Head and neck cancer patients who report poor sleep quality one year after diagnosis had more symptoms of chronic pain and complaints of dry mouth related to radiation treatments, according to a recent study from the University of Michigan Comprehensive Cancer Center. 

Because these side effects can be controlled or modified, the study suggests that reducing these factors in head and neck cancer patients may be warranted to improve sleep hygiene and enhance quality of life.

Previous U-M studies have shown that head and neck cancer patients who reported lower physical quality of life were more likely to die from their disease.

“Sleep disturbances are a common complaint in head and neck cancer patients and have been shown to decrease quality of life, decrease mental health and serve as a predictor of other complications in the treatment of the cancer. They can also negatively affect the immune system and the ability to deal with stresses of the diagnosis,” says senior study author Jeffrey Terrell, M.D., professor of otolaryngology at the U-M Medical School.

The study found that a tracheotomy, depression, and younger age also adversely affected sleep in patients. 

“While cancer patients in general have been known to have decreased sleep quality, head and neck cancer patients may have unique issues such as facial disfigurements and side effects from treatments that can affect the mouth and throat.

These problems may thereby contribute to breathing problems which can impede sleep,” says study author Sonia A. Duffy, Ph.D., R.N., associate professor of nursing at the U-M School of Nursing and otolaryngology at the U-M Medical School and research scientist at the VA Ann Arbor Healthcare System. 

The researchers surveyed 457 people at three otolaryngology clinics who had been recently diagnosed with head and neck cancer.

Participants responded to questions about their physical and emotional quality of life, including pain, sleep health, eating and respiratory problems. The subjects were then surveyed again one year after diagnosis. 

Among those surveyed, it was found that sleep quality did not change dramatically from the time of diagnosis to one year after treatment. But quality of sleep at both time points was worse than typical sleep scores for the average person.

The researchers suggest that the relatively minor change in sleep quality one year after diagnosis may be due to symptoms and side effects from treatments such as surgery, radiation therapy and chemotherapy.

Results of the study currently appear in the online version of the journal The Laryngoscope.

“Head and neck cancer patients have a high prevalence of pain compared to other cancer sites and pain is associated with insomnia. Pain is often correlated with depression among cancer patients, and the majority of depressed patients report some sleep disturbances,” says Terrell.

“Additionally, radiation therapy to treat head and neck cancer can contribute to dry mouth, which requires excessive drinking and urination throughout the night,” Terrell said.

Based on their findings, the study authors recommend intensity-modulated radiation therapy techniques that treat head and neck cancer but avoid destroying saliva-producing glands, a practice that U-M specializes in.

This method significantly reduces the severity of permanently dry mouth, which can be a significant complication of radiation to treat head and neck cancer.

The researchers also note the importance of recognizing depression during or after head and neck cancer treatment.

Given the high incidence of dry mouth as a side effect of certain drugs that treat depression, doctors should carefully consider which medications may be better tolerated when treating these ailments among head and neck cancer patients.

“It’s imperative for patients to work with physicians to determine a cause of the sleep disorder. This is especially important given that the targeted treatment of sleep disorders is likely to improve sleep quality and therefore improve quality of life,” Duffy says.

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Adults with sleep apnea often have more heart trouble than those who sleep soundly, research from the American Heart Association demonstrates.

It’s estimated that about 90 percent of people with sleep apnea have never had an official diagnosis, so if a loved one says you gasp for air as you sleep, don’t ignore the news.

Sleep apnea is a disorder in which breathing becomes shallow or stops altogether during sleep. It can result in extreme fatigue .

Researchers looked at almost 4,500 adults 40 and older who were free of heart problems when the study began. All adults were tested for sleep apnea and then for the next eight years researchers kept track of the differences in the heart health of those with the condition and those without.

“Men with severe obstructive sleep apnea were 58 percent more likely to develop new congestive heart failure over eight years of follow up compared to men without sleep apnea,” says Daniel Gottlieb, study author and associate professor at Boston University’s School of Medicine. 

The researchers also discovered that men under the age of 70 were at much higher risk of developing coronary heart disease, a condition in which fat deposits clog blood vessels, which can lead to chest pain, blockages or a heart attack.

This is different from congestive heart failure, which is a continued weakening of the heart, leaving it less and less able to pump enough blood to keep the body going. 

Women in the study didn’t suffer from these heart and vessel problems and researchers aren’t sure whether it’s because women as a group have less sleep apnea than men or because of other factors. Gottlieb says more research is needed to understand the differences in the sexes.

