Daily Morning Blue Light Therapy Improves Daytime Sleepiness, Sleep Quality, and Quality of Life Following a Mild Traumatic Brain Injury

Abstract

Objective: Identify the treatment effects of 6 weeks of daily 30-minute sessions of morning blue light therapy compared with placebo amber light therapy in the treatment of sleep disruption following mild traumatic brain injury. Design: Placebo-controlled randomized trial. Participants: Adults aged 18 to 45 years with a mild traumatic brain injury within the past 18 months (n = 35). Main Outcome Measures: Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory II, Rivermead Post-concussion Symptom Questionnaire, Functional Outcomes of Sleep Questionnaire, and actigraphy-derived sleep measures. Results: Following treatment, moderate to large improvements were observed with individuals in the blue light therapy group reporting lower Epworth Sleepiness Scale (Hedges' g = 0.882), Beck Depression Inventory II (g = 0.684), Rivermead Post-concussion Symptom Questionnaire chronic (g = 0.611), and somatic (g = 0.597) symptoms, and experiencing lower normalized wake after sleep onset (g = 0.667) than those in the amber light therapy group. In addition, individuals in the blue light therapy group experienced greater total sleep time (g = 0.529) and reported improved Functional Outcomes of Sleep Questionnaire scores (g = 0.929) than those in the amber light therapy group. Conclusion: Daytime sleepiness, fatigue, and sleep disruption are common following a mild traumatic brain injury. These findings further substantiate blue light therapy as a promising nonpharmacological approach to improve these sleep-related complaints with the added benefit of improved postconcussion symptoms and depression severity.

Blue-wavelength Light Therapy for Post-traumatic Brain Injury Sleepiness, Sleep Disturbance, Depression, Fatigue: A Systematic Review and Network Meta-analysis

“…To our knowledge, this is the rst quantitative synthesis of BWLT for post-TBI sleepiness, sleep disturbance, depression, and fatigue. The e cacy of BWLT for post-TBI depression and fatigue found in this systematic review was in line with the results of three individual studies [21,32,33]. Its e cacy for depression and fatigue has also been reported in other medical and psychiatric conditions.…”

“…Three studies reported the effectiveness of BWLT in reducing sleepiness [21,31,33], one study in reducing sleep disturbance [33], three studies in reducing depression [21,32,33], and three studies in reducing fatigue [21,32,33]. (see Appendix 3 in Supplementary File).…”

“…The dropouts were reported in only three nine studied groups of two RCTs [31,33]. Because both RCTs compared the same pair of BWLT and amber light therapy, we decided to conduct a pairwise metaanalysis of these dropout rates separately as an additional analysis.…”

“…After the duplicate removal, 1,034 records remained for title and abstract screening. We assessed 19 full-text publications and, nally, included four randomized controlled trials in this systematic review [21,[31][32][33]. amber light therapy vs. no light therapy (2 trials).…”

“…The wavelengths of blue light therapy and amber light therapy used ranged between λ max = 465 nm and λ max = 480 nm and ranged between λ max = 530 nm and λ max = 578 nm. While three trials provided light therapy using a LED light box [21,31,33], one trial gave light therapy using a face- [36,37], and iv) Fatigue Severity Scale (FSS) for fatigue [38].…”