Archive for February 2010

What my sleep’s up to these days

February 26, 2010

The yellow bulbs in the hall are continuing to work well to light the bathroom, and the salt lamp is now confirmed for staying by the bed with a pink 15W pygmy bulb in it.  I should probably mention that there’s no reason why anyone should get a salt lamp, I just find them pretty myself, and they already filter out a certain amount of blue light (though not all) through being orangey.  It’s odd, the light looks deep pink if you put it on when the room is already lit, and more orange if you put it on when the room is dark.  It’s useful for when I want to sneak out of bed and get dressed when my partner’s still asleep, as it’s not bright or blue enough to wake him up, or as soft background lighting in the late evening.  Most useful of all, the cable has ended up positioned so that the switch is down the side of the bedside cabinet, about as easy to get to from the bed as is humanly possible, which saves fumbling around in the drawer to find the red bike light or similar. By the way, if you do decide that salt lamps are nice and go looking for one, ignore all the nonsensical health claims.  They’re just pretty lamps.

For some reason my sleep’s been a little odd over the last couple of weeks.  It may be because when my partner had a week off, our routines changed slightly.  I set the clock on the dawn simulator so that it would come on an hour later, as he said he wanted a bit of a lie-in but not to end up losing the whole morning.  I was often up and lightboxing before the dawn simulation as my wake-up time seems to be well-programmed, but it seemed to work well for him.  Then we went to bed an hour or so later than usual, which for me is strange as by now you generally can’t keep me up much past midnight however you try.  I’ve also been a lot more tired than usual during the afternoons and evenings, which I am now putting down to the ME/CFIDS having a minor flare.

Now that he’s back at work, I have been wrestling with the problem of my body’s sudden ardent desire to have siestas.  I’ve snapped back into my usual wake-up time with no trouble whatsoever, but I keep getting irresistibly sleepy later in the day.  I’ve tried fighting it for a few days, using the lightbox on a double stint in the morning and/or an extra session after lunch or early afternoon, and putting the little blue LED bulb into a clip-on light (which leaves it fully visible; at 1W it’s not so bright that you can’t look at it comfortably) and putting it by the bed or laptop from 9.30 am to 3 pm.  I’ve known that LED bulb to keep me quite wired at night if used up to 4.30 pm, but it didn’t do a thing for keeping me awake in the afternoons this time.  I wondered about adding a bit of 470nm blue light to my dawn simulation in the hope that it would get the message across to my circadian clock more effectively, and tried setting it for 15 min before and after the start of the dawn simulation.  When it actually came on, it turned out to be much brighter in a dark room than I’d expected, so I immediately turned it off.  I’d still be curious to try a blue or white LED dawn simulator one day.  The only blue one I know of was put together by this guy, and the only white one that’s meant to be any good (there are some cheap ‘n’ nasty things