Researchers suspect the connection between sleep apnea and heart trouble all begins with the shutting off of air as you sleep. Patients gasp for breath as their throats narrow or collapse preventing the flow of air into the lungs.

The lack of oxygen sets the body into a type of panic raising blood pressure, stressing the heart, and pouring sugar into the blood.

Gottlieb says those in the study with severe cases had an average of 30 breathing interruptions per hour lasting at least 10 seconds.

About 70 percent of patients suffering from the condition are obese and it’s believed added fat in the upper airway may be partly to blame. Sleep apnea is more common in those with diabetes and high blood pressure.

Fortunately getting treatment can make a great difference. Therapies include using a device to keep the airway open during sleep, or an oral appliance that is worn at night, and in some cases surgery.

“Sleep apnea is a very treatable condition and it appears that treatment may prevent the adverse health consequences of sleep apnea including heart disease, heart attack, stroke and congestive heart failure,” explains Gottlieb.

Dr. Richard Stein cardiologist and spokesperson for the American Heart Association says weight loss through diet and exercise may help those battling the condition.

He adds, “If you are obese, hypertensive or diabetic, if your partner in bed says you are snorting or snoring, if you’re waking up unrested, you should go to your doctor and ask if you have sleep apnea.”

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A popular belief that specific dietary changes can improve the symptoms of children with autism was not supported by a tightly controlled University of Rochester study, which found that eliminating gluten and casein from the diets of children with autism had no impact on their behavior, sleep or bowel patterns.

The study is the most controlled diet research in autism to date. The researchers took on the difficult yet crucial task of ensuring participants received needed nutrients, as children on gluten-free, casein-free diets may eat inadequate amounts of vitamin D, calcium, iron and high quality protein.

Unlike previous studies, they also controlled for other interventions, such as what type of behavioral treatments children received, to ensure all observed changes were due to dietary alterations.

Past studies did not control for such factors. Although no improvements were demonstrated, the researchers acknowledged some subgroups of children, particularly those with significant gastrointestinal (GI) symptoms, might receive some benefit from dietary changes.

“It would have been wonderful for children with autism and their families if we found that the GFCF diet could really help, but this small study didn’t show significant benefits,” said Susan Hyman, M.D., associate professor of pediatrics at Golisano Children’s Hospital at the University of Rochester Medical Center (URMC), who was also the principal investigator for the study.

“However, the study didn’t include children with significant gastrointestinal disease. It’s possible those children and other specific groups might see a benefit,” Hyman said.

In response to widespread parent-reported benefits, URMC initiated the trial in 2003 to scientifically evaluate the effects of the gluten-free and casein-free diet, which eliminates wheat, rye, barley and milk proteins.

Parent observation has played an important role in earlier treatment discoveries in children with autism, such as melatonin’s benefits for sleep.

Hyman’s study enrolled 22 children between 2½- and 5½-years-old. Fourteen children completed the intervention, which was planned for 18 weeks for each family. The families had to strictly adhere to a gluten-free and casein-free diet and participate in early intensive behavioral intervention throughout the study.

Children were screened for iron and vitamin D deficiency, milk and wheat allergies and celiac disease. One child was excluded because of a positive test for celiac disease and one was excluded for iron deficiency.

Other volunteers who were excluded were unable to adhere to the study requirements. The children’s diets were carefully monitored throughout the study to make sure they were getting enough vitamin D, iron, calcium, protein and other nutrients.

After at least four weeks on the strict diet, the children were challenged with either gluten, casein, both or placebo in randomized order. They were given a snack once weekly with either 20 grams of wheat flour, 23 grams of non fat dried milk, both, or neither until every child received each snack three times.

The type of snack was given in randomized order and presented so that no one observing – including the family, child, research staff and therapy team – knew what it contained. The snacks were carefully engineered to look, taste and feel the same, which was an exercise in innovative cooking.

In addition, the nutrition staff worked closely with the families to make a snack that met their child’s preferences. Casein was disguised in pudding, yogurt or smoothies and gluten in banana bread, brownies, or cookies depending on the child’s food preferences.

Parents, teachers and a research assistant filled out standardized surveys about the child’s behavior the day before they received the snack, at two and 24 hours after the snack. If the child’s behavior wasn’t usual at the scheduled snack time, the snack would be postponed until the child was back to baseline.

In addition, the parents kept a standard diary of food intake, sleep and bowel habits. Social interaction and language were evaluated through videotaped scoring of a standardized play session with a research assistant.

