Morning vs evening light treatment of patients with winter depression

Alfred Lewy, Vance K. Bauer, Neil L. Cutler, Robert Sack, Saeeduddin Ahmed, Katherine H. Thomas, Mary L. Blood, Jeanne M Latham Jackson

Research output: Contribution to journalArticle

219 Citations (Scopus)

Abstract

Background: According to the phase-shift hypothesis for winter depression, morning light (which causes a circadian phase advance) should be more antidepressant than evening light (which causes a delay). Although no studies have shown evening light to be more antidepressant than morning light, investigations have shown either no difference or morning light to be superior. The present study assesses these light-exposure schedules in both crossover and parallel-group comparisons. Methods: Fifty-one patients and 49 matched controls were studied for 6 weeks. After a prebaseline assessment and a light/dark and sleep/wake adaptation baseline week, subjects were exposed to bright light at either 6 to 8 AM or 7 to 9 PM for 2 weeks. After a week of withdrawal from light treatment, they were crossed over to the other light schedule. Dim-light melatonin onsets were obtained 7 times during the study to assess circadian phase position. Results: Morning light phase-advanced the dim-light melatonin onset and was more antidepressant than evening light, which phase-delayed it. These findings were statistically significant for both crossover and parallel-group comparisons. Dim-light melatonin onsets were generally delayed in the patients compared with the controls. Conclusions: These results should help establish the importance of circadian (morning or evening) time of light exposure in the treatment of winter depression. We recommend that bright-light exposure be scheduled immediately on awakening in the treatment of most patients with seasonal affective disorder.

Original languageEnglish (US)
Pages (from-to)890-896
Number of pages7
JournalArchives of General Psychiatry
Volume55
Issue number10
DOIs
StatePublished - Oct 1998

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Depression
Light
Therapeutics
Melatonin
Antidepressive Agents
Appointments and Schedules
Seasonal Affective Disorder
Sleep

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Lewy, A., Bauer, V. K., Cutler, N. L., Sack, R., Ahmed, S., Thomas, K. H., ... Jackson, J. M. L. (1998). Morning vs evening light treatment of patients with winter depression. Archives of General Psychiatry, 55(10), 890-896. https://doi.org/10.1001/archpsyc.55.10.890

Morning vs evening light treatment of patients with winter depression. / Lewy, Alfred; Bauer, Vance K.; Cutler, Neil L.; Sack, Robert; Ahmed, Saeeduddin; Thomas, Katherine H.; Blood, Mary L.; Jackson, Jeanne M Latham.

In: Archives of General Psychiatry, Vol. 55, No. 10, 10.1998, p. 890-896.

Research output: Contribution to journalArticle

Lewy, A, Bauer, VK, Cutler, NL, Sack, R, Ahmed, S, Thomas, KH, Blood, ML & Jackson, JML 1998, 'Morning vs evening light treatment of patients with winter depression', Archives of General Psychiatry, vol. 55, no. 10, pp. 890-896. https://doi.org/10.1001/archpsyc.55.10.890
Lewy, Alfred ; Bauer, Vance K. ; Cutler, Neil L. ; Sack, Robert ; Ahmed, Saeeduddin ; Thomas, Katherine H. ; Blood, Mary L. ; Jackson, Jeanne M Latham. / Morning vs evening light treatment of patients with winter depression. In: Archives of General Psychiatry. 1998 ; Vol. 55, No. 10. pp. 890-896.
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