Weak relationships between suppression of melatonin and suppression of sleepiness/fatigue in response to light exposure

The Circadian Response to Evening Light Spectra in Early Childhood: Preliminary Insights

Although the sensitivity of the circadian system to the characteristics of light (e.g., biological timing, intensity, duration, spectrum) has been well studied in adults, data in early childhood remain limited. Utilizing a crossover, within-subjects design, we examined differences in the circadian response to evening light exposure at two different correlated color temperatures (CCT) in preschool-aged children. Healthy, good sleeping children (n = 10, 3.0-5.9 years) completed two 10-day protocols. In each protocol, after maintaining a stable sleep schedule for 7 days, a 3-day in-home dim-light circadian assessment was performed. On the first and third evenings of the in-home protocol, dim-light melatonin onset (DLMO) was assessed. On the second evening, children received a 1-h light exposure of 20 lux from either 2700 K (low CCT) or 5000 K (high CCT) (~9 and ~16 melanopic equivalent daylight illuminance (mEDI lux), respectively) centered around their habitual bedtime. Children received the remaining light condition during their second protocol, with the order counterbalanced across participants. Salivary melatonin was collected to compute melatonin suppression and circadian phase shift resulting from each experimental light condition. Melatonin suppression across the 1-h light stimulus was significantly greater during exposure to the high CCT light (M = 56.3%, SD = 19.25%) than during the low CCT light (M = 23.90%, SD = 41.06%). Both light conditions resulted in marked delays of circadian timing, but only a small difference (d = -0.25) was observed in the delay between the 5000 K (M = 35.3 min, SD = 34.3 min) and 2700 K (M = 26.7 min, SD = 15.9 min) conditions. Together, these findings add to a growing literature demonstrating high responsivity of the circadian clock to evening light exposure in early childhood and provide preliminary evidence of melatonin suppression sensitivity to differences in light spectrum in preschool-aged children.

Time-Dependent Effects of Altered Prebedtime Light Exposure in Enclosed Spaces on Sleep Performance Associated with Human States

Purpose

Exposure to artificial light influences human performance, which is essential for maintaining healthy work and sleep. However, existing research has not explored the intrinsic links between sleep performance and human states over time under prebedtime light exposure interventions (LEIs).

Methods

To investigate the time-dependent effects of altered prebedtime light exposure, four LEI groupings (#L1 - #L4) and a Time factor (D8, D9, and D10) were chosen for sleep experiments in enclosed spaces. Forty-eight young adults recruited were available for data analysis. Subjective alertness (SA), negative affect (NA), subjective sleep, and objective sleep were measured via the Karolinska Sleepiness Scale, Positive and Negative Affect Schedule, Next-day Self-assessment Sleep Quality, and joint assessment of wrist actigraphy and sleep diaries, respectively. Statistical analysis was used for the effects of light exposure on the human states (corresponding to the SA and NA) and sleep performance, while the process model helped construct the associations between the two.

Results

The statistical effects revealed that the Time had a significant main effect on subjective sleep and changes in prebedtime alertness; the LEI had a significant main effect only on sleep onset latency (SOL). After undergoing altered prebedtime light exposure, the mean SA increased at prebedtime of D9 (p = 0.022) and D10 (p = 0.044); No significant effect on the NA was observed; Mean subjective sleep had a significant increase from D8 to D10. Moreover, five actigraphy-estimated sleep parameters were interrelated. In light of this, a chained pathway relationship was identified. The SOL played a mediating predictor between prebedtime state and objective sleep, which was linked to the awakening state through subjective sleep.

Conclusion

Our study suggests that time-dependent effects of altered prebedtime light exposure on sleep performance are associated with human states at prebedtime and awakening, with implications for its prediction of sleep health.

Intelligent interior atmosphere lamp system based on quantum dot LEDs for safe driving assistance

A driver safety assisting system is essential to reduce the probability of traffic accidents. But most of the existing driver safety assisting systems are simple reminders that cannot improve the driver's driving status. This paper proposes a driver safety assisting system to reduce the driver's fatigue degree by the light with different wavelengths that affect people's moods. The system consists of a camera, an image processing chip, an algorithm processing chip, and an adjustment module based on quantum dot LEDs (QLEDs). Through this intelligent atmosphere lamp system, the experimental results show that blue light reduced the driver's fatigue degree when just turned on; but as time went on, the driver's fatigue degree rebounded rapidly. Meanwhile, red light prolonged the driver's awake time. Different from blue light alone, this effect can remain stable for a long time. Based on these observations, an algorith was designed to quantify the degree of fatigue and detect its rising trend. In the early stage, the red light is used to prolong the awake time and the blue light to suppress when the fatigue value increases, so as to maximize the awake driving time. The result showed that our device prolonged the awake driving time of the drivers by 1.95 times and reduced fatigue during driving: the quantitative value of fatigue degree generally decreased by about 0.2 times. In most experiments, the subjects were able to complete four hours of safe driving, which reached the maximum length of continuous driving at night allowed by China laws. In conclusion, our system changes the assisting system from a reminder to a helper, thus effectively reducing the driving risk.