Following the gluten and casein snacks, study participants had no change in attention, activity, sleep or frequency or quality of bowel habits.

Children demonstrated a small increase in social language and interest in interaction after the challenges with gluten or casein on the Ritvo Freeman Real Life Rating Scale; however, it did not reach statistical significance. That means because of the small difference and the small number of participants in the study, the finding may be due to chance alone.

The investigators note that this study was not designed to look at more restrictive diets or the effect of nutritional supplements on behavior.

This study was designed to look at the effects of the removal of gluten and casein from the diet of children with autism — without celiac disease — and subsequent effect of challenges with these substances in a group of children getting early intensive behavioral intervention.

Hyman said, “This is really just the tip of the iceberg. There are many possible effects of diet including over- and under-nutrition, on behavior in children with ASD that need to be scientifically investigated so families can make informed decisions about the therapies they choose for their children.”

This study was funded by the NIH’s National Institutes of Mental Health Studies to Advance Autism Treatment Research and National Center for Research Resources (NCRR).

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Some 19 percent of soldiers returning from Iraq have migraine and migraine is suspected in another 17 percent.

While prevalence of migraine among the U.S. military is well documented, little is known about sleep quality in soldiers with chronic headaches including post-traumatic headache and migraine.

A research team from the Madigan Army Medical Center in Tacoma, WA, found that although sleep quality is poor in soldiers with post-traumatic headaches, treatment, including education, may improve the condition.

“The research sought to determine if treatment for headache and insomnia could improve sleep quality among our patients with post-traumatic headaches,” said Cong Zhi Zhao, M.D., lead author of the study.

“We found that three months after initial treatment, those with post-traumatic headache reported significantly improved sleep quality and sleep onset than baseline, although their nightmares and interrupted sleep were not significantly changed,”  Zhao said.

“Post-traumatic headache and migraine is an important cause of disability in our soldiers that affects their field performance and their lives after returning from the battlefield,” said David Dodick, M.D., president of the AHS.

“Sleep quality is an important factor which is both a result of and a contributing factor to the disability imposed by these disorders, so this work is an important step in understanding the influence of effective headache treatment on sleep quality,” he said.

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Bright light therapy has significant effects on sleep disturbances associated with combat-related post-traumatic stress disorder, according to research presented at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies.

Results indicate that bright light therapy produced a significantly greater improvement than placebo in sleep disturbances specific to PTSD. Bright light therapy also produced a moderate improvement in PTSD symptoms and depression.

“Results of this ongoing study show significant effects of bright light on disruptive nocturnal behaviors associated with combat PTSD, as well as positive effects of bright light therapy on PTSD symptom severity,” said study coordinator Shannon Cornelius, Ph.D, graduate research assistant for Dr. Shawn D. Youngstedt in the department of exercise science at the University of South Carolina in Columbia, S.C.

“Because bright light therapy is a relatively simple, self-administered, inexpensive treatment with few side effects, these results are an important step to further establish the efficacy of bright light therapy as an alternative or adjunct treatment for combat-related PTSD,” Youngstedt said.

The study involved 16 soldiers who returned to the U.S. with combat-related PTSD after serving in Operation Enduring Freedom or Operation Iraqi Freedom.

Following a one-week baseline, participants were randomized to one of two four-week treatments. Eight soldiers received 10,000 lux of bright light therapy for 30 minutes each day.

The other eight participants were assigned to the placebo group and received sham treatment with an inactivated negative ion generator.

The Clinician-Administered PTSD Scale (CAPS-2) was completed at baseline and immediately following completion of the study.

At weekly intervals, depression was assessed with the Beck Depression Inventory (BDI-II), and sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) with addendum for PTSD (PSQI-PTSD).

Cornelius noted that sleep disturbance is a commonly reported problem that can play both a precipitating and perpetuating role in PTSD, making it an important target for therapy.

“Disturbed sleep is known to interact with depression and anxiety in a vicious cycle,” said Cornelius. “By reducing the severity and occurrence of sleep disturbances, it may be possible to reduce the severity of symptoms such as anxiety and depression in combat-related PTSD.”

The study was supported by a U.S. Department of Veterans Affairs Merit Award.

The American Academy of Sleep Medicine reports that 70 to 90 percent of people with PTSD describe subjective sleep disturbance.

Recurrent nightmares of the traumatic event represent one of the most problematic and enduring symptoms of PTSD. These nightmares may take the form of a realistic reliving of the traumatic event or depict only some of its elements.

