Blue-blocking Glasses Research Articles

Is adjunctive treatment with blue-blocking glasses (virtual darkness) or dark therapy effective in decreasing the duration and severity of bipolar-associated manic episodes in adults?

Is adjunctive treatment with blue-blocking glasses (virtual darkness) or dark therapy effective in decreasing the duration and severity of bipolar-associated manic episodes in adults?

Influence of different light intensities during the day on the motor activity in adolescents

This study investigates the impact of varying light intensities throughout the day on motor activity levels in adolescent girls aged between 14-16, who are students at a boarding school. The study lasted for three weeks, with each week consisting of four days. During this period, participants experienced three different lighting conditions from 07:00 to 18:00. These conditions included: standard light intensity in real-life settings, wearing blue-blocking glasses, and spending at least 1.5 hours outdoors daily for natural light exposure. The aim was to understand how modern lighting sources can replace natural lighting and to assess the influence of the lighting spectrum on the daily rhythms of motor activity. Restriction of blue light led to an increase in the average daily level (MESOR) of the intensity of movements denoted by HPIM (High Proportional Integrative Measures), as well as a decrease in the amplitude of the circadian rhythm ZCM (Zero Crossing Mode). This confirms the important role of blue light during the daytime as a Zeitgeber of the circadian rhythm. When adolescents spent at least 1.5 hours outside, mostly in the afternoon, the acrophases of ZCM’s 24-hour rhythm shifted half an hour later.

Watching intense movies increase IOP of primary open angle glaucoma patients: A prospective study

To investigate intraocular pressure (IOP) changes while viewing smartphone movies under artificial intelligence (AI) monitoring. In all, 48 subjects were recruited from the glaucoma clinic of Xianyou maternal and child health hospital from January 2018 to March 2020. The research consisted of three parts. In part 1, movies rated by the Motion Picture Association of America (MPAA) were viewed via smartphones of various screen sizes under AI supervision for 90minutes, at a distance of 40cm. IOP and biological parameters including anterior chamber angle, Schlemm's canal (SC) cross-sectional area, heart rate, systolic and diastolic blood pressures (SBP and DBP) were measured and analyzed. In part 2, blue-blocking glasses (BB glasses) were worn to repeat the above experiments. In part 3, the efficacy of AI in decreasing attention loss was analyzed. In addition, results were analyzed to determine whether interval breaks, prompted by AI, prevented IOP from rising. In part 1, the mean IOP of primary open angle glaucoma (POAG) subjects' right eyes significantly increased by 4.828 and 4.974mmHg after watching R and NC-17movies, respectively. In their left eyes, it increased by 2.876 and 5.767 after watching R and NC-17movies, respectively. The maximum IOP difference was also increased by 4.782 and 4.510 on right and left eyes, respectively, after viewing NC-17 movies on a 6.1-inch screen. Furthermore, the SC became narrower, whereas heart rate, DBP and SBP increased in the POAG group. In addition, maximum IOP difference was significantly correlated with SC cross-sectional area, DBP and SBP in the POAG group. In part 2, symptom scores were improved by BB glasses; however, IOP was not decreased. In part 3, attention loss was significantly decreased by AI monitoring. On the contrary, AI also prevented IOP from rising via promoting interval rest. Watching adult movies (NC-17) can significantly increase the IOP of POAG patients. AI can prevent IOP from rising by promoting interval rest when viewing NC-17 movies.

Circadian Interventions as Adjunctive Therapies to Cognitive-Behavioral Therapy for Insomnia.

The circadian system plays a key role in the sleep-wake cycle. A mismatch between the behavioral timing of sleep and the circadian timing of sleepiness/alertness can contribute to insomnia. Patients who report primarily difficulty falling asleep or early morning awakenings may benefit from circadian interventions administered adjunctively to cognitive-behavioral therapy for insomnia. Specific circadian interventions that clinicians may consider include bright light therapy, scheduled dim light, blue-blocking glasses, and melatonin. Implementation of these interventions differs depending on the patient's insomnia subtype. Further, careful attention must be paid to the timing of these interventions to ensure they are administered correctly.

