Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, United States.
Department of Neurology, University of Michigan, Ann Arbor, MI 48109, United States.
Pain Med. 2023 Jul 5;24(7):787-795. doi: 10.1093/pm/pnad007.
Fibromyalgia is characterized by chronic widespread pain, mood, and sleep disturbance. Pharmacological treatments have modest efficacy and are associated with negative side effects, and alternative approaches are needed. Morning bright light treatment may assist in the management of fibromyalgia as it can reduce depressive symptoms, improve sleep, and advance circadian timing.
Sixty people with fibromyalgia (58 women, mean age 41.8 ± 13.3 years) were enrolled in a study comparing 4 weeks of a 1-hour daily morning bright light treatment (active treatment) to a morning dim light treatment (comparison treatment). Both light treatments included behavioral procedures to stabilize sleep timing. The morning bright light treatment was expected to produce larger improvements in pain and function than the dim light treatment and larger improvements in potential mediators (mood, sleep, and circadian timing).
Both the bright and dim light treatment groups achieved significant but similar levels of improvement in pain intensity, pain interference, physical function, depressive symptoms, and sleep disturbance. Overall, the sample on average displayed a clinically meaningful improvement in the Fibromyalgia Impact Questionnaire-Revised score (mean reduction of 11.2 points), comparable to that reported following physical exercise treatments. Minimal side effects were observed.
Findings indicate that the effects of a morning bright light treatment did not exceed those of a comparison dim light treatment; yet the changes on average in both conditions revealed clinically meaningful improvements. Future research is warranted to identify what elements of this trial may have contributed to the observed effects.
纤维肌痛的特征为慢性广泛性疼痛、情绪和睡眠障碍。药物治疗的疗效有限，且伴有负面副作用，因此需要替代方法。晨光疗法可能有助于纤维肌痛的管理，因为它可以减轻抑郁症状、改善睡眠并调整昼夜节律。
60 名纤维肌痛患者（58 名女性，平均年龄 41.8±13.3 岁）参与了一项比较 4 周每日 1 小时晨光治疗（主动治疗）与晨光弱光治疗（比较治疗）的研究。两种光照治疗均包括稳定睡眠时间的行为程序。预计晨光治疗比弱光治疗在疼痛和功能方面产生更大的改善，以及在潜在的调节因素（情绪、睡眠和昼夜节律）方面产生更大的改善。
强光和弱光治疗组在疼痛强度、疼痛干扰、身体功能、抑郁症状和睡眠障碍方面均取得了显著但相似的改善。总体而言，样本平均在纤维肌痛影响问卷修订版评分上显示出有临床意义的改善（平均减少 11.2 分），与运动治疗报告的改善相当。观察到最小的副作用。
研究结果表明，晨光治疗的效果并不优于比较弱光治疗；但两种条件下的平均变化均显示出有临床意义的改善。需要进一步研究以确定该试验的哪些元素可能促成了观察到的效果。
