If you can’t sleep and are feeling blue in your forties and early fifties, you are not alone. Experts are just starting to understand the connection between depression and the reproductive hormone fluctuations that women experience during perimenopause. (And for the record, it’s not the drop in hormones that causes the mood disruption but the ebb and flow.) Adding to the problem: Depression is associated with sleep disturbances such as insomnia and night sweats.
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A New Treatment Approach Combines UV Light and Sleep Phase Adjustment
It has long been established that light therapy (or therapeutic light treatment, using full spectrum light with ultraviolet light blocked out) is effective in treating depression caused by seasonal affective disorder (SAD). According to data presented at the North American Menopause Society Annual Meeting in San Diego this week, combining light therapy with sleep shifting can significantly help women suffering from depression and sleep problems due to perimenopause.
Light and Sleep Pattern Tweaks Are Drug-Free Fixes for Difficult Problems
The importance of this finding lies in the fact that current therapy options are antidepressants or estrogen, which each can cause side effects. “Light therapy and changing sleep habits present a relatively safe and efficacious noninvasive option,” says Barbara Parry, MD, a professor of psychiatry at the University of California in San Diego and one of the lead authors of the study.
How Does Light Therapy Improve Sleep and Mood?
The beneficial effects come through the eyes and not the skin. Studies have looked at SAD subjects who were exposed to bright ambient light; one group wore bathing suits and had their eyes blocked. The second group had their bodies covered but their eyes exposed. The group of people with eyes covered did not receive the positive boost that subjects who had their eyes exposed did, says Dr. Parry: “The light has to be perceived by the retina and via the hypothalamic tract, [which] goes to the pineal gland where melatonin is secreted.”
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Sleep Shifting and Light Combo Produces Stronger, Faster Results, Relief
“We know that if we make a depressed person stay up all night, their mood will improve. However, that effect often ends as soon as they go back to a regular sleep cycle. We also know that using light therapy alone can take up to eight weeks to have positive effects in nonseasonal depression, and the older you are, the longer it seems to take. We wanted to see what happens when we combine light therapy with sleep shifting, when you adjust your sleep schedule to later or earlier bedtimes and restrict sleep to half of the night,” says Parry.
As part of the small study, researchers looked at depressed people and a healthy control group. The initial group of 17 women were randomized into two groups: One had their sleep cycle shifted earlier and received morning light, and the other shifted to a later sleep cycle, receiving evening light. Both groups received additional light therapy from light boxes. At the end of eight weeks, subjects were assessed in terms of mood, sleep measures, and melatonin levels.
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“We found that when we combined the sleep shift with the light treatment, instead of taking eight weeks to work, we could get an effect within two weeks. It improved measures in both mood and sleep,” says Parry.
Which Light Is More Beneficial — Morning or Evening?
Parry reports that although all the women who received some form of light therapy and sleep shifting improved to some degree, “the women whose melatonin circadian rhythms were shifted toward morning light did better in association with the sleep and depression than those whose rhythms were shifted toward the evening light.”
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Importance of Sleep Shifting in Treatment Length
“I think if we had just used the light treatment alone, it would have taken at least eight weeks to get an effect. If we had just done the sleep treatment alone, we would have gotten an effect in one night but the light treatment helps sustain that effect. It was like a booster effect. It’s the combination of the sleep and light therapy that contributed to the results,” notes Parry.
Consult Your Doctor Before Trying Light Therapy and Sleep Shifting on Your Own
- There is a risk that if someone has bipolar disorder, both the sleep and the light conditions can switch them into mania.
- There are different kinds of light boxes. “You need a box that has sufficient intensity, blocks out the UV light, and exposes the whole visual field. There are some individual differences in circadian rhythms, so you need to find one that suits you,” says Parry.
- Bright light treatment potentially can interact with certain medications; it’s best to get clearance from your prescribing physician.
- Ultraviolet light can harm eyes; make sure you use a light box that screens out those rays.