Hybrid effectiveness-implementation study of two novel spectrally engineered lighting interventions for shiftworkers on a high-security watchfloor.

Shiftwork leads to myriad negative health and safety outcomes. Lighting countermeasures can benefit shiftworkers via physiological effects of light (e.g. alerting, circadian adjustment), and short-wavelength light is the most potent for eliciting those responses; however, limited work indicates it may not be required for alerting. We developed similar-appearing light boxes (correlated color temperature: 3000-3375 K; photopic illuminance: 260-296 lux), enriched (SW+, melanopic EDI: 294 lux) or attenuated (SW-, melanopic EDI: 103 lux) in short-wavelength energy, and implemented them on a high-security watchfloor. Efficacy and feasibility of these two novel lighting interventions were assessed in personnel working 12-hour night shifts (n = 47) in this within-participants, crossover study. For each intervention condition, light boxes were arranged across the front of the watchfloor and illuminated the entire shift; blue-blocking glasses were worn post-shift and before sleep; and sleep masks were used while sleeping. Comparisons between baseline and intervention conditions included alertness, sleep, mood, quality of life (QOL), and implementation measures. On-shift alertness (Karolinska Sleepiness Scale) increased in SW- compared to baseline, while changes in SW+ were more limited. Under SW+, both mood and sleep improved. Psychomotor vigilance task performance did not vary by condition; however, perceived performance and QOL were higher, and reported caffeine consumption and sleep onset latency were lower, under SW-. For both interventions, satisfaction and comfort were high, and fewer symptoms and negative feelings were reported. The addition of spectrally engineered lights to this unique work environment improved sleep, alertness, and mood without compromising visual comfort and satisfaction. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.

A randomized controlled trial on the effect of blue-blocking glasses compared to partial blue-blockers on melatonin profile among nulliparous women in third trimester of the pregnancy

ObjectiveIn pregnancy melatonin regulates circadian rhythms, induce sleep, and has a neuroprotective positive effect on fetal development. Artificial blue light in the evening delays and suppresses melatonin production. Thus, we investigated the effect of blocking blue light on the melatonin profile. MethodsA randomized controlled trial (n=30 blue-blocking glasses vs. n=30 control glasses with partial blue-blocking effect) including healthy nulliparous pregnant women in the beginning of the third trimester. Salivary melatonin and subjective sleep were measured before and after two weeks of intervention/control condition. Saliva was sampled at 30-min intervals from 3 h before normal bedtime. Melatonin onset was set at 4.0 pg/ml. ResultsDue to missing data melatonin onset was estimated for 47 participants. At posttreatment, melatonin onset advanced by 28 min in the blue-blocking group compared with the control condition (p=.019). Melatonin levels were significantly higher, favoring the blue-blocking glass condition, at clock time 20:00, 21:00 and 22:00 h, and for sample number 3 and 4. The phase angle (time interval) between melatonin onset and sleep bedtime and sleep onset time increased within the blue blocking group (+45 min and +41 min, respectively), but did not reach statistical significance compared to control condition (+13 min and +26 min, respectively). ConclusionBlocking blue light in the evening had a positive effect on the circadian system with an earlier onset and rise of melatonin levels in healthy nulliparous pregnant women. This demonstrated the effectiveness and feasibility of a simple non-pharmacological chronobiological intervention during pregnancy.

