The effect of evening bright light in delaying the circadian rhythms and lengthening the sleep of early morning awakening insomniacs.

Past studies have predicted that early morning awakening insomnia is associated with advanced or early circadian rhythms. Because bright light stimulation in the evening can delay the phase of circadian rhythms, we tested its effects on nine (4 females, 5 males) early morning awakening insomniacs. Their sleep was evaluated with wrist actigraphy and their temperature and melatonin circadian rhythms were measured in constant routine procedures. In the initial evaluation, the temperature rhythm phase positions of these insomniacs did appear to be earlier than normal. The subjects were then exposed to bright light stimulation (2,500 lux) from 2000 to 2400 hours on two consecutive evenings. Following the evening bright light treatment, temperature rhythm phase markers were delayed 2-4 hours and melatonin phase markers were delayed 1-2 hours. Sleep onset times were not changed but the mean final wake-up time was delayed from 0459 hours to 0611 hours, resulting in a mean increase of total sleep time of > 1 hour. This pilot study suggests that evening bright light stimulation may be an effective nondrug treatment for early morning awakening insomnia.