Bright light therapy exposes your eyes to intense but safe amounts of light for a specific and regular length of time. Typically it involves exposure to up to 10,000 lux of light for scheduled periods of 20 minutes or more using a small light box.

In a 2007 study published in the journal BMC Psychiatry, Youngstedt reported that bright light exposure may have an anxiolytic effect. Three hours of exposure to 3,000 lux of bright light for three consecutive days reduced anxiety in a group of low-anxiety adults.

ResMed Corp. today released the new Mirage Micro for Kids nasal mask, its second patient interface for the treatment of obstructive sleep apnea (OSA) in children.

Based on the design and personalized comfort features of the original Mirage Micro, the nasal mask now comes in a small headgear size, but also includes a small cushion suitable for children.

The typical OSA patient today is male, overweight and hypertensive. ResMed’s goal in developing the Mirage Micro for Kids was to provide an additional solution for a segment of the patient population that has traditionally been overlooked.

While the prevalence of diagnosed OSA in children seems relatively low, it has actually shown to be a common condition in childhood and can result in severe complications if not treated.

An increasing number of studies have recognized the behavioral, cognitive and health consequences associated with pediatric OSA. In fact, a recent study confirmed that obesity is commonly associated with sleep-disordered breathing in children.

Sleep-disordered breathing is an umbrella term that applies to a variety of sleep dysfunctions, of which OSA is the most common form.

Because children with OSA often display symptoms such as irritability, poor attention span, and lack of concentration during the day, it is often mistaken for attention deficit hyperactivity disorder (ADHD).

Studies also show that sleep-associated respiratory disorders are a major cause of morbidity and mortality in children with neuromuscular disease.

 “The pediatric OSA market has often been neglected because of its low prevalence, but the consequences of untreated sleep apnea in children are just as devastating as with adults, if not worse,” said Bernadette McBrearty, the senior director for patient interfaces.

“ResMed … is proud to be the first to offer a second nasal mask designed specifically for children. We understand that children with OSA have unique needs, and the Mirage Micro for Kids is designed to meet those needs while providing the comfort, convenience and security that ResMed is well known for,” said McBrearty.

The mask’s central feature is the MicroFit dial, which allows children or their parents to adjust the mask themselves so they can find the most comfortable and secure fit the first time — and every time — they wear it. It features 24 positions that adjust the forehead support in small increments; the MicroFit dial offers the most precise and comfortable mask fitting option available.

The dial works in combination with the cushion to enhance the seal without having to over-tighten the headgear.

ResMed’s Mirage dual-wall cushion maintains a stable, effective seal but soft enough to reduce pressure on small noses and sensitive nasal bridges.

The mask’s slender design and streamlined forehead support provide a clear field of vision, helping to reduce feelings of anxiety or claustrophobia and make therapy less intimidating. The set-and-forget headgear clips, which retain the child’s preferred headgear settings, are easy for small hands to attach and detach. The unique vent design disperses air gently for quiet, undisturbed sleep.

The air tubing can also easily be attached and detached, a convenient feature for children who frequently need to get up in the middle of the night.

“Mirage Micro for Kids is based on one of our most successful nasal masks, which allows users to find the personal fit that’s most comfortable and secure for them,” said McBrearty. “The MicroFit dial is one of the many innovative features ResMed has developed …, and now children and their parents can experience this benefit for themselves.”

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Severe obstructive sleep apnea (OSA) raised the risk of heart failure for middle-aged and older men — and significantly raised the risk of coronary heart disease in men up to age 70, according to research reported in Circulation: Journal of the American Heart Association.

After adjusting for known heart risk factors, researchers found that men with the most severe OSA faced a 58 percent higher risk of developing heart failure than those without OSA. And those ages 40 to 70 with the most severe OSA had a 68 percent higher risk of developing coronary heart disease than those without OSA.

“The Sleep Heart Health Study is the first to demonstrate prospectively that sleep apnea is associated with an increased incidence of heart failure,” said Daniel J. Gottlieb, M.D., M.P.H., lead study author and associate professor at Boston University’s School of Medicine.

“It’s also the first large community-based study specifically designed to examine the association of sleep apnea with either coronary heart disease or heart failure. Previous work has focused more narrowly on patients receiving care at sleep clinics,” said  Gottlieb.

In obstructive sleep apnea, the airway collapses during sleep, leaving patients struggling to breathe.

In the study, researchers defined severe apnea as an hourly average of 30 or more breathing interruptions causing oxygen depletion and lasting at least 10 seconds.