257 How Much Blue Do Blue-Blockers Block if Blue-Blockers Do Block Blue?

Abstract Introduction Short-wavelength light (440-530nm) can suppress endogenous melatonin secretion from the pineal gland. This has been observed in realworld settings when people use electronic media at night that emits light from this part of the visible spectrum. Blue-blocking glasses are a possible intervention to reduce blue light exposure. The present study evaluated the ability of commercially available blue-blockers to block blue light emitted by LEDs. Methods A calibrated spectroradiometer (Ocean Insight), cosine corrector, optic fiber, and software package were used to measure the absolute irradiance (uW/cm^2/nm) generated from a blue light source (Phillips Go Lite Blu) in an otherwise completely dark room. Thirty-one different commercially-available blue-blockers were individually placed between the cosine corrector and the light source at a standardized distance, and then intensity was measured and analyzed. Lenses were evaluated with regards to the amount of blue light they suppressed both individually and grouped by lens tint: red-tinted lenses (RTL), orange-tinted lenses (OTL), orange-tinted lenses with blue reflectivity (OBL), brown-tinted lenses (BTL), yellow-tinted lenses (YTL), and clear lenses with blue reflectivity (RBL). Results RTL blocked 100% of the short-wavelength light, while OTL and OBL blocked 99%, BTL blocked 66%, YTL blocked 38%, and RBL blocked 11% of it. This represented a statistically significant between-group difference (one-way ANOVA, < 0.0001). Within groups, there was variability in performance among individual lenses, though this variability was small compared to the between-group differences. Conclusion The RTL, OTL, and OBL block light best capable of suppressing melatonin secretion at night (440-530 nm); with slightly less efficacy, BTL and YTL also restricted much of the light exposure. Lastly, RBL were not effective at curtailing short-wavelength light. Those looking to optimize blue-blocking capabilities should use RTL, OTL, and OBL, rather than other lens types. Support (if any):

258 Blue Blockers’ Ability to Block Circadian-Active Light Emitted from a Tablet

Abstract Introduction Short-wavelength light emitted from electronic devices in the evening can harm circadian health by suppressing endogenous melatonin and phase-delaying the timing of the wake-sleep cycle. Blue-blocking glasses are one possible intervention to reduce this exposure. The present study evaluated the differential ability of commercially available blue-blockers to filter out the blue range of visible-spectrum light emitted by a common electronic device. Methods A calibrated spectroradiometer (Ocean Insight), cosine corrector, optic fiber, and software package were used to measure the absolute irradiance (uW/cm^2/nm) emitted from a commercially-available computer tablet (iPad) displaying a blank white screen in a closeted dark room. Thirty-one commercially-available blue-blockers were individually placed between the cosine corrector and the tablet. At a standardized distance and angle, the resulting intensity profile was measured and analyzed. Each lens was evaluated individually relative to the light source and then evaluated across subtypes, including red-tinted lenses (RTL), orange-tinted lenses (OTL), orange-tinted lenses with blue reflectivity (OBL), brown-tinted lenses (BTL), yellow-tinted lenses (YTL), and clear reflective blue lenses (RBL). Results There was significant variation in tablet-generated light-blocking across the full spectrum (one-way ANOVA, p < 0.0001) and for the 440-530nm range in particular (one-way ANOVA, p < 0.0001). RTL blocked 99%, OTL blocked 81%, OBL blocked 75%, BTL blocked 83%, YTL blocked 33%, and RBL blocked 17% of broadspectrum light (380-780nm). In the 440nm-530nm range, RTL, OTL, and OBL blocked 100% of the emission, while BTL blocked 81%, YTL blocked 47%, and RBL blocked 18% of it. Conclusion When using a popular tablet device, RTL, OTL and OBL blocked the most circadian photosensitive parts of the light exposure, indicating they can best preserve the timing of endogenous melatonin secretion in the presence of tablet light at night. By contrast, RBL demonstrated very little efficacy. Support (if any) R01MD011600, R01DA051321

Blue light filtering ophthalmic lenses: A systematic review

ABSTRACT Background: Blue blocking (BB) lenses, including spectacles and intraocular lenses, work by attenuating short-wavelength light. BB glasses are being marketed with the aim to reduce eye fatigue symptoms when using digital devices, improve sleep quality and potentially confer protection from retinal phototoxicity. BB intraocular lenses following cataract surgery may be implanted because they are thought to prevent age-related macular degeneration (AMD) progression. Methods: The present study is a systematic review aiming to analyze BB lenses clinical efficacy in preventing blue light-related ocular disorders, including AMD progression, eye fatigue, and their impact on sleep quality. We searched Medline, PubMed, Web of Science and the Cochrane Library until May 2020. Results:Although several studies have been performed investigating BB lenses, clinical efficacy for preventing or attenuating the above-mentioned ocular disorders is often theorical or based on laboratory or animal experiments. Conclusions: To date, there is a lack of consistent evidence for a larger-sclale introduction of BB lenses in the routine clinical practice.

