100,000 lumens to treat seasonal affective disorder: A proof of concept RCT of Bright, whole‐ROom, All‐Day (BROAD) light therapy

Abstract

Background: Seasonal affective disorder (SAD) is common and debilitating. The standard of care includes light therapy provided by a light box; however, this treatment is restrictive and only moderately effective. Advances in LED technology enable lighting solutions that emit vastly more light than traditional light boxes. Here, we assess the feasibility of BROAD (Bright, whole-ROom, All-Day) light therapy and get a first estimate for its potential effectiveness.Methods: Patients were randomly assigned to a treatment for 4 weeks; either a very brightly illuminated room in their home for at least 6 h per day (BROAD light therapy) or 30 min in front of a standard 10,000 lux SAD light box. Feasibility was assessed by monitoring recruitment, adherence, and side effects. SAD symptoms were measured at baseline and after 2 and 4 weeks, with the Hamilton Depression Rating Scale-Seasonal Affective Disorders 29-items, self-report version.Results: All 62 patients who started treatment were available at 4-week follow-up and no significant adverse effects were reported. SAD symptoms of both groups improved similarly and considerably, in line with previous results. Exploratory analyses indicate that a higher illuminance (lux) is associated with a larger symptom improvement in the BROAD light therapy group.Conclusions: BROAD light therapy is feasible and seems similarly effective as the standard of care while not confining the participants to 30 min in front of a light box.In follow-up trials, BROAD light therapy could be modified for increased illuminance, which would likely improve its effectiveness.

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“…No notable differences between the SAD group and the non–SAD group were observed [ 218 ]. Light therapy is expected to adjust abnormal melatonin levels initiated by inadequate sunlight which causes a shift in the timing (phase) of circadian rhythms [ 238 , 241 , 243 , 244 ]. Theoretically, light therapy in the morning has the most beneficial effect [ 245 ] since it prevents a delay in circadian rhythms.…”

“…This intervention supported the idea that a light therapy room can potentially be applied in the treatment of SAD like portable bright light therapy. More recently, in a randomized controlled trial, a cohort of 62 participants were exposed to either BROAD light therapy 6 h per day in a room inside their home or exposed to a 10,000 lux SAD light box for 30 min per day [ 244 ]. Both methods were similarly effective, with improved SAD symptoms among the participants.…”