Other Disorders Treated With Light Therapy

Eating disorders such as Bulemia Nervosa

• About one third of patients with this disorder have SAD and binge and purge more in winter. Physicians should pay attention to seasonality in assessing treatment efficacy. Patients with bulimia often seek help in January when they are most ill. Their improvement in late spring may be the result of treatment, or it may just be seasonal. Worsening in the fall may be misinterpreted as a relapse caused by discontinuing treatment. Research shows that light therapy acutely and rapidly improves both mood and eating symptoms in persons with bulimia.

Sleeping Disorders

• These are not disorders of sleep per se, but of the timing of sleep. Patients may complain of sleep that starts too late, ends too early, is too fragile, or is irregular. People with delayed sleep phase syndrome, for example, report trouble falling asleep until 3 AM and trouble getting going before 10 or 11 AM. This disorder affects 7% of all persons seeking treatment for insomnia at sleep disorders centers. It is most common in adolescents. Light therapy in the early morning may help such people fall asleep earlier. Advanced sleep phase syndrome affects mainly the elderly, causing trouble staying awake in the evening and fragile sleep in the second half of the night. Older adults with trouble maintaining sleep with exposure to 4000 lux light for 2 hours in the evening, finding they awakened less frequently and slept nearly 1 hour longer. Other research has found that evening light exposure improves sleep and reduces nighttime wandering, or sundowning, in elderly nursing home residents with dementia.

Non Seasonal Depression

• Light may produce antidepressant benefits within 1 week, in contrast to psychopharmacological treatments, which typically take several weeks. In a recent review of clinical trials it was found that bright light therapy for nonseasonal major depression produced statistically significant net reductions in mood symptoms of about 12% to 35% on the Hamilton Depression Rating Scale. These results are comparable with those obtained in major trials of antidepressant medications. Light and medications appear to work best in combination suggesting it would be advantageous to offer depressed patients speedy relief with light therapy while also starting them on medications that have more extensively verified efficacy. Combined treatment should lower costs because faster improvement means less disability and morbidity.

Jet Lag

• Jet lag is actually caused by disruption of your "body clock" - a small cluster of brain cells that controls the timing of biological functions (circadian rhythms), including when you eat and sleep. The body clock is designed for a regular rhythm of daylight and darkness, so that it is thrown out of "sync" when it experiences daylight and darkness at the "wrong" times in a new time zone. The symptoms of jetlag often persist for days while the internal body clock slowly adjusts to the new time zone. Bright light, at least theoretically, can ease jet lag by speeding adaptation to new time zones. While the few field trials conducted to date are encouraging the studies' applicability to the population at large and optimal timing after travel are still unresolved.

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