Abstract
Objectives: The discovery of the blue lightsensitive retinal photoreceptor responsible for signaling daytime to the brain suggested that light to the circadian system could be inhibited by using blue-blocking orange tinted glasses. Blue-blocking (BB) glasses are a potential treatment option for bipolar mania. We examined the effectiveness of BB glasses in hospitalized patients with bipolar disorder in a manic state.
Methods: In a single-blinded, randomized, placebo-controlled trial (RCT), eligible patients (with bipolar mania; age 18-70 years) were recruited from five clinics in Norway. Patients were assigned to BB glasses or placebo (clear glasses) from 6 p.m. to 8 a.m. for 7 days, in addition to treatment as usual. Symptoms were assessed daily by use of the Young Mania Rating Scale (YMRS). Motor activity was assessed by actigraphy, and compared to data from a healthy control group. Wearing glasses for one evening/night qualified for inclusion in the intention-to-treat analysis.
Results: From February 2012 to February 2015, 32 patients were enrolled. Eight patients dropped out and one was excluded, resulting in 12 patients in the BB group and 11 patients in the placebo group. The mean decline in YMRS score was 14.1 [95% confidence interval (CI): 9.7-18.5] in the BB group, and 1.7 (95% CI: -4.0 to 7.4) in the placebo group, yielding an effect size of 1.86 (Cohen's d). In the BB group, one patient reported headache and two patients experienced easily reversible depressive symptoms.
Conclusions: This RCT shows that BB glasses are effective and feasible as add-on treatment for bipolar mania.
https://pubmed.ncbi.nlm.nih.gov/27226262/
Bipolar disorder
Bipolar affective disorder is a mental disorder characterised by large periodic fluctuations in mood. In the past, the term manic-depressive illness was used. Those suffering from bipolar affective disorder experience periods of greatly elevated mood (mania), periods of greatly depressed mood (depression) and periods of normal state. Bipolar affective disorder affects the level of activity, behaviour, the ability to function in everyday life and the ability to think clearly and make sensible choices.
Description
There are many theories and trials in connection with bipolar affective disorder, and some of them propose a new approach to the treatment of the disease.
Firstly, some researchers have the theory that the root of the problem is a failure of the body's internal clock, whereby the circadian rhythm does not function normally.
Second, remarkable success has been achieved in the treatment of bipolar affective disorder by subjecting patients to long periods of darkness.
Thirdly, sleep glasses, which filter out the blue light in the light spectrum, can be used to create dark periods even in daylight. Sleep glasses start the production and secretion of melatonin.
Taking these three factors into account, a new type of treatment for bipolar affective disorder has been proposed and is now being used in trials.
In the period 2012 to 2015, researchers in Norway used sleep glasses from MelaMedic as a supplement to the medical treatment of patients with bipolar disorder. All the patients achieved a marked improvement in their condition.
Bipolar disorder and sleep glasses
The patients with bipolar affective disorder must initially wear the sleep glasses for a longer period than usual, so the time the sleep glasses are worn plus the time the patients sleep in the dark amounts to approximately 12 hours a day.
Patients must develop a routine to fall asleep at a certain time and to wake up at a certain time, and they must not sleep in the middle of the day. If they feel tired in the middle of the day, they should be exposed to strong light - preferably outdoors. As an example, they can wear sleep glasses from 7 p.m. in the evening and until they go to bed in the dark at 11 p.m. Shortly after the patients wake up at 7 a.m., they must expose their eyes to strong light – preferably outdoors or alternatively using light therapy.
Patients must not be exposed to blue light during the aforementioned 12 hours. This means that they must either wear the sleep glasses, which filter out the blue light, or use special lamps and screen filters mounted on TVs and PCs, which have the same property.
It can take several days before the internal clock is synchronised with the circadian rhythm.
Always consult your doctor if you want to use sleep glasses in connection with bipolar disorder.
Research regarding bipolar disorder
Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial
Bipolar Disord. 2016 May;18(3):221-32. doi: 10.1111/bdi.12390.Tone Eg Henriksen, Silje Skrede, Ole B Fasmer, Helle Schoeyen, Ieva Leskauskaite, Jeanette Bjørke-Bertheussen, Jörg Assmus, Børge Hamre, Janne Grønli, Anders Lund PMID: 27226262 / PMCID: PMC5089565 / DOI: 10.1111/bdi.12390
We investigated the effectiveness of sleep glasses in hospitalised patients with bipolar disorder in a manic state, who had to wear the sleep glasses as a supplement to their medical...
Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial
We investigated the effectiveness of sleep glasses in hospitalised patients with bipolar disorder in a manic state, who had to wear the sleep glasses as a supplement to their medical treatment. The trial as perceived use of placebo glasses shows that sleep glasses are effective and possible to use in adjunctive treatment for bipolar mania.
Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial
Bipolar Disord. 2016 May;18(3):221-32. doi: 10.1111/bdi.12390.
PMID: 27226262 / PMCID: PMC5089565 / DOI: 10.1111/bdi.12390
Blocking blue light during mania - markedly increased regularity of sleep and rapid improvement of symptoms: a case report
Bipolar Disord. 2014 Dec;16(8):894-8. doi: 10.1111/bdi.12265. Epub 2014 Sep 27.Tone E G Henriksen, Silje Skrede, Ole Bernt Fasmer, Børge Hamre, Janne Grønli, Anders LundPMID: 25264124 / DOI: 10.1111/bdi.12265
Virtual dark therapy using sleep glasses is a promising new treatment option for mania. The basis for this may be the recently identified blue light-sensitive retinal photoreceptor, which is solely...
Blocking blue light during mania - markedly increased regularity of sleep and rapid improvement of symptoms: a case report
Virtual dark therapy using sleep glasses is a promising new treatment option for mania. The basis for this may be the recently identified blue light-sensitive retinal photoreceptor, which is solely responsible for the light stimulus to the internal clock that controls the circadian rhythm. This is the first case report describing the clinical course of a closely monitored inpatient in a manic episode who was first given clear glasses and then sleep glasses. The patient's total length of hospital stay was 20 days shorter than the average time during his previous manic episodes. The unusually rapid decline in symptoms, accompanied by consistent sleep parameter changes toward markedly increased regularity, suggest that sleep glasses may target a central mechanism in the pathophysiology of mania that needs to be explored in both clinical and basic science research.
Blocking blue light during mania - markedly increased regularity of sleep and rapid improvement of symptoms: a case report
Bipolar Disord. 2014 Dec;16(8):894-8. doi: 10.1111/bdi.12265. Epub 2014 Sep 27.
PMID: 25264124 / DOI: 10.1111/bdi.12265
Abstract
Objective: Available pharmacological treatment of mania is insufficient. Virtual darkness therapy (blue light-blocking treatment by means of orange-tinted glasses) is a promising new treatment option for mania. The basis for this might be the recently identified blue light-sensitive retinal photoreceptor, which is solely responsible for light stimulus to the circadian master clock. This is the first case report describing the clinical course of a closely monitored, hospitalized patient in a manic episode first receiving clear-lensed, and then blue light-blocking glasses.
Methods: A 58-year-old Caucasian man, with bipolar I disorder and three previous manic episodes, was hospitalized during a manic episode. In addition to pharmacological treatment, he was treated with clear-lensed glasses for seven days, then one day without glasses, followed by six days of blue light-blocking glasses. During the entire observational period, he wore an actigraph with internal light sensors.
Results: Manic symptoms were unaltered during the first seven days. The transition to the blue-blocking regime was followed by a rapid and sustained decline in manic symptoms accompanied by a reduction in total sleep, a reduction in motor activity during sleep intervals, and markedly increased regularity of sleep intervals. The patient's total length of hospital stay was 20 days shorter than the average time during his previous manic episodes.
Conclusions: The unusually rapid decline in symptoms, accompanied by uniform sleep parameter changes toward markedly increased regularity, suggest that blue-blockers might be targeting a central mechanism in the pathophysiology of mania that needs to be explored both in clinical research and in basic science.
https://pubmed.ncbi.nlm.nih.gov/25264124/
Objective: Available pharmacological treatment of mania is insufficient. Virtual darkness therapy (blue light-blocking treatment by means of orange-tinted glasses) is a promising new treatment option for mania. The basis for this might be the recently identified blue light-sensitive retinal photoreceptor, which is solely responsible for light stimulus to the circadian master clock. This is the first case report describing the clinical course of a closely monitored, hospitalized patient in a manic episode first receiving clear-lensed, and then blue light-blocking glasses.
Methods: A 58-year-old Caucasian man, with bipolar I disorder and three previous manic episodes, was hospitalized during a manic episode. In addition to pharmacological treatment, he was treated with clear-lensed glasses for seven days, then one day without glasses, followed by six days of blue light-blocking glasses. During the entire observational period, he wore an actigraph with internal light sensors.
Results: Manic symptoms were unaltered during the first seven days. The transition to the blue-blocking regime was followed by a rapid and sustained decline in manic symptoms accompanied by a reduction in total sleep, a reduction in motor activity during sleep intervals, and markedly increased regularity of sleep intervals. The patient's total length of hospital stay was 20 days shorter than the average time during his previous manic episodes.