Melatonin suppression does not automatically alter sleepiness, vigilance, sensory processing, or sleep

Presleep exposure to short-wavelength light suppresses melatonin and decreases sleepiness with activating effects extending to sleep. This has mainly been attributed to melanopic effects, but mechanistic insights are missing. Thus, we investigated whether two light conditions only differing in the melanopic effects (123 vs. 59 lx melanopic EDI) differentially affect sleep besides melatonin. Additionally, we studied whether the light differentially modulates sensory processing during wakefulness and sleep. Twenty-nine healthy volunteers (18-30 years, 15 women) were exposed to two metameric light conditions (high- vs. low-melanopic, ≈60 photopic lx) for 1 h ending 50 min prior to habitual bed time. This was followed by an 8-h sleep opportunity with polysomnography. Objective sleep measurements were complemented by self-report. Salivary melatonin, subjective sleepiness, and behavioral vigilance were sampled at regular intervals. Sensory processing was evaluated during light exposure and sleep on the basis of neural responses related to violations of expectations in an oddball paradigm. We observed suppression of melatonin by ≈14% in the high- compared to the low-melanopic condition. However, conditions did not differentially affect sleep, sleep quality, sleepiness, or vigilance. A neural mismatch response was evident during all sleep stages, but not differentially modulated by light. Suppression of melatonin by light targeting the melanopic system does not automatically translate to acutely altered levels of vigilance or sleepiness or to changes in sleep, sleep quality, or basic sensory processing. Given contradicting earlier findings and the retinal anatomy, this may suggest that an interaction between melanopsin and cone-rod signals needs to be considered. Clinical Trial Registry: German Clinical Trials Register, DRKS00023602, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023602.

Verification, analytical validation and clinical validation (V3) of wearable dosimeters and light loggers

Background

Light exposure is an important driver and modulator of human physiology, behavior and overall health, including the biological clock, sleep-wake cycles, mood and alertness. Light can also be used as a directed intervention, e.g., in the form of light therapy in seasonal affective disorder (SAD), jetlag prevention and treatment, or to treat circadian disorders. Recently, a system of quantities and units related to the physiological effects of light was standardized by the International Commission on Illumination (CIE S 026/E:2018). At the same time, biometric monitoring technologies (BioMeTs) to capture personalized light exposure were developed. However, because there are currently no standard approaches to evaluate the digital dosimeters, the need to provide a firm framework for the characterization, calibration, and reporting for these digital sensors is urgent.

Objective

This article provides such a framework by applying the principles of verification, analytic validation and clinical validation (V3) as a state-of-the-art approach for tools and standards in digital medicine to light dosimetry.

Results

This article describes opportunities for the use of digital dosimeters for basic research, for monitoring light exposure, and for measuring adherence in both clinical and non-clinical populations to light-based interventions in clinical trials.

Blue-wavelength light therapy for post-traumatic brain injury sleepiness, sleep disturbance, depression, and fatigue: A systematic review and network meta-analysis

OBJECTIVE

This review aimed to determine the efficacy of blue-wavelength light therapy (BWLT) for post-traumatic brain injury (TBI) sleepiness, sleep disturbance, depression, and fatigue.

METHODS

Pubmed, Scopus, Web of Science, Cochrane Library, Academic Search Complete, and CINAHL. Included trials were randomized controlled trials (RCTs) of BWLT in adults with a history of TBI. Outcomes of interest included sleepiness, sleep disturbance, depression, or fatigue. Two reviewers independently screened the searched items, selected the trials, extracted the data, and rating the quality of trials. We aggregated the data using a random-effect, frequentist network meta-analysis (NMA).

RESULTS

We searched the databases on July 4, 2020. This review included four RCTs of 117 patients with a history of TBI who were randomized to received BWLT, amber light therapy (ALT), or no light therapy (NLT). Moderate-quality evidence revealed that: i) BWLT was significantly superior to NLT in reducing depression (SMD = 0.81, 95% CI = 0.20 to 1.43) ii) BWLT reduced fatigue at a significantly greater extent than NLT (SMD = 1.09, 95% CI = 0.41 to 1.76) and ALT (SMD = 1.00, 95% CI = 0.14 to 1.86). Low-quality evidence suggested that BWLT reduced depression at a greater extent than ALT (SMD = 0.57, 95% CI = 0.04 to 1.10). Low-quality evidence found that the dropout rates of those receiving BWLT and ALT were not significantly different (RR = 3.72, 95% CI = 0.65 to 21.34).

CONCLUSION

Moderate-quality evidence suggests that BWLT may be useful for post-TBI depression and fatigue.

Light Pollution, Circadian Photoreception, and Melatonin in Vertebrates

Artificial light at night (ALAN) is increasing exponentially worldwide, accelerated by the transition to new efficient lighting technologies. However, ALAN and resulting light pollution can cause unintended physiological consequences. In vertebrates, production of melatonin—the “hormone of darkness” and a key player in circadian regulation—can be suppressed by ALAN. In this paper, we provide an overview of research on melatonin and ALAN in vertebrates. We discuss how ALAN disrupts natural photic environments, its effect on melatonin and circadian rhythms, and different photoreceptor systems across vertebrate taxa. We then present the results of a systematic review in which we identified studies on melatonin under typical light-polluted conditions in fishes, amphibians, reptiles, birds, and mammals, including humans. Melatonin is suppressed by extremely low light intensities in many vertebrates, ranging from 0.01–0.03 lx for fishes and rodents to 6 lx for sensitive humans. Even lower, wavelength-dependent intensities are implied by some studies and require rigorous testing in ecological contexts. In many studies, melatonin suppression occurs at the minimum light levels tested, and, in better-studied groups, melatonin suppression is reported to occur at lower light levels. We identify major research gaps and conclude that, for most groups, crucial information is lacking. No studies were identified for amphibians and reptiles and long-term impacts of low-level ALAN exposure are unknown. Given the high sensitivity of vertebrate melatonin production to ALAN and the paucity of available information, it is crucial to research impacts of ALAN further in order to inform effective mitigation strategies for human health and the wellbeing and fitness of vertebrates in natural ecosystems.

