Abstract

Abstract Introduction Long-term sleep disruption, fatigue, and depression are common after mild traumatic brain injuries (mTBIs). Efficacious treatments for these disturbances in the context of mTBIs are lacking. Morning blue light therapy (BLT) effectively treats sleep disruption and improves mood. This study evaluated the treatment effects of morning BLT on post-mTBI daytime sleepiness, depression, and post-concussion symptoms. Methods 62 individuals (Boston: n=31; age: 23.11±7.20y; 17 females; days post-injury: 236.00±121.40; Tucson: n=31; age: 26.35±8.08y; 20 females; days post-injury: 272.94±167.69) received either BLT (n=30) or placebo amber light therapy (ALT; n=32). All participants completed the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Rivermead Post-concussion Symptom Questionnaire (RPQ3 and RPQ13 subscales) pre- and post-treatment. Treatment consisted of direct exposure to either blue or amber light (30 minutes each morning), delivered via tabletop light-box, over six weeks. Baseline and post-treatment values were compared to a non-mTBI, non-treated control sample (Tucson: n=32, age: 23.94±5.41y; 19 females). Results Baseline scores were higher in both mTBI light groups (BLT, ALT, respectively) than controls for the ESS (Cohen’s d=0.83, 0.83), PSQI (d=1.45, 1.71), BDI (d=1.46, 1.62), RPQ3 (d=1.72, 1.62) and RPQ13 (d=1.86, d=1.76). BLT resulted in lower within-group ESS (d=-0.58), BDI (d=-0.50), PSQI (d=-0.57), and RPQ13 (d=-0.45, p=0.005) scores. No improvements were seen following ALT. Minimal ESS score differences between the BLT and controls were observed after treatment (d=0.25). Conclusion Daily morning BLT resulted in moderate improvements in post-mTBI daytime sleepiness, sleep quality, depression, and post-concussion symptoms. These improvements may contribute to enhanced academic and job performance, post-mTBI quality of life, and general recovery. Future work is needed to clarify optimal dosage and precision medicine factors indentifying those most likely to benefit from morning BLT. Support This research was supported by multiple grants from the US Army Medical Research and Materiel Command (USAMRMC) to Dr. William D. S. Killgore, including W81XWH-11-1-0056 and W81XWH-14-1-0571.

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