Let there be blue-depleted light: in-patient dark therapy, circadian rhythms and length of stay

SUMMARYLight is the most important environmental influence (zeitgeber) on the synchronization of the circadian system in humans. Excess light exposure during the evening and night-time affects secretion of the hormone melatonin, which in turn modifies the temporal organization of circadian rhythms, including the sleep–wake cycle. As sleep disturbances are prominent in critically ill medical and psychiatric patients, researchers began to examine the impact of light exposure on clinical outcomes and length of hospitalization. In psychiatric inpatients, exposure to bright morning light or use of blue blocking glasses have proved useful interventions for mood disorders. Recently, knowledge about light and the circadian system has been applied to the design of inpatient facilities with dynamic lighting systems that change according to time of day. The installation of ‘circadian lighting’ alongside technologies for monitoring sleep–wake patterns could prove to be one of the most practical and beneficial innovations in inpatient psychiatric care for more than half a century.

A double-blind, randomized, placebo-controlled trial of adjunctive blue-blocking glasses for the treatment of sleep and circadian rhythm in patients with bipolar disorder.

Recent studies have suggested that evening blue light exposure is associated with sleep and circadian rhythm abnormalities. This study examined the effect of blue-blocking (BB) glasses on sleep and circadian rhythm in patients with bipolar disorder (BD). We used a randomized, placebo-controlled, double-blinded design. Outpatients with BD and also with insomnia were randomly assigned to wear either orange glasses (BB) or clear ones (placebo) and were instructed to use these from 20:00hours until bedtime for 2weeks. The primary outcome metric was the difference in change from baseline to after intervention in sleep quality, as measured by the visual analog scale (VAS). Forty-three patients were included in this study (BB group, 21; placebo group, 22). The change in sleep quality as per the VAS metric was not significantly different between the two groups (95% confidence interval [CI], -3.34 to 24.72; P=.13). However, the Morningness-Eveningness Questionnaire score had shifted to an advanced rhythm in the BB group and to a delayed rhythm in the placebo group, and the difference in these changes was statistically significant (95% CI, 1.69-7.45; P=.003). The change in the actigraphy sleep parameters and mood symptoms was not significantly different between the two groups. Although concurrent medications may have influenced, our results suggest that BB glasses may be useful as an adjunctive treatment for circadian rhythm issues in patients with BD.

Blue-blocking glasses as additive treatment for mania: Effects on actigraphy-derived sleep parameters.

Improvement of sleep is a central treatment goal for patients in a manic state. Blue-blocking (BB) glasses as adjunctive treatment hasten overall recovery from mania. This method is an evolvement from dark therapy and builds on the discovery of the blue-light-sensitive retinal ganglion cell that signals daytime to the brain. We report effects of adjunctive BB glasses on actigraphy-derived sleep parameters for manic inpatients as compared to placebo. Hospitalized patients with bipolar disorder in a manic state aged 18-70years were recruited from five clinics in Norway from February 2012 to February 2015. The participants were randomly allocated to wearing BB glasses or placebo (clear glasses) as an adjunctive treatment from 18:00 to 08:00hours for seven consecutive nights. Sleep and wake were monitored by actigraphy. From 32 eligible patients, 10 patients in each group qualified for the group analyses. The BB group's mean sleep efficiency was significantly higher at night 5 as compared to the placebo group (92.6% vs. 83.1%, p=.027). The 95% confidence interval (CI) was 89.4%-95.8% in the BB group and 75.9%-90.3% in the placebo group. There were fewer nights of interrupted sleep in the BB group: 29.6% versus 43.8% in the placebo group. The BB group received less-intensive sleep-promoting pharmacological treatment and showed significantly higher sleep efficiency and more consolidated sleep as compared to the placebo group. Our findings suggest sleep-promoting effects through deactivating mechanisms. Adjunctive BB glasses seem to be useful for improving sleep for manic patients in the hospital setting.