Melatonin suppression and sleepiness in children exposed to blue-enriched white LED lighting at night

Light-induced melatonin suppression in children is reported to be more sensitive to white light at night than that in adults; however, it is unclear whether it depends on spectral distribution of lighting. In this study, we investigated the effects of different color temperatures of LED lighting on children's melatonin secretion during the night. Twenty-two healthy children (8.9 ± 2.2 years old) and 20 adults (41.7 ± 4.4 years old) participated in this study. A between-subjects design with four combinations, including two age groups (adults and children) and the two color temperature conditions (3000 K and 6200 K), was used. The experiment was conducted for two consecutive nights. On the first night, saliva samples were collected every hour under a dim light condition (<30 lx). On the second night, the participants were exposed to either color temperature condition. Melatonin suppression in children was greater than that in adults at both 3000 K and 6200 K condition. The 6200 K condition resulted in greater melatonin suppression than did the 3000 K condition in children (P < 0.05) but not in adults. Subjective sleepiness in children exposed to 6200 K light was significantly lower than that in children exposed to 3000 K light. In children, blue-enriched LED lighting has a greater impact on melatonin suppression and it inhibits the increase in sleepiness during night. Light with a low color temperature is recommended at night, particularly for children's sleep and circadian rhythm.

Effects of Bright Light with Reduced Blue Light on Sleepiness on Rising: A Small Exploratory Study

Bright light therapy is a treatment modality for seasonal affective disorder and circadian rhythm disorders in which artificial light of 2,500 lux or higher at the eye is effective. Although short-wavelength visible light is more effective than long-wavelength visible light, it may be hazardous to the retina. Recently, light-emitting diodes (LEDs) have been used as the light source in bright light therapy apparatuses. We developed goggles for bright light therapy equipped with LEDs as the light source. The aim of this study was to examine the efficacy and safety of our goggles when emitting 10,000-lux light with its short-wavelength light content reduced by 30% or 50% (denoted as 30%-cut and 50%-cut light, respectively, henceforth). Six healthy young males participated in this study. They were administered no light, 50%-cut light, and 30%-cut light for 30 min early in the morning for 4 days each. Subjective sleepiness and sleep quality were evaluated by the Stanford Sleepiness Scale (SSS) and the Oguri–Shirakawa–Azumi sleep inventory MA version (OSA-MA), respectively. Subjective sleepiness evaluated by the SSS and the subscale of the OSA-MA significantly decreased with 30%-cut light compared with no light. Psychomotor performance evaluated by a calculation task improved with the 30%-cut light, although not significant after multiple comparisons were considered. No abnormality was found by ophthalmoscopy and the vision test. In conclusion, our goggles with 30%-cut light may be safe and have an awakening effect.

Light exposure via a head-mounted device suppresses melatonin and improves vigilant attention without affecting cortisol and comfort

We aimed at assessing whether a head-mounted light therapy device, enriched in blue wavelengths, suppresses melatonin secretion and improves vigilant attention in the late evening hours. We also assessed whether using such light device is associated with discomfort and physiological stress. Seventeen healthy young participants (eight females) participated in a counterbalanced within-subject design during which they were exposed for 2 hr before habitual sleep time to a blue-enriched light (1500 lx) or to a lower intensity red-light (150 lx) control condition, using a new-generation light emitting diode (LED) head-mounted device. Compared to the red light control condition, blue-enriched light significantly reduced melatonin secretion and reaction times during a psychomotor vigilance task while no significant differences were detected in discomfort and cortisol levels. These results suggest that, compared to a control condition, blue-enriched light, delivered by a new-generation head-mounted device, elicits typical non-visual responses to light without detectable discomfort and physiological stress. They suggest that such devices might constitute an effective alternative to standard light boxes.

Differential impact in young and older individuals of blue-enriched white light on circadian physiology and alertness during sustained wakefulness

We tested the effect of different lights as a countermeasure against sleep-loss decrements in alertness, melatonin and cortisol profile, skin temperature and wrist motor activity in healthy young and older volunteers under extendend wakefulness. 26 young [mean (SE): 25.0 (0.6) y)] and 12 older participants [(mean (SE): 63.6 (1.3) y)] underwent 40-h of sustained wakefulness during 3 balanced crossover segments, once under dim light (DL: 8 lx), and once under either white light (WL: 250 lx, 2,800 K) or blue-enriched white light (BL: 250 lx, 9,000 K) exposure. Subjective sleepiness, melatonin and cortisol were assessed hourly. Skin temperature and wrist motor activity were continuously recorded. WL and BL induced an alerting response in both the older (p = 0.005) and the young participants (p = 0.021). The evening rise in melatonin was attentuated under both WL and BL only in the young. Cortisol levels were increased and activity levels decreased in the older compared to the young only under BL (p = 0.0003). Compared to the young, both proximal and distal skin temperatures were lower in older participants under all lighting conditions. Thus the color temperature of normal intensity lighting may have differential effects on circadian physiology in young and older individuals.