This can cause blood oxygen to drop and can rouse people from sleep with a burst of adrenaline that increases blood pressure, which may contribute to vascular problems.

OSA is common, affecting 24 percent of adult men and nine percent of adult women, said Gottlieb, who is also director of the Sleep Disorders Center at VA Boston Healthcare System.

Research from the Sleep Heart Health Study also breaks ground because it included many women, Gottlieb said.

Researchers found no link between OSA and heart problems in women, who are about half as likely as men to have sleep apnea, making it difficult to detect an apnea-heart disease link. This is an area for further study, he said.

The 1,927 men and 2,495 women were 40 or older and free of heart problems when the study began. Twenty-four percent of the men and 11 percent of the women had at least moderately severe obstructive sleep apnea.

Researchers assessed participants’ health for a median follow-up of 8.7 years.

The ages of the study subjects may have limited researchers’ ability to detect a stronger link between apnea and coronary heart disease, Gottlieb said.

Coronary heart disease risk from sleep apnea may be greatest at a relatively young age, with previous research suggesting increased risk of cardiovascular related death from sleep apnea in individuals ages 30 to 50.

Furthermore, sleep apnea is typically diagnosed years or decades after its onset. So, the requirement that study subjects be free of heart problems at enrollment would have excluded people who already suffered heart disease consequences that might be linked to long-term apnea, Gottlieb said.

By contrast, heart failure tends to occur more frequently in elderly people. Heart failure is a chronic weakening of the heart, leaving it unable to pump enough blood to meet the body’s needs.

Coronary heart disease is a narrowing of the coronary arteries that reduces blood flow to the heart.

The study didn’t include enough minorities to detect trends for specific racial or ethnic groups, Gottlieb said.

Given the evidence that men 40 to 70 years old with obstructive sleep apnea face a higher risk of coronary heart disease, “it’s really time for us to perform clinical trials to assess whether coronary heart disease risk can be reduced in patients with severe sleep apnea by treating the apnea,” he said.

The most common treatment, called continuous positive airway pressure, involves the use of a machine that forces air into the airways to prevent breathing interruptions.

“The take-away from our study is that obstructive sleep apnea is a serious condition that warrants medical treatment,” said Gottlieb. “Many patients don’t experience symptoms of obstructive sleep apnea, such as daytime sleepiness, or if they do, don’t mention it during routine medical exams. It’s important for anyone who suspects they have obstructive sleep apnea to discuss it with their primary care physician.” 

The National Heart, Lung, and Blood Institute funded the study.

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Philips Respironics has released its newest nasal mask, the ComfortGel Blue nasal mask, used in the treatment of obstructive sleep apnea (OSA).

Based on the company’s blue gel masks, the product is designed to help patient comfort and compliance.

Retaining the comfort and flexibility features found in previous gel masks, ComfortGel Blue incorporates several new features to make it the next generation of comfort and technology.

Included in the mask are improved forehead pad design to help reduce pressure points; a lower profile exhalation port with an integrated swivel that quietly directs air flow up and away from a bed partner; and a new gel cushion that gently conforms to facial features.

Used with Philips Respironics System One Resistance Control, the mask may help deliver optimum PAP therapy and comfort.

“We have more than 15 years of experience delivering gel masks to thousands of health care professionals and hundreds of thousands of patients around the world,” said Maura Weis, director of  sleep marketing for North America.

“As a result, we understand what our customers—and their patients—need from a gel mask for effective therapy,” Weis said.

ComfortGel Blue is available in four sizes: petite, small, medium, and large.  To further simplify fitting and inventory management, FitPacks with two sizes of cushions are available.

DuoPacks with multiple cushions of the same size also are offered to support supply replacement initiatives for patients.

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Patients with suspected obstructive sleep apnea (OSA) may no longer have to spend an expensive and uncomfortable night at a sleep center to monitor their sleep-disordered breathing.

According to new research, those who performed sleep testing in their home with portable monitors showed similar improvements after three months of treatment with continuous positive airway pressure (CPAP) in daytime function as compared to patients who underwent overnight testing in a sleep center. 

Furthermore, patient adherence to CPAP over the first three months of treatment was similar in patients with OSA who received home versus in-lab testing.

Obstructive sleep apnea, a breathing disorder during sleep, is common, dangerous, and relatively easy to treat, but expensive to diagnose. “These findings represent a possible turning point for both patients with sleep-disordered breathing and the clinicians who treat them,” said Samuel T. Kuna, M.D., chief of the pulmonary, critical care and sleep section at the Philadelphia VA Medical Center, who led the research.