Do green-blocking glasses enhance the nonvisual effects of white polychromatic light?

BackgroundIt is well known that light containing the blue component stimulates the intrinsically photosensitive retinal ganglion cells (ipRGCs) and plays a role in melatonin suppression and pupillary constriction. In our previous studies, we verified that simultaneous exposure to blue and green light resulted in less pupillary constriction than blue light exposure. Hence, we hypothesized that the nonvisual effects of polychromatic white light might be increased by blocking the green component. Therefore, we conducted an experiment using optical filters that blocked blue or green component and examined the nonvisual effects of these lights on pupillary constriction and electroencephalogram power spectra.MethodsTen healthy young males participated in this study. The participant sat on a chair with his eyes facing an integrating sphere. After 10 min of light adaptation, the participant’s left eye was exposed to white pulsed light (1000 lx; pulse width 2.5 ms) every 10 s with a blue-blocking glasses, a green-blocking glasses, or control glasses (no lens), and pupillary constriction was measured. Then, after rest for 10 min, the participant was exposed a continuous white light of 1000 lx with a blue- or green-blocking glasses or control glasses and electroencephalogram was measured.ResultsPupillary constriction with the blue-blocking glasses was significantly less than that observed with the green-blocking glasses. Furthermore, pupillary constriction under the green-blocking glasses was significantly greater than that observed with the control glasses.ConclusionsA reduction in the green component of light facilitated pupillary constriction. Thus, the effects of polychromatic white light containing blue and green components on ipRGCs are apparently increased by removing the green component.

Blue blocking glasses worn at night in first year higher education students with sleep complaints: a feasibility study

BackgroundLate adolescence and early adulthood is a period of highest incidence for onset of mental health problems. Transition to college environment has been associated with many risk factors such as the initial disruption—and subsequent irregularity—of the student’s sleep and activity schedule. We tested the feasibility of using blue blocking glasses (BBG) at night in first year higher education students with sleep complaints, to obtain preliminary evidence for the impact of BBG on sleep, activity, and mood.MethodsParticipants were 13 first year undergraduates (from 10 different academic courses) living on campus for the first time with sleep complaints/disorders confirmed at screening via the Duke Structured Interview Schedule for Sleep Disorders. We used a 2-week, balanced crossover design (BBG vs placebo glasses; participants were unaware which was the active intervention) with computer-generated random allocation. Exploratory analyses provided descriptive and frequency summaries to evaluate feasibility of the intervention.ResultsPreliminary evidence supports the feasibility and acceptability of the trial; almost all screened participants consented and completed the protocol with high adherence; missing data were negligible. Additionally, the effectiveness of BBGs to enhance sleep, mood, and activity levels in young adults was supported.ConclusionsThe results of this feasibility trial suggest that BBG have potential as an inexpensive and feasible intervention for reducing sleep and circadian dysregulation in young adult students. A larger trial, following this successfully implemented protocol, is necessary to fully test the efficacy of BBG.

Blue blocking glasses worn at night in first year higher education students with sleep complaints: a feasibility study

Blue blocking glasses worn at night in first year higher education students with sleep complaints: a feasibility study

Attenuation of short wavelengths alters sleep and the ipRGC pupil response.

