Treating sleep disruption in teens with millisecond light exposure during sleep

描述（由申请人提供）：延迟睡眠相位障碍（DSPD）是一种现象，其中内部昼夜节律时钟被设置为与期望的睡眠定时相比相对较晚的时间。DSPD的特征是难以在期望的睡觉时间入睡和早上醒来。DSPD在青少年中非常常见，因为他们有生物和社会变化，导致昼夜节律时间延迟（延迟）。这导致 异常晚的就寝时间睡眠时间的延迟本身并没有问题。然而，当起床时间固定时，就像大多数上学的青少年一样，DSPD会导致睡眠减少，这与各种负面后果有关，包括抑郁症，药物滥用，疲劳，学业或工作表现不佳，社交不良，冒险行为增加，以及糖尿病和肥胖症发展的风险增加。青春期的睡眠不足是普遍存在的，通常会使青少年和家庭都感到虚弱。明亮的光“光疗”通常用于治疗DSPD。这种治疗包括每天在所需的唤醒时间之前给予2-3小时的强光，以将生物钟的计时提前到更早的时间。这意味着需要在早上7点起床上学的青少年需要在早上4点或5点起床，每天坐在明亮的灯光前2-3个小时，这是一套很难遵循的指令。我们实验室最近的数据表明，一系列短暂的毫秒级闪光可以改变生物钟的时间。此外，这些闪光可以在受试者睡眠时改变昼夜节律。也就是说，闪光可以在睡眠期间施用，并且光将穿透闭合的眼睑。当以这种方式管理光时，它不会干扰睡眠。我们的目的是研究新的假设，即在睡眠期间给予DSPD青少年一系列明亮的闪光可以改变生物钟的时间，使其被设置为更早的时间，并使更早的就寝时间。我们假设这将改善DSPD的症状，并改善整体情绪和行为。为了检验这些假设，将招募全日制高中入学的青少年参加为期一个月的家庭研究。在这个月的每个晚上，参与者将在睡觉时暴露在一系列闪光灯下。他们的睡眠质量 以及从青少年和父母的角度测量情绪，将在协议之前，期间和结束时捕获。这项实验的结果可以从根本上改变DSPD的治疗方式，显着改善青少年的睡眠，同时改善情绪，学习成绩和家庭生活。这项研究的结果也将有助于了解睡眠期间的光管理如何有助于治疗其他基于昼夜节律的疾病，如时差，轮班工作睡眠障碍和高级睡眠阶段障碍。

DESCRIPTION (provided by applicant): Delayed Sleep Phase Disorder (DSPD) is a phenomenon in which the internal circadian clock is set to a time relatively late compared to desired sleep timing. DSPD is characterized by difficulty both going to sleep at a desired bed time and waking up in the morning. DSPD is very common in adolescents as they have both biological and social changes that cause a delay (latening) of circadian timing. This results in an abnormally late bedtime. The delay in sleep timing, by itself, is not problematic. When wake time is fixed, however, as it is for most adolescents attending school, DSPD results in a curtailment of sleep that is associated with a variety of negative consequences including depression, substance abuse, fatigue, poor academic or work performance, poor socialization, increased risk-taking behavior, and an increased risk for the development of diabetes and obesity. The loss of sleep in adolescence is pervasive and often debilitating for both the teen and the family. Bright light "phototherapy" is often prescribed for treatment of DSPD. This treatment consists of 2-3 hours of bright light administered every day prior to desired wake time to advance the timing of the circadian clock to an earlier hour. This means that an adolescent who needs to wake up at 7AM for school would need instead to wake up at 4 or 5AM and sit in front of bright lights for 2-3 hours every day, a difficult if not impossible set of instructions to follow. Recent data from our laboratory has shown that a sequence of brief, millisecond flashes of light can change the timing of the circadian clock. Furthermore, these flashes of light can change circadian timing while the subject is asleep. That is, the flashes can be administered during sleep and the light will penetrate closed eyelids. When light is administered in such a manner, it does not disturb sleep. We aim to examine the novel hypothesis that a sequence of bright light flashes administered during sleep to adolescents with DSPD can change the timing of the circadian clock such that it will be set to an earlier hour and enable an earlier bedtime. We hypothesize that this will improve the symptoms of DSPD as well as improve overall mood and behavior. In order to examine these hypotheses, adolescents enrolled full-time in high school will be recruited to take part in a one-month, at-home study. During every night of this month, participants will be exposed to a sequence of flashes while they sleep. The quality of their sleep, as well as measurements of mood from both the adolescent's and the parent's perspectives, will be captured before, during, and at the end of the protocol. Results from this experiment could fundamentally change the manner in which DSPD is treated, significantly improving sleep in adolescents and simultaneously improving mood, academic performance, and family life. Results from this study will also be useful in understanding how light administration during sleep could be useful in the treatment of other circadian-based disorders, such as jet lag, shift work sleep disorder, and Advance Sleep Phase Disorder.