Crowley Stephanie J, Eastman Charmane I
Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, 1645 West Jackson Blvd. Suite 425, Chicago, IL 60612, USA.
Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, 1645 West Jackson Blvd. Suite 425, Chicago, IL 60612, USA.
Sleep Med. 2015 Feb;16(2):288-97. doi: 10.1016/j.sleep.2014.12.004. Epub 2014 Dec 18.
Efficient treatments to phase-advance human circadian rhythms are needed to attenuate circadian misalignment and the associated negative health outcomes that accompany early-morning shift work, early school start times, jet lag, and delayed sleep phase disorder. This study compared three morning bright-light exposure patterns from a single light box (to mimic home treatment) in combination with afternoon melatonin.
Fifty adults (27 males) aged 25.9 ± 5.1 years participated. Sleep/dark was advanced 1 h/day for three treatment days. Participants took 0.5 mg of melatonin 5 h before the baseline bedtime on treatment day 1, and an hour earlier each treatment day. They were exposed to one of three bright-light (~5000 lux) patterns upon waking each morning: four 30-min exposures separated by 30 min of room light (2-h group), four 15-min exposures separated by 45 min of room light (1-h group), and one 30-min exposure (0.5-h group). Dim-light melatonin onsets (DLMOs) before and after treatment determined the phase advance.
Compared to the 2-h group (phase shift = 2.4 ± 0.8 h), smaller phase-advance shifts were seen in the 1-h (1.7 ± 0.7 h) and 0.5-h (1.8 ± 0.8 h) groups. The 2-h pattern produced the largest phase advance; however, the single 30-min bright-light exposure was as effective as 1 h of bright light spread over 3.25 h, and it produced 75% of the phase shift observed with 2 h of bright light.
A 30-min morning bright-light exposure with afternoon melatonin is an efficient treatment to phase-advance human circadian rhythms.
需要有效的治疗方法来使人体昼夜节律提前，以减轻昼夜节律失调以及与清晨轮班工作、过早的上学时间、时差反应和延迟睡眠相位障碍相关的负面健康后果。本研究比较了来自单个灯箱的三种早晨强光照射模式（以模拟家庭治疗）与下午褪黑素联合使用的效果。
50名年龄在25.9±5.1岁的成年人（27名男性）参与了研究。在三个治疗日中，睡眠/黑暗时间每天提前1小时。参与者在治疗日1的基线就寝时间前5小时服用0.5毫克褪黑素，之后每天提前1小时服用。每天早晨醒来后，他们接受三种强光（约5000勒克斯）照射模式之一：四次30分钟的照射，中间间隔30分钟的室内光线（2小时组）；四次15分钟的照射，中间间隔45分钟的室内光线（1小时组）；以及一次30分钟的照射（0.5小时组）。治疗前后的暗光褪黑素起始时间（DLMOs）确定了相位提前情况。
与2小时组（相位偏移=2.4±0.8小时）相比，1小时组（1.7±0.7小时）和0.5小时组（1.8±0.8小时）的相位提前偏移较小。2小时模式产生的相位提前最大；然而，单次30分钟的强光照射与分散在3.25小时内的1小时强光照射效果相同，且产生了2小时强光照射所观察到的相位偏移的75%。
早晨30分钟的强光照射与下午褪黑素联合使用是使人体昼夜节律提前的有效治疗方法。