Exposure to increasing amounts of artificial light during the night may contribute to the high prevalence of reported sleep dysfunction. Release of the sleep hormone melatonin is mediated by the intrinsically photosensitive retinal ganglion cells (ipRGCs). This study sought to investigate whether melatonin level and sleep quality can be modulated by decreasing night-time input to the ipRGCs. Subjects (ages 17-42, n=21) wore short wavelength-blocking glasses prior to bedtime for 2weeks. The ipRGC-mediated post illumination pupil response was measured before and after the experimental period. Stimulation was presented with a ganzfeld stimulator, including one-second and five-seconds of long and short wavelength light, and the pupil was imaged with an infrared camera. Pupil diameter was measured before, during and for 60s following stimulation, and the six-second and 30s post illumination pupil response and area under the curve following light offset were determined. Subjects wore an actigraph device for objective measurements of activity, light exposure, and sleep. Saliva samples were collected to assess melatonin content. The Pittsburgh Sleep Quality Index (PSQI) was administered to assess subjective sleep quality. Subjects wore the blue-blocking glasses 3:57±1:03h each night. After the experimental period, the pupil showed a slower redilation phase, resulting in a significantly increased 30s post illumination pupil response to one-secondshort wavelength light, and decreased area under the curve for one and five-second short wavelength light, when measured at the same time of day asbaseline. Night time melatonin increased from 16.1±7.5pgmL-1 to 25.5±10.7pgmL-1 (P<0.01). Objectively measured sleep duration increased 24min, from 408.7±44.9 to 431.5±42.9min (P<0.001). Mean PSQI score improved from 5.6±2.9 to 3.0±2.2. The use of short wavelength-blocking glasses at night increased subjectively measured sleep quality and objectively measured melatonin levels and sleep duration, presumably as a result of decreased night-time stimulation of ipRGCs. Alterations in the ipRGC-driven pupil response suggest a shift in circadian phase. Results suggest that minimising short wavelength light following sunset may help in regulating sleep patterns.

Effect of blue-blocking glasses in major depressive disorder with sleep onset insomnia: A randomized, double-blind, placebo-controlled study

ABSTRACTBlue wavelengths form the portion of the visible electromagnetic spectrum that most potently regulates circadian rhythm. We hypothesized that wearing blue-blocking (BB) glasses in the evening may influence circadian rhythm disturbances in patients with major depressive disorder (MDD), resulting in improved sleep and mood. We used a randomized placebo-controlled double-blinded design. Patients with MDD with sleep onset insomnia were randomly assigned to wearing either BB glasses or clear glasses (placebo). Patients were instructed to wear the glasses from 20:00 hours until bedtime for 2 weeks. We assessed sleep state (sleep quality on a visual analog scale, the Morningness–Eveningness Questionnaire [MEQ], and a sleep diary) and depressive symptoms at baseline and after 2 weeks. Data were analyzed with a full analysis set. In total, 20 patients were randomly assigned to the BB and placebo groups (BB group, n = 10; placebo group, n = 10). There were three dropouts (BB group, n = 1; placebo group, n = 2). At baseline, sleep quality, sleep latency (assessed via a sleep diary), and antipsychotics use differed between the groups. To take account of these differences, the baseline sleep state or depressive symptoms and antipsychotics use were used as covariates in the later analysis. The change scores for sleep quality did not show a significant improvement in the BB group compared with the placebo group (mean [standard deviation, SD] scores for BB versus placebo: 36.1 [31.7] versus 16.2 [15.1], p = 0.43), although half of the BB group showed a clear improvement in sleep quality. The change in MEQ scores did not significantly differ between the groups (p = 0.14), although there was a trend of a shift to morning type in the BB group (3.10 [4.95] points) and to evening type in the placebo group (0.50 [3.89] points). There were no statistically significant changes in depressive symptoms in either group. Across both groups, 40% of the participants reported pain or discomfort from wearing the glasses, which were available in only one size. Thus, the failure to find significant differences may have resulted from the glasses used in this study. Glasses fitted to individual patients may improve efficacy and safety. Replication of the study with a larger sample size and size-adjustable glasses is needed.

Commentary on 'Blue-blocking glasses as additive treatment for mania: A randomized placebo-controlled trial'.

Commentary on 'Blue-blocking glasses as additive treatment for mania: A randomized placebo-controlled trial'.

Commentary on "Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial".

Commentary on "Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial".

Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial.

ObjectivesThe 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.MethodsIn 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.ResultsFrom 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.ConclusionsThis RCT shows that BB glasses are effective and feasible as add‐on treatment for bipolar mania.