The efficacy of combined bright light and melatonin therapies on sleep and circadian outcomes: A systematic review - 30/07/21

Doi : 10.1016/j.smrv.2021.101491

Daniel Chih Yung Cheng ^a,^{^{1
These authors have contributed equally to this work.}}, James L. Ganner ^a,^{^{1
These authors have contributed equally to this work.}}, Christopher J. Gordon ^c,^d, Craig L. Phillips ^a,^c,^e, Ronald R. Grunstein ^b,^c,^f, Maria Comas ^b,^c,^⁎
^a Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
^b Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
^c CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, NSW, Australia
^d Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW, Australia
^e Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia
^f Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia

^∗Corresponding author. CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037 Australia. Fax: +61 2 9114 0014.CIRUSCentre for Sleep and ChronobiologyWoolcock Institute of Medical Research431 Glebe Point RoadGlebeNSW2037Australia

Summary

The aim of this systematic review was to investigate the effects of combined melatonin and bright light therapies on improved sleep and circadian outcomes. We conducted a systematic review that resulted in a total of eight papers meeting criteria. Four papers investigated the effectiveness of combined therapy in inducing a circadian phase shift on healthy participants. Combined therapy outperformed single light and melatonin therapies in phase advancing, but not in delaying, dim light melatonin onset (DLMO). The other four papers investigated the effect of combined therapy on sleep outcomes. Two of them were performed in elderly populations suffering from cognitive decline and two in delayed sleep-wake phase disorder (DSWPD) patients. While combined therapy was more beneficial than single therapy in elderly populations it did not show any benefit in DSWPD patients. The reported adverse effects of melatonin in elderly populations must be carefully considered. Future studies should investigate the separate and combined effect of melatonin and bright light on sleep and circadian outcomes in different target populations.

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Keywords : Circadian rhythms, Sleep, Light therapy, Exogenous melatonin

Plan

Introduction

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Study selection and data extraction

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Study selection and characteristics

Circadian clock phase shift

Objective sleep outcomes

Subjective sleep quality and sleepiness

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Vol 58

Article 101491- août 2021 Retour au numéro

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The efficacy of combined bright light and melatonin therapies on sleep and circadian outcomes: A systematic review - 30/07/21

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