Background: We aimed to determine the efficacy of blue-wavelength light therapy (BWLT) for post-traumatic brain injury (TBI) sleepiness, sleep disturbance, depression, and fatigue.Methods: We searched six databases for randomized controlled trials of BWLT for adults with a history of TBI. Outcomes of interest included sleepiness, sleep disturbance, depression, or fatigue. We conducted random-effect frequentist network meta-analyses (NMA) to compare the efficacy and a pairwise meta-analysis to examine the dropout rates.Results: We included four randomized controlled trials that compared BWLT, amber light therapy, and no light therapy. BWLT was significantly superior in reducing depression as compared to amber light therapy (SMD = 0.57, 95% CI = 0.04 to 1.10) and no light therapy (SMD = 0.81, 95% CI = 0.20 to 1.43). BWLT was also significantly superior in reducing fatigue as compared to amber light therapy (SMD = 1.00, 95% CI = 0.14 to 1.86) and no light therapy (SMD = 1.09, 95% CI = 0.41 to 1.76). There was no significant heterogeneity of depression and fatigue data (I2 = 0% for both). The relative risk of dropout rates (95% CI) shows no significant difference between BWLT and amber light therapy groups (RR = 3.72, 95% CI = 0.66 to 21.34, I2 = 0%).Conclusion: BWLT may be effective for post-TBI depression and fatigue. Due to the risks of bias and the inability to exclude publication bias among included studies, the current evidence remains insufficient to support the clinical application of BWLT for post-TBI depression and fatigue. Protocol registration: The protocol of this systematic review is available at Open Science Framework (https://osf.io/yf2qe/).
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