Investigation of an Immediate Effect of Bright Light on Oxygen Consumption, Heart Rate, Cortisol, and α-Amylase in Seasonal Affective Disorder Subjects and Healthy Controls

BACKGROUND

Body (fat) mass has been shown to decrease following bright light treatment for overweight women, irrespective of their seasonal (light) dependence. It is not known if this is due to an (immediate) increase of metabolism.

METHODS

Ten women with seasonal affective disorder (SAD) and 10 non-SAD women matched by age, body mass index, and menopausal status participated in a laboratory study in the morning, twice within 1-5 days. During one session, bright light (4,300 lx) was presented for 30 min, and during the other session, red light (250 lx "placebo") was used. After an initial 15 min of sitting quietly in an experimental chamber, 10-min measurements were done before, at the end, and 15 min after light exposure; the subjects remained seated for 80 min in total. The measurements included 5-min oxyspirography (oxygen consumption, carbon dioxide emission, and heart rate), saliva sampling for the estimation of cortisol and α-amylase concentrations, and self-rating of mood, energy, and sleepiness.

RESULTS

There was no light-specific effect on the measured variables, except that sleepiness was reduced more with bright light than with red light in the combined group. α-Amylase values were lower in the SAD patients than in the non-SAD controls.

CONCLUSIONS

Morning artificial bright light, in comparison with dim red light, had no immediate effect on metabolism and resting sympathetic tone, though subjective sleepiness decreased more with bright light. SAD patients have low salivary α-amylase levels, indicating lower sympathetic tone.

Daytime Exposure to Short- and Medium-Wavelength Light Did Not Improve Alertness and Neurobehavioral Performance

While previous studies have demonstrated short-wavelength sensitivity to the acute alerting effects of light during the biological night, fewer studies have assessed the alerting effect of light during the daytime. This study assessed the wavelength-dependent sensitivity of the acute alerting effects of daytime light exposure following chronic sleep restriction in 60 young adults (29 men, 31 women; 22.5 ± 3.1 mean ± SD years). Participants were restricted to 5 h time in bed the night before laboratory admission and 3 h time in bed in the laboratory, aligned by wake time. Participants were randomized for exposure to 3 h total of either narrowband blue (λmax 458-480 nm, n = 23) or green light (λmax 551-555 nm, n = 25) of equal photon densities (2.8-8.4 × 10(13) photons/cm(2)/sec), beginning 3.25 h after waking, and compared with a darkness control (0 lux, n = 12). Subjective sleepiness (Karolinska Sleepiness Scale), sustained attention (auditory Psychomotor Vigilance Task), mood (Profile of Mood States Bi-Polar form), working memory (2-back task), selective attention (Stroop task), and polysomnographic and ocular sleepiness measures (Optalert) were assessed prior to, during, and after light exposure. We found no significant effect of light wavelength on these measures, with the exception of a single mood subscale. Further research is needed to optimize the characteristics of lighting systems to induce alerting effects during the daytime, taking into account potential interactions between homeostatic sleep pressure, circadian phase, and light responsiveness.

Artificial Outdoor Nighttime Lights Associate with Altered Sleep Behavior in the American General Population

STUDY OBJECTIVES

Our study aims to explore the associations between outdoor nighttime lights (ONL) and sleep patterns in the human population.

METHODS

Cross-sectional telephone study of a representative sample of the general US population age 18 y or older. 19,136 noninstitutionalized individuals (participation rate: 83.2%) were interviewed by telephone. The Sleep-EVAL expert system administered questions on life and sleeping habits; health; sleep, mental and organic disorders (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; International Classification of Sleep Disorders, Second Edition; International Classification of Diseases, 10(th) Edition). Individuals were geolocated by longitude and latitude. Outdoor nighttime light measurements were obtained from the Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS), with nighttime passes taking place between 19:30 and 22:30 local time. Light data were correlated precisely to the geolocation of each participant of the general population sample.

RESULTS

Living in areas with greater ONL was associated with delayed bedtime (P < 0.0001) and wake up time (P < 0.0001), shorter sleep duration (P < 0.01), and increased daytime sleepiness (P < 0.0001). Living in areas with greater ONL also increased the dissatisfaction with sleep quantity and quality (P < 0.0001) and the likelihood of having a diagnostic profile congruent with a circadian rhythm disorder (P < 0.0001).

CONCLUSIONS

Although they improve the overall safety of people and traffic, nighttime lights in our streets and cities are clearly linked with modifications in human sleep behaviors and also impinge on the daytime functioning of individuals living in areas with greater ONL.