“One of the biggest and most insurmountable barriers to treatment is the need for overnight testing in a sleep laboratory. Our research suggests that this may no longer be a mandatory for diagnosis.”

It is conservatively estimated that four percent of women and nine percent of men in the United States have moderate to severe OSA and that 80 percent of these individuals are undiagnosed and untreated. Patients with untreated OSA are at increased risk for traffic accidents, hypertension, and cardiovascular disease.

“Currently, most patients with OSA need to perform overnight sleep testing (polysomnogram) in a sleep center,” explained Dr. Kuna. “The result has been unacceptably long patient wait times and restricted access to care.”

The researchers conducted a two-site study in which they randomized nearly 300 patients to undergo either standard in-laboratory sleep-testing or at-home testing. Of the 223 patients who started CPAP treatment after evaluation, 185 completed three months of follow-up.

They found that those who had undergone at-home testing showed improvements after three months of CPAP treatment similar to those who had undergone in-lab diagnosis.

The CPAP machines used in the study recorded the patient’s use of the treatment. Average hours of daily use over the 3 month period were similar in the two groups. 

“Proponents of in-laboratory testing argue that patients performing in-lab testing might have better outcomes than those performing home testing. For example, during in-lab testing, the patient spends a greater amount of time with a technologist who is able to educate the patient about OSA and CPAP and help the patient overcome any barriers to diagnosis and treatment that might arise during testing,” said Dr. Kuna.

“But our results did not find a difference between home versus in-lab testing in terms of clinical outcomes. The two management pathways appear to be equivalent in terms of patients’ functional outcomes and ability to use CPAP treatment.” 

While prospective studies are needed to evaluate the cost effectiveness of home portable monitor testing, medical care costs were examined in the study.

“Those results are still being analyzed, but we believe that they will show that home portable monitor testing is less expensive than in-laboratory testing,” said Dr. Kuna. Such a result, combined with the equivalent results of portable monitor testing in terms of health-related outcomes suggest that the portable devices may soon make in-lab testing a thing of the past for many OSA patients.

“Our study indicates that home portable monitor testing can be used to diagnose and manage patients with OSA,” said Dr. Kuna. “Greater use of portable monitors will improve patient access to care and hopefully reduce medical care cost by replacing an expensive test (in-lab polysomnography) with the less expensive home testing.”

This study was done in collaboration with Dr. Charles Atwood at the VA Pittsburgh Healthcare System and the University of Pittsburgh.

Exposure to extraordinarily brief, millisecond flashes of bright light improves alertness at night, according to a research presented at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies. 

Results indicate that subjective sleepiness decreased and objective nighttime alertness improved after participants received a two-millisecond pulse of bright light once per minute for 60 minutes.

Flash exposure, as compared with darkness, elicited significant improvement in self-rated alertness and a significant 57-millisecond improvement in median reaction time on the auditory Psychomotor Vigilance Test, compared with no significant improvement after 60 minutes of darkness. This was accompanied by significant changes in the faster frequencies of the EEG following exposure to the flashes.

“We found it shocking that light exposure as brief as a few milliseconds could engender changes in alertness and brain wave activity,” said principal investigator Jamie M. Zeitzer, PhD, assistant professor in the department of psychiatry and behavioral sciences at Stanford University in Palo Alto, Calif. “These results change the manner in which we think about the brain’s capacity to respond to light. 

The randomized crossover study involved seven people who were tested two times, with the sessions separated by more than two weeks. In each testing condition they were wakened two hours after their typical bedtime for stimulus administration.

Once they were exposed to an hour of darkness, and once they were exposed to a total of 120 milliseconds of bright light pulses during an hour of darkness. Vigilance was measured immediately before and at the end of the 60-minute stimulus.

According to the American Academy of Sleep Medicine, the solar light-dark cycle is the primary environmental time cue for synchronizing the circadian system to the 24-hour day. Artificial light absorbed by visual photoreceptors also can affect circadian timing by triggering the suppression of melatonin, a hormone that acts as a “darkness signal.”

AASM practice parameters indicate that timed light exposure in the work environment can decrease sleepiness and improve alertness during night shift work. However, bright light therapy typically involves exposure to up to 10,000 lux of light for scheduled periods of 20 minutes or more.

The study was supported by the Air Force Office of Scientific Research, the U.S. Department of Veterans Affairs and Stanford University.

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