Conclusions: The unusually rapid decline in symptoms, accompanied by uniform sleep parameter changes toward markedly increased regularity, suggest that blue-blockers might be targeting a central mechanism in the pathophysiology of mania that needs to be explored both in clinical research and in basic science.
https://pubmed.ncbi.nlm.nih.gov/25264124/
Dark therapy for bipolar disorder using amber lenses for blue light blockade
Med Hypotheses. 2008;70(2):224-9. doi: 10.1016/j.mehy.2007.05.026. Epub 2007 Jul 16.James PhelpsPMID: 17637502 / DOI: 10.1016/j.mehy.2007.05.026
Sleep glasses have already been shown to maintain normal night-time melatonin levels in a light environment that otherwise completely suppresses melatonin production. Preliminary trials show that some patients with bipolar...
Dark therapy for bipolar disorder using amber lenses for blue light blockade
Sleep glasses have already been shown to maintain normal night-time melatonin levels in a light environment that otherwise completely suppresses melatonin production. Preliminary trials show that some patients with bipolar disorder experience reduced latency to sleep onset with sleep glasses, suggesting an impact on the circadian rhythm. If sleep glasses can effectively simulate darkness, a wide range of conditions may respond to this inexpensive therapeutic device, such as: common forms of insomnia; lack of sleep in nursing mothers; disruption of the circadian rhythm of shift workers; and maybe even rampant bipolar disorder.
Dark therapy for bipolar disorder using amber lenses for blue light blockade
Med Hypotheses. 2008;70(2):224-9. doi: 10.1016/j.mehy.2007.05.026. Epub 2007 Jul 16.
PMID: 17637502 / DOI: 10.1016/j.mehy.2007.05.026
Abstract
"Dark Therapy", in which complete darkness is used as a mood stabilizer in bipolar disorder, roughly the converse of light therapy for depression, has support in several preliminary studies. Although data are limited, darkness itself appears to organize and stabilize circadian rhythms. Yet insuring complete darkness from 6 p.m. to 8 a.m. the following morning, as used in several studies thus far, is highly impractical and not accepted by patients. However, recent data on the physiology of human circadian rhythm suggests that "virtual darkness" may be achievable by blocking blue wavelengths of light. A recently discovered retinal photoreceptor, whose fibers connect only to the biological clock region of the hypothalamus, has been shown to respond only to a narrow band of wavelengths around 450 nm. Amber-tinted safety glasses, which block transmission of these wavelengths, have already been shown to preserve normal nocturnal melatonin levels in a light environment which otherwise completely suppresses melatonin production. Therefore it may be possible to influence human circadian rhythms by using these lenses at night to blunt the impact of electrical light, particularly the blue light of ubiquitous television screens, by creating a "virtual darkness". One way to investigate this would be to provide the lenses to patients with severe sleep disturbance of probable circadian origin. A preliminary case series herein demonstrates that some patients with bipolar disorder experience reduced sleep-onset latency with this approach, suggesting a circadian effect. If amber lenses can effectively simulate darkness, a broad range of conditions might respond to this inexpensive therapeutic tool: common forms of insomnia; sleep deprivation in nursing mothers; circadian rhythm disruption in shift workers; and perhaps even rapid cycling bipolar disorder, a difficult- to -treat variation of a common illness.
https://pubmed.ncbi.nlm.nih.gov/17637502/
"Dark Therapy", in which complete darkness is used as a mood stabilizer in bipolar disorder, roughly the converse of light therapy for depression, has support in several preliminary studies. Although data are limited, darkness itself appears to organize and stabilize circadian rhythms. Yet insuring complete darkness from 6 p.m. to 8 a.m. the following morning, as used in several studies thus far, is highly impractical and not accepted by patients. However, recent data on the physiology of human circadian rhythm suggests that "virtual darkness" may be achievable by blocking blue wavelengths of light. A recently discovered retinal photoreceptor, whose fibers connect only to the biological clock region of the hypothalamus, has been shown to respond only to a narrow band of wavelengths around 450 nm. Amber-tinted safety glasses, which block transmission of these wavelengths, have already been shown to preserve normal nocturnal melatonin levels in a light environment which otherwise completely suppresses melatonin production. Therefore it may be possible to influence human circadian rhythms by using these lenses at night to blunt the impact of electrical light, particularly the blue light of ubiquitous television screens, by creating a "virtual darkness". One way to investigate this would be to provide the lenses to patients with severe sleep disturbance of probable circadian origin. A preliminary case series herein demonstrates that some patients with bipolar disorder experience reduced sleep-onset latency with this approach, suggesting a circadian effect. If amber lenses can effectively simulate darkness, a broad range of conditions might respond to this inexpensive therapeutic tool: common forms of insomnia; sleep deprivation in nursing mothers; circadian rhythm disruption in shift workers; and perhaps even rapid cycling bipolar disorder, a difficult- to -treat variation of a common illness.
https://pubmed.ncbi.nlm.nih.gov/17637502/