Passive phototherapy to improve sleep in teens

被动光疗改善青少年睡眠

• 批准号: 10407036
• 负责人: JAMIE M ZEITZER
• 金额: $ 55.47万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-18 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10407036
• 关键词: Adolescence; Adolescent; Agitation; Behavior; Behavior Therapy; Behavioral; Biological; Biological Response Modifier Therapy; Circadian Rhythms; Clinical Trials; Cognition; Cognitive; Coupling; Development; Diabetes Mellitus; Disease; Enrollment; Event; Exploratory/Developmental Grant; Exposure to; Family; Fatigue; Funding; Future; Healthy People 2020; Home; Hour; Human; Hyperactivity; Individual; Instruction; Jet Lag Syndrome; Lead; Length; Life; Light; Measures; Medical; Melatonin; Mental Depression; Mental Health; Metabolic; Moods; National Institute of Child Health and Human Development; Obesity; Parents; Participant; Patient Self-Report; Performance; Performance at work; Phase; Phototherapy; Physiological; Placebo Control; Polysomnography; Protocols documentation; Puberty; Regimen; Risk; Risk-Taking; Salivary; Schools; Series; Shift-Work Sleep Disorder; Sleep; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Socialization; Students; Substance abuse problem; System; Teenagers; Testing; Therapeutic; Time; Travel; Truancy; United States Dept. of Health and Human Services; Work; adequate sleep; base; circadian; circadian pacemaker; cost; depressive symptoms; direct application; effective therapy; executive function; experimental study; high school; improved; inattention; laboratory experiment; millisecond; novel; novel therapeutics; open label; recruit; shift work; sleep quality; social; standard care; standard of care; week trial

It is a nearly ubiquitous phenomenon – teens have a difficult time going to sleep early enough to get a full night of sleep. The resulting sleep curtailment 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. According to the Department of Health and Human Services in Healthy People 2020, fewer than one-third of all students in grades 9-12 get sufficient sleep – a number that has remained unchanged since 2009. This pervasive loss of sleep in adolescence is often debilitating for both the teen and the family. There are both biological (natural delay in circadian timing) and social causes, which are mutually reinforcing, for this delay in sleep timing. As a treatment for the biological component, bright light “phototherapy” is often prescribed for teens who wish to go to sleep earlier. This treatment often consists of 1-2 hours of bright light administered every day prior to desired wake time; this treatment is meant 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 5 or 6 AM and sit in front of bright lights for hours every day (the changes in circadian timing would revert without the daily light exposure), a difficult if not impossible set of instructions to follow. We have recently demonstrated that: (1) sequences of brief, millisecond light flashes are more potent than continuous light at changing the timing of the circadian clock, (2) exposure to such sequences of light during sleep impacts circadian timing without significantly interfering with sleep, and (3) at-home exposure to such sequences to teens increases self-reported nightly sleep by nearly one-hour per night. We hypothesize that such a light sequence can increase objective measures of sleep length, as well as improve mood and cognition in teens. In order to examine these hypotheses, adolescents enrolled full-time in high school will be recruited to take part in a 10-week, at-home placebo-controlled parallel group study, followed by a 10-week open-label study. For 8 of the 10 weeks of the parallel group study and during all 10 weeks of the open-label study, adolescents will be exposed to a sequence of flashes while they sleep. The quality and quantity of their objectively-determined sleep, measurements of mood from both the adolescent’s and the parent’s perspectives, and executive function, will be captured before, during, and at the end of the protocol. Results from this experiment could fundamentally change the manner in which delayed sleep 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 circadian-based sleep disorders, such as jet lag, shift work sleep disorder, and Advanced Sleep Wake Phase Disorder.

这几乎是一个无处不在的现象--青少年很难睡得足够早才能得到一个 一整晚的睡眠。由此导致的睡眠减少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， 增加冒险行为，增加患糖尿病和肥胖症的风险。根据 卫生与公众服务部在2020年的健康人中，不到三分之一的学生 9-12年级有充足的睡眠--这个数字自2009年以来一直保持不变。这种无处不在的损失 青春期的睡眠通常会让青少年和家庭都变得虚弱。既有生物学的(自然的) 昼夜节律的延迟)和社会原因，这是相辅相成的，导致这种睡眠时间的延迟。 作为生物成分的一种治疗方法，强光“光疗”通常是青少年的处方药。 希望早点上床睡觉的人。这种疗法通常包括每天1-2小时的强光照射。 在期望的唤醒时间之前；这种治疗意味着将生物钟的计时提前到更早的时间 小时。这意味着，需要早上7点起床上学的青少年需要在早上7点起床。 每天早上5点或6点坐在明亮的灯光前几个小时(昼夜节律的变化会恢复 在没有日常光照的情况下)，很难遵循一套即使不是不可能遵循的说明。我们最近做了 证明：(1)短时、毫秒级的闪光序列比连续光更有效 改变生物钟的定时，(2)在睡眠影响期间暴露在这样的光序列中 昼夜节律而不会显著干扰睡眠，以及(3)在家中暴露在这样的序列中 青少年自我报告的每晚睡眠时间增加了近一小时。我们假设这样的光 序列可以增加睡眠时间的客观测量，也可以改善青少年的情绪和认知。 为了检验这些假设，全日制高中入学的青少年将被招募到 参加为期10周的在家安慰剂对照的平行小组研究，然后进行为期10周的开放标签研究 学习。在平行小组研究的10周中的8周和开放标签研究的所有10周期间， 青少年在睡觉时会暴露在一系列的闪光中。他们的质量和数量 客观决定的睡眠，从青少年和父母的角度衡量情绪， 和执行功能，将在协议之前、期间和结束时捕获。 这项实验的结果可能会从根本上改变治疗延迟睡眠的方式， 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时如何管理光线 可用于治疗基于昼夜节律的睡眠障碍，如时差、轮班工作睡眠障碍、 和高级睡眠觉醒相紊乱。