Afternoon nap and bright light exposure improve cognitive flexibility post lunch

Beneficial effects of napping or bright light exposure on cognitive performance have been reported in participants exposed to sleep loss. Nonetheless, few studies investigated the effect of these potential countermeasures against the temporary drop in performance observed in mid-afternoon, and even less so on cognitive flexibility, a crucial component of executive functions. This study investigated the impact of either an afternoon nap or bright light exposure on post-prandial alterations in task switching performance in well-rested participants. Twenty-five healthy adults participated in two randomized experimental conditions, either wake versus nap (n=15), or bright light versus placebo (n=10). Participants were tested on a switching task three times (morning, post-lunch and late afternoon sessions). The interventions occurred prior to the post-lunch session. In the nap/wake condition, participants either stayed awake watching a 30-minute documentary or had the opportunity to take a nap for 30 minutes. In the bright light/placebo condition, participants watched a documentary under either bright blue light or dim orange light (placebo) for 30 minutes. The switch cost estimates cognitive flexibility and measures task-switching efficiency. Increased switch cost scores indicate higher difficulties to switch between tasks. In both control conditions (wake or placebo), accuracy switch-cost score increased post lunch. Both interventions (nap or bright light) elicited a decrease in accuracy switch-cost score post lunch, which was associated with diminished fatigue and decreased variability in vigilance. Additionally, there was a trend for a post-lunch benefit of bright light with a decreased latency switch-cost score. In the nap group, improvements in accuracy switch-cost score were associated with more NREM sleep stage N1. Thus, exposure to bright light during the post-lunch dip, a countermeasure easily applicable in daily life, results in similar beneficial effects as a short nap on performance in the cognitive flexibility domain with possible additional benefits on latency switch-cost scores.

Intense illumination in the morning hours improved mood and alertness but not mental performance

Cognitive performance and alertness are two determinants for work efficiency, varying throughout the day and depending on bright light. We conducted a prospective crossover study evaluating the impacts of exposure to an intense, early morning illumination on sustained attention, alertness, mood, and serum melatonin levels in 33 healthy individuals. Compared with a dim illumination, the intense illumination negatively impacted performance requiring sustained attention; however, it positively impacted subjective alertness and mood and had no impact on serum melatonin levels. These results suggest that brief exposure to bright light in the morning hours can improve subjective measures of mood and alertness, but can also have detrimental effects on mental performance as a result of visual distraction. Therefore, it is important that adequate lighting should correspond to both non-visual and visual demands.

Effects of pre-sleep media use on sleep/wake patterns and daytime functioning among adolescents: the moderating role of parental control

The aim of this cross-sectional study was to investigate the influence of media use in the hour before bedtime on sleep/wake patterns and daytime functioning among adolescents and to examine the moderating role of parental control. A total of 1,926 Belgian students, 55% girls and 45% boys, with a mean age of 16.9 ± 1.5 years, completed a modified version of the School Sleep Habits Survey. Correlational analyses showed that media use, except television viewing, was associated with later bedtimes and longer sleep latencies. Cell phone and computer usage was negatively associated with daytime functioning. On schooldays, parental control had a moderating effect on the relationship between bedtime and computer use (β = .05; p < .05) and between bedtime and mp3 player use (β = .08; p < .01). During the weekend, parental control played a moderating role between bedtime and television viewing (β = .06; p = .01). As media use can influence the sleep of adolescents considerably, parental control is necessary to regulate the exposure of adolescents to media and to moderate the detrimental effect of media use on sleep.

Effects of bright light treatment on psychomotor speed in athletes

Purpose: A recent study suggests that transcranial brain targeted light treatment via ear canals may have physiological effects on brain function studied by functional magnetic resonance imaging (fMRI) techniques in humans. We tested the hypothesis that bright light treatment could improve psychomotor speed in professional ice hockey players.

Methods: Psychomotor speed tests with audio and visual warning signals were administered to a Finnish National Ice Hockey League team before and after 24 days of transcranial bright light or sham treatment. The treatments were given during seasonal darkness in the Oulu region (latitude 65 degrees north) when the strain on the players was also very high (10 matches during 24 days). A daily 12-min dose of bright light or sham (n = 11 for both) treatment was given every morning between 8 and 12 am at home with a transcranial bright light device. Mean reaction time and motor time were analyzed separately for both psychomotor tests. Analysis of variance for repeated measures adjusted for age was performed.

Results: Time × group interaction for motor time with a visual warning signal was p = 0.024 after adjustment for age. In Bonferroni post-hoc analysis, motor time with a visual warning signal decreased in the bright light treatment group from 127 ± 43 to 94 ± 26 ms (p = 0.024) but did not change significantly in the sham group 121 ± 23 vs. 110 ± 32 ms (p = 0.308). Reaction time with a visual signal did not change in either group. Reaction or motor time with an audio warning signal did not change in either the treatment or sham group.

Conclusion: Psychomotor speed, particularly motor time with a visual warning signal, improves after transcranial bright light treatment in professional ice-hockey players during the competition season in the dark time of the year.

Association between melanopsin gene polymorphism (I394T) and pupillary light reflex is dependent on light wavelength

Background

Our aim was to determine the association between melanopsin gene polymorphism and pupillary light reflex under diverse photic conditions, including different intensities and wavelengths.

