Treating sleep disruption in teens with millisecond light exposure during sleep

描述(由申请人提供)：延迟睡眠相紊乱(DSPD)是一种现象，其中内部生物钟被设置为与期望的睡眠定时相比相对较晚的时间。DSPD的特点是在理想的就寝时间入睡和早上醒来都有困难。DSPD在青少年中非常常见，因为他们的生理和社会变化都会导致昼夜节律的延迟(延迟)。这将导致一个 反常的晚睡时间。睡眠时间的延迟本身并不是问题。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，这与一系列负面后果有关，包括抑郁、滥用药物、疲劳、学习或工作表现差、社交能力差、冒险行为增加，以及患糖尿病和肥胖症的风险增加。青春期睡眠不足是无处不在的，对青少年和家庭来说往往都是虚弱的。强光“光疗”是治疗DSPD的常用处方。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，以将生物钟的时间提前一小时。这意味着，需要早上7点起床上学的青少年需要每天早上4点或5点起床，坐在明亮的灯光前2-3个小时，这是一套即使不是不可能遵循的指令，也是很难遵循的。来自我们实验室的最新数据表明，一系列短暂的毫秒闪光可以改变生物钟的计时。此外，当受试者睡着时，这些闪光会改变昼夜节律。也就是说，闪光灯可以在睡眠时使用，光线会穿透闭着的眼皮。当光线以这种方式照射时，它不会干扰睡眠。我们的目标是检验这一新的假设，即在睡眠期间对患有DSPD的青少年进行一系列明亮的闪光可以改变生物钟的时间，从而将其设置为更早的小时，从而实现更早的就寝时间。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，全日制高中入学的青少年将被招募参加一项为期一个月的在家研究。在这个月的每个晚上，参与者在睡觉时都会接触到一系列的闪光。他们的睡眠质量， 以及从青少年和父母的角度对情绪的测量，将在协议之前、期间和结束时捕获。这项实验的结果可能从根本上改变DSPD的治疗方式，显著改善青少年的睡眠，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理解睡眠中的光线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相障碍。

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.