1010 MORNING BRIGHT LIGHT TREATMENT IMPROVES FUNCTION AND REDUCES PAIN SENSITIVITY IN FIBROMYALGIA

Abstract

Fibromyalgia is characterized by chronic widespread pain, mood and sleep disturbance, cognitive dysfunction, and affects over 20 million Americans. Pharmacological treatments (antidepressants, antiepileptics, opioids) often have small treatment effects and adverse side-effects. Exercise therapy requires significant patient motivation, and psychotherapy requires specialized personnel. Here we report on a pilot study in which we tested a home-based morning and evening bright light treatment in patients with fibromyalgia and examined changes in function and pain sensitivity. Ten adults (22–59 years) meeting ACR 2010 diagnostic criteria for fibromyalgia participated in a 15-day protocol. Each subject slept at home on their usual sleep schedule for 1 week before an overnight session. During the overnight session, baseline function (Fibromyalgia Impact Questionnaire, FIQ), pain sensitivity (heat threshold and tolerance), and circadian timing (dim light melatonin onset, DLMO) were assessed. The next morning subjects were randomized to either 6 days of a self-administered home morning or evening light treatment (light boxes, 1 hour per day). Afterwards, function, pain sensitivity and circadian timing were reassessed. On average, subjects completed 84% of the scheduled light treatments. No side effects were reported. Both morning and evening light treatments led to improvements in function and pain sensitivity. However, only morning light treatment led to a clinically meaningful improvement in function (>14% reduction in FIQ) and heat pain threshold (p<0.05). Phase advances in circadian timing were associated with an increase in pain tolerance (r=0.67, p<0.05). Morning bright light treatment should be further explored as a potentially feasible, acceptable and effective adjunctive treatment for fibromyalgia. The improvement in function was similar to that seen after psychotherapy, and about half of the improvement seen after months of exercise training. Phase advances in circadian timing may be one mechanism by which morning bright light improves function and pain sensitivity in fibromyalgia. Fogarty Sleep Research Pilot Grant, Rush University Medical Center.