Methods

A total of 195 visually corrected subjects volunteered for investigation of the melanopsin gene of single nucleotide polymorphism (SNP) of rs1079610 (I394T). The genotype groups were TT (n = 126), TC (n = 55), and CC (n = 8), and 75 of the subjects, including subjects with TT (n = 34), TC (n = 33), and CC (n = 8) participated in our experiment. Three monochromatic lights with peak wavelengths of 465 nm (blue), 536 nm (green), and 632 nm (red) were prepared, and each light was projected to the subjects with five intensities, 12, 13, 14, 14.5 and 15 log photons/(cm² s), for one minute. The pupil size of the left eye was measured under each light condition after a 1-minute adaptation.

Results

The pupils of the TC + CC genotypes (n = 38) were significantly smaller than those of the TT genotype (n = 31) under a blue (463 nm) light condition with 15 log photons/(cm² s) (P < 0.05). In contrast, there were no significant differences under green (536 nm) and red (632 nm) light conditions. Conversely, relative pupil constrictions of the TC + CC genotypes were greater than those of the TT genotype under both blue and green conditions with high intensities (14.5 and 15 log photons/(cm² s)). In contrast, there were no significant differences between genotype groups in pupil size and relative pupilloconstriction under the red light conditions.

Conclusions

Our findings suggest that the melanopsin gene polymorphism (I394T) functionally interacts with pupillary light reflex, depending on light intensity and, particularly, wavelength, and that under a light condition fulfilling both high intensity and short wavelength, the pupillary light response of subjects with the C allele (TC + CC) is more sensitive to light than that of subjects with the TT genotype.

Effects of artificial dawn and morning blue light on daytime cognitive performance, well-being, cortisol and melatonin levels

Light exposure elicits numerous effects on human physiology and behavior, such as better cognitive performance and mood. Here we investigated the role of morning light exposure as a countermeasure for impaired cognitive performance and mood under sleep restriction (SR). Seventeen participants took part of a 48h laboratory protocol, during which three different light settings (separated by 2 wks) were administered each morning after two 6-h sleep restriction nights: a blue monochromatic LED (light-emitting diode) light condition (BL; 100 lux at 470 nm for 20 min) starting 2 h after scheduled wake-up time, a dawn-simulating light (DsL) starting 30 min before and ending 20 min after scheduled wake-up time (polychromatic light gradually increasing from 0 to 250 lux), and a dim light (DL) condition for 2 h beginning upon scheduled wake time (<8 lux). Cognitive tasks were performed every 2 h during scheduled wakefulness, and questionnaires were administered hourly to assess subjective sleepiness, mood, and well-being. Salivary melatonin and cortisol were collected throughout scheduled wakefulness in regular intervals, and the effects on melatonin were measured after only one light pulse. Following the first SR, analysis of the time course of cognitive performance during scheduled wakefulness indicated a decrease following DL, whereas it remained stable following BL and significantly improved after DsL. Cognitive performance levels during the second day after SR were not significantly affected by the different light conditions. However, after both SR nights, mood and well-being were significantly enhanced after exposure to morning DsL compared with DL and BL. Melatonin onset occurred earlier after morning BL exposure, than after morning DsL and DL, whereas salivary cortisol levels were higher at wake-up time after DsL compared with BL and DL. Our data indicate that exposure to an artificial morning dawn simulation light improves subjective well-being, mood, and cognitive performance, as compared with DL and BL, with minimal impact on circadian phase. Thus, DsL may provide an effective strategy for enhancing cognitive performance, well-being, and mood under mild sleep restriction.

Short-wavelength attenuated polychromatic white light during work at night: limited melatonin suppression without substantial decline of alertness

Exposure to light at night increases alertness, but light at night (especially short-wavelength light) also disrupts nocturnal physiology. Such disruption is thought to underlie medical problems for which shiftworkers have increased risk. In 33 male subjects we investigated whether short-wavelength attenuated polychromatic white light (<530 nm filtered out) at night preserves dim light melatonin levels and whether it induces similar skin temperature, alertness, and performance levels as under full-spectrum light. All 33 subjects participated in random order during three nights (at least 1 wk apart) either under dim light (3 lux), short-wavelength attenuated polychromatic white light (193 lux), or full-spectrum light (256 lux). Hourly saliva samples for melatonin analysis were collected along with continuous measurements of skin temperature. Subjective sleepiness and activation were assessed via repeated questionnaires and performance was assessed by the accuracy and speed of an addition task. Our results show that short-wavelength attenuated polychromatic white light only marginally (6%) suppressed salivary melatonin. Average distal-to-proximal skin temperature gradient (DPG) and its pattern over time remained similar under short-wavelength attenuated polychromatic white light compared with dim light. Subjects performed equally well on an addition task under short-wavelength attenuated polychromatic white light compared with full-spectrum light. Although subjective ratings of activation were lower under short-wavelength attenuated polychromatic white light compared with full-spectrum light, subjective sleepiness was not increased. Short-wavelength attenuated polychromatic white light at night has some advantages over bright light. It hardly suppresses melatonin concentrations, whereas performance is similar to the bright light condition. Yet, alertness is slightly reduced as compared with bright light, and DPG shows similarity to the dim light condition, which is a physiological sign of reduced alertness. Short-wavelength attenuated polychromatic white light might therefore not be advisable in work settings that require high levels of alertness.

Melanopsin gene polymorphism I394T is associated with pupillary light responses in a dose-dependent manner

BACKGROUND

Melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs) play an important role in non-image forming responses to light, such as circadian photoentrainment, light-induced melatonin suppression, and pupillary light response. Although it is known that there are some single nucleotide polymorphisms (SNPs) in the melanopsin (OPN4) gene in humans, the associations of the SNPs with non-image forming responses to light remains unclear. In the present study, we examined the associations of melanopsin gene polymorphisms with pupillary light response.

METHODS

Japanese university students (mean age: 21.0 ± 1.7 years) with the genotypes of TT (n = 38), TC (n = 28) and CC (n = 7) at rs1079610 (I394T) located in the coding region participated in the present study. They were matched by age and sex ratio. Dark-adapted pupil size (<1 lx) was first measured. Then steady-state pupil size was measured during exposure to five lighting conditions (10 lx, 100 lx, 1000 lx, 3000 lx, 6000 lx in the vertical direction at eye level).

RESULTS

Significant interaction between the genotype of I394T (TT versus TC+CC) and luminance levels was found in pupil size. Under high illuminance levels (1000 lx, 3000 lx and 6000 lx), pupil sizes in subjects with the C allele were significantly smaller than those in subjects with the TT genotype. On the other hand, pupil size in subjects with the C allele under low illuminance (<1 lx) was significantly larger than that in subjects with the TT genotype. Percentages of pupil constriction under high illuminance levels were significantly greater in subjects with the C allele than in subjects with the TT genotype.

CONCLUSIONS

Human melanopsin gene polymorphism I394T interacted with irradiance in association with pupil size. This is the first evidence suggesting a functional connection between melanopsin gene polymorphism and pupillary light response as an index of non-image forming response to light.

Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment

There are three mechanisms that may contribute to the health, performance, and safety problems associated with night-shift work: (1) circadian misalignment between the internal circadian clock and activities such as work, sleep, and eating, (2) chronic, partial sleep deprivation, and (3) melatonin suppression by light at night. The typical countermeasures, such as caffeine, naps, and melatonin (for its sleep-promoting effect), along with education about sleep and circadian rhythms, are the components of most fatigue risk-management plans. We contend that these, while better than nothing, are not enough because they do not address the underlying cause of the problems, which is circadian misalignment. We explain how to reset (phase-shift) the circadian clock to partially align with the night-work, day-sleep schedule, and thus reduce circadian misalignment while preserving sleep and functioning on days off. This involves controlling light and dark using outdoor light exposure, sunglasses, sleep in the dark, and a little bright light during night work. We present a diagram of a sleep-and-light schedule to reduce circadian misalignment in permanent night work, or a rotation between evenings and nights, and give practical advice on how to implement this type of plan.

Effectiveness of a red-visor cap for preventing light-induced melatonin suppression during simulated night work

Bright light at night improves the alertness of night workers. Melatonin suppression induced by light at night is, however, reported to be a possible risk factor for breast cancer. Short-wavelength light has a strong impact on melatonin suppression. A red-visor cap can cut the short-wavelength light from the upper visual field selectively with no adverse effects on visibility. The purpose of this study was to investigate the effects of a red-visor cap on light-induced melatonin suppression, performance, and sleepiness at night. Eleven healthy young male adults (mean age: 21.2±0.9 yr) volunteered to participate in this study. On the first day, the subjects spent time in dim light (<15 lx) from 20:00 to 03:00 to measure baseline data of nocturnal salivary melatonin concentration. On the second day, the subjects were exposed to light for four hours from 23:00 to 03:00 with a nonvisor cap (500 lx), red-visor cap (approx. 160 lx) and blue-visor cap (approx. 160 lx). Subjective sleepiness and performance of a psychomotor vigilance task (PVT) were also measured on the second day. Compared to salivary melatonin concentration under dim light, the decrease in melatonin concentration was significant in a nonvisor cap condition but was not significant in a red-visor cap condition. The percentages of melatonin suppression in the nonvisor cap and red-visor cap conditions at 4 hours after exposure to light were 52.6±22.4% and 7.7±3.3%, respectively. The red-visor cap had no adverse effect on performance of the PVT, brightness and visual comfort, though it tended to increase subjective sleepiness. These results suggest that a red-visor cap is effective in preventing melatonin suppression with no adverse effects on vigilance performance, brightness and visibility.

Sleep length and quality, sleepiness and urinary melatonin among healthy Danish nurses with shift work during work and leisure time

BACKGROUND

Sleep problems are common effects of shift work. The aim of the present study was to evaluate how different types of shift affect sleep and sleepiness, and to relate sleepiness to urinary 6-sulfatoxymelatonin.

METHODS

A total of 166 volunteer healthy Danish nurses working day, evening, or night, respectively fixed and mixed schedules were included. Self-reports of sleep were assessed together with real-time sleepiness and spot urine samples analyzed for 6-sulfatoxymelatonin on a workday and a leisure day.

RESULTS

On a day off the nurses slept longer, with a better quality and reported less sleepiness compared to a workday. Nurses on nightshift reported poorer sleep quality than nurses on other shifts. Sleepiness was highest for nurses on mixed schedules. Concentrations of urinary 6-sulfatoxymelatonin and sleepiness were generally correlated except for nurses working fixed nights.

