 90 minutes.
Light therapy, in general, is a proactive regimen of controlled, intentional light exposure using specific kinds of light across the spectrum to help reset the circadian system. The eyes are exposed to intense (but safe) levels of light following a specific protocol. Light therapy is used to advance or delay sleep for people who do not fall asleep or wake up at appropriate times. Treating these circadian shifts means resetting those rhythms so they can return to normal life.
The timing of light exposure is critical. For delayed sleep phase syndrome, the light must be delivered to the retina as soon as possible after spontaneous awakening to achieve the desired effect. People have also reported success with lights that turn on shortly before awakening, to simulate dawn.
It is important to note that bright light avoidance in the evening is also crucial in phototherapy. Avoiding sources of blue spectrum light is not only complementary to the efforts made in the morning but is also critical for evening melatonin production.
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Light intensity and duration
Light therapy for delayed sleep phase syndrome (DSPS) involves controlled, intentional exposure to intense (but safe) levels of natural or artificial light to reset the body's circadian rhythm. The timing, duration, and intensity of light exposure are critical to the success of the treatment.
For DSPS, light therapy is most effective when delivered to the retina as soon after spontaneous awakening as possible. Morning light exposure within an hour of waking up is ideal for resetting the circadian rhythm. A common recommendation is 20 minutes of morning light exposure, but this can vary depending on individual needs. The recommended exposure duration ranges from 30 to 90 minutes, with longer properly timed light exposure being more beneficial.
The intensity of the light is also an important factor. Light boxes producing around 10,000 lux of light are commonly recommended for light therapy. At this intensity, 30 minutes of exposure is generally sufficient, but if using a lower-intensity light source, such as a portable visor, a longer duration of 2 hours may be necessary.
It is important to note that the use of light therapy should be supervised by a sleep specialist, who can help determine the appropriate timing, duration, and intensity of light exposure based on the patient's symptoms and circumstances. Additionally, bright light avoidance in the evening is crucial to the success of light therapy, as it complements the efforts made in the morning to reset the body's rhythms and promotes evening melatonin production.
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Complementary treatments
Light therapy, also known as phototherapy, is a popular treatment for people trying to improve their sleep health. It involves exposure to artificial light to regulate the body's circadian rhythm. However, it is not the only treatment available for DSPS.
Bright Light Avoidance
Bright light avoidance in the evening is an important complementary therapy to morning light exposure. Avoiding sources of blue light in particular is critical for the evening production of melatonin, which helps to regulate the sleep-wake cycle.
Cognitive Behavioural Therapy
DSPS may be a conditioned response at bedtime that requires cognitive behavioural therapy (CBTi) to correct.
Melatonin Supplements
The prescription and dosing of melatonin supplements in the evening may be part of a successful treatment protocol for DSPS.
Stimulants
Stimulants taken during the day may also be part of a successful treatment protocol for DSPS.
Chronotherapy
Sleep specialists less commonly use chronotherapy to treat DSPS. This technique aims to reset the circadian clock by slowly delaying the bedtime by about two hours every few days. However, this strategy invariably disrupts a person's normal schedule of activity.
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Frequently asked questions
Delayed sleep phase syndrome (DSPS) is a condition that affects your ability to fall asleep and wake up. People with DSPS may struggle to go to bed at a reasonable hour and often sleep well past the morning.
Light therapy, also known as phototherapy or bright light therapy, involves exposure to artificial light to regulate the body's circadian rhythm. By mimicking natural sunlight, light therapy can improve the timing and quality of sleep.
Light therapy is typically administered early in the morning, within an hour of waking up. Morning light exposure is more effective for DSPS than evening light exposure.
A light therapy session should last between 20 to 40 minutes. Patients should keep their eyes open during the session to absorb the light.
The source of light can be artificial, such as a full-spectrum lamp at 10,000 lux, or natural outdoor light. Bright light lamps or light boxes can be purchased specifically for light therapy.
