Feasibility and preliminary efficacy for morning bright light therapy to improve sleep and plasma biomarkers in US Veterans with TBI. A prospective, open-label, single-arm trial

Elliott, Jonathan E.; McBride, Alisha A.; Balba, Nadir M.; Thomas, Stanley V.; Pattinson, Cassandra L.; Morasco, Benjamin J.; Wilkerson, Andrea; Gill, Jessica M.; Lim, Miranda M.

doi:10.1371/journal.pone.0262955

Title: Feasibility and preliminary efficacy for morning bright light therapy to improve sleep and plasma biomarkers in US Veterans with TBI. A prospective, open-label, single-arm trial

Journal Article · Thu Apr 14 00:00:00 EDT 2022 · PLoS ONE

DOI:https://doi.org/10.1371/journal.pone.0262955· OSTI ID:1864744

^[1]; McBride, Alisha A. ^[2]; Balba, Nadir M. ^[1]; Thomas, Stanley V. ^[3]; Pattinson, Cassandra L. ^[4]; Morasco, Benjamin J. ^[1];

^[5]; Gill, Jessica M. ^[6]; Lim, Miranda M. ^[7]

VA Portland Health Care System, Portland, OR (United States); Oregon Health & Science Univ., Portland, OR (United States)
VA Portland Health Care System, Portland, OR (United States)
Creighton Univ., Omaha, NE (United States)
Univ. of Queensland, Brisbane, QLD (Australia); National Inst. of Nursing Research, Bethesda, MD (United States)
Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Oregon Health & Science Univ., Portland, OR (United States)
National Inst. of Nursing Research, Bethesda, MD (United States)
Oregon Health & Science Univ., Portland, OR (United States); Pacific Northwest National Lab. (PNNL), Richland, WA (United States); VA Portland Health Care System, Portland, OR (United States)

Mild traumatic brain injury (TBI) is associated with persistent sleep-wake dysfunction, including insomnia and circadian rhythm disruption, which can exacerbate functional outcomes including mood, pain, and quality of life. Present therapies to treat sleep-wake disturbances in those with TBI (e.g., cognitive behavioral therapy for insomnia) are limited by marginal efficacy, poor patient acceptability, and/or high patient/provider burden. Thus, this study aimed to assess the feasibility and preliminary efficacy of morning bright light therapy, to improve sleep in Veterans with TBI (NCT03578003). Thirty-three Veterans with history of TBI were prospectively enrolled in a single-arm, open-label intervention using a lightbox (~10,000 lux at the eye) for 60-minutes every morning for 4-weeks. Pre- and post-intervention outcomes included questionnaires related to sleep, mood, TBI, post-traumatic stress disorder (PTSD), and pain; wrist actigraphy as a proxy for objective sleep; and blood-based biomarkers related to TBI/sleep. The protocol was rated favorably by ~75% of participants, with adherence to the lightbox and actigraphy being ~87% and 97%, respectively. Post-intervention improvements were observed in self-reported symptoms related to insomnia, mood, and pain; actigraphy-derived measures of sleep; and blood-based biomarkers related to peripheral inflammatory balance. The severity of comorbid PTSD was a significant positive predictor of response to treatment. Morning bright light therapy is a feasible and acceptable intervention that shows preliminary efficacy to treat disrupted sleep in Veterans with TBI. A full-scale randomized, placebo-controlled study with longitudinal follow-up is warranted to assess the efficacy of morning bright light therapy to improve sleep, biomarkers, and other TBI related symptoms.

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Research Organization:: Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

Sponsoring Organization:: USDOE

Grant/Contract Number:: AC05-76RL01830

OSTI ID:: 1864744

Report Number(s):: PNNL-SA-154724

Journal Information:: PLoS ONE, Vol. 17, Issue 4; ISSN 1932-6203

Publisher:: Public Library of ScienceCopyright Statement

Country of Publication:: United States

Language:: English

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Feasibility and preliminary efficacy for morning bright light therapy to improve sleep and plasma biomarkers in US Veterans with TBI. A prospective, open-label, single-arm trial Elliott, Jonathan; McBride, Alisha; Balba, Nadir Dryad https://doi.org/10.5061/dryad.rjdfn2zcr	dataset	January 2022

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Title: Feasibility and preliminary efficacy for morning bright light therapy to improve sleep and plasma biomarkers in US Veterans with TBI. A prospective, open-label, single-arm trial

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