CONCLUSIONS

The poorest sleep quality was observed for nurses in mixed schedules working nights. The lack of correlation between sleepiness and 6-sulfatoxymelatonin on mixed night shift may indicate that the influence of endogenous melatonin is limited.

Effects of variable lighting intensities and colour temperatures on sulphatoxymelatonin and subjective mood in an experimental office workplace

Workplace illumination is of paramount importance in determining the employee's productivity and well-being. Moreover, light exerts non-visual effects with respect to biological rhythms. In this study, we investigated the impact of different lighting conditions (500-1800 lx, 6500 K; 500 lx, 4000 K) on sulphatoxymelatonin (aMT6-s) and subjective mood in an experimental office accommodation. Urinary aMT6-s concentrations were significantly decreased at all days of the experiment in both lights. On day 3, differences between aMT6-s concentrations in specimen collected at 05:00 p.m. and at 09:00 a.m. were significantly higher under variable lighting conditions. Analyses of a mood rating inventory revealed a benefit of variable light with respect to the dimensions of "Activity", while "Deactivation" and "Fatigue" were increased in regular light on day 1. "Activity", "Concentration", and "Deactivation" changed in opposite directions when comparing variable with regular illumination on two consecutive days. In conclusion, variable light exerts a potential advantage in indoor office accommodations with respect to subjective mood, although no unequivocal differences in the profile of aMT6-s were found as compared to regular light.

Bright light therapy in Parkinson's disease: a pilot study

Several observations suggest a beneficial effect of melatonin antagonism for Parkinson's disease (PD). Although bright light therapy (BLT) suppresses melatonin release and is an established treatment for depression and sleep disturbances, it has not been evaluated in PD. We examined effects of BLT on motor symptoms, depression, and sleep in PD in a randomized placebo-controlled double-blind study in 36 PD patients, using Parkinson's Disease Rating Scale (UPDRS) I-IV, Beck's Depression Inventory, and Epworth Sleepiness Scale. All patients received BLT for 15 days in the morning, 30 min daily. Illuminance was 7.500 lux in the active treatment group and 950 lux in the placebo group. Although group differences were small, BLT led to significant improvement of tremor, UPDRS I, II, and IV, and depression in the active treatment group but not in the placebo group. It was very well tolerated. Follow up studies in more advanced patient populations employing longer treatment durations are warranted.

Alerting effects of light are sensitive to very short wavelengths

In humans a range of non-image-forming (NIF) light responses (melatonin suppression, phase shifting and alertness) are short wavelength sensitive (440-480 nm). The aim of the current study was to assess the acute effect of three different short wavelength light pulses (420, 440 and 470 nm) and 600 nm light on subjective alertness. Healthy male subjects (n = 12, aged 27 +/- 4 years, mean +/- S.D.) were studied in 39, 4-day laboratory study sessions. The subjects were maintained in dim light (<8 lx) and on day 3 they were exposed to a single 4-h light pulse (07:15-11:15 h). Four monochromatic wavelengths were administered at two photon densities: 420 and 440 nm at 2.3 x 10(13)photons/cm(2)/s and 440, 470 and 600 nm at 6.2 x 10(13)photons/cm(2)/s. Subjective mood and alertness were assessed at 30 min intervals during the light exposure, using four 9-point VAS scales. Mixed model regression analysis was used to compare alertness and mood ratings during the 470 nm light to those recorded with the other four light conditions. There was a significant effect of duration of light exposure (p < 0.001) on alertness but no significant effect of subject. Compared to 470 nm light, alertness levels were significantly higher in 420 nm light and significantly lower in the 600 nm light (p < 0.05). These data (420 nm>470 nm>600 nm) suggest that subjective alertness may be maximally sensitive to very short wavelength light.

Time-of-day-dependent effects of bright light exposure on human psychophysiology: comparison of daytime and nighttime exposure

Bright light can influence human psychophysiology instantaneously by inducing endocrine (suppression of melatonin, increasing cortisol levels), other physiological changes (enhancement of core body temperature), and psychological changes (reduction of sleepiness, increase of alertness). Its broad range of action is reflected in the wide field of applications, ranging from optimizing a work environment to treating depressed patients. For optimally applying bright light and understanding its mechanism, it is crucial to know whether its effects depend on the time of day. In this paper, we report the effects of bright light given at two different times of day on psychological and physiological parameters. Twenty-four subjects participated in two experiments (n = 12 each). All subjects were nonsmoking, healthy young males (18-30 yr). In both experiments, subjects were exposed to either bright light (5,000 lux) or dim light <10 lux (control condition) either between 12:00 P.M. and 4:00 P.M. (experiment A) or between midnight and 4:00 A.M. (experiment B). Hourly measurements included salivary cortisol concentrations, electrocardiogram, sleepiness (Karolinska Sleepiness Scale), fatigue, and energy ratings (Visual Analog Scale). Core body temperature was measured continuously throughout the experiments. Bright light had a time-dependent effect on heart rate and core body temperature; i.e., bright light exposure at night, but not in daytime, increased heart rate and enhanced core body temperature. It had no significant effect at all on cortisol. The effect of bright light on the psychological variables was time independent, since nighttime and daytime bright light reduced sleepiness and fatigue significantly and similarly.