635 Evening Sunglasses Plus Stable Wake Times: Can This Intervention Help Adolescents with Delayed Sleep-wake Phase Disorder?

Abstract

Abstract Introduction Evening light can increase alertness and shift the circadian clock later (delay) and, in turn, delay sleep onset timing. We are examining whether reducing evening light exposure (by wearing sunglasses) paired with stable wake times can shift circadian and sleep onset times earlier in adolescents with Delayed Sleep-Wake Phase Disorder (DSWPD). Methods Fifteen adolescents (14.7–18.1 years; 4 male) diagnosed with DSWPD are included in this interim analysis. Participants sleep without restriction at home for a baseline week, and then complete a 2-week intervention. One group (Amber; n=7) wears glasses with amber lenses (Cocoons®, Live Eyewear) beginning 7 hours before their baseline mid-sleep time until self-selected bedtime or for 7 hours (corresponds to the phase delay region of the adolescent phase response curve to light). The amber lens transmits 14% of light to the eye and absorbs most short wavelength light. The frame blocks light from all angles. Amber participants are also instructed to wake at their average baseline school-morning wake-up time (±30 mins). Another group (Clear; n=8) wears identical glasses with clear lenses at the same time and wake time is unrestricted. Glasses wear time is monitored with an iButton placed at the temple tip. Dim Light Melatonin Onset (DLMO) is measured after the baseline week and after the 2-week intervention; 2 participants (one from each group) do not have melatonin data due to technical error. Sleep is measured with wrist actigraphy and sleep diaries throughout the study. DLMO and sleep onset changes (baseline-intervention) are compared between groups with t-tests. Results Amber DLMOs shifted 1.0±2.0h earlier (min-max: 0.4-h delay-5.0-h advance) and Clear DLMOs shifted 0.4±1.1h later (min-max: 2.0-h delay-0.6-h advance) [t(11)=1.60,p=0.14]. Average school-night sleep onset shifted earlier in both groups (Amber:0.4±1.3h; Clear:0.6±1.0h; t(13)=0.2,p=0.8]. Average non-school-night sleep onset shifted 1.1±1.0h earlier in Amber (min-max:0.6-h delay-2.2-h advance) and remained stable (0.03±1.0h) in Clear (min-max: 1.8-h delay-1.7-h advance) [t(13)=1.92,p=.08]. Conclusion Trends from this ongoing study suggest that amber-lensed glasses to block evening light plus stable wake-up times may shift circadian rhythms earlier. This strategy appears to help adolescents with DSWPD fall asleep earlier predominantly on non-school nights. Support (if any) AASMF Strategic Research Award (184-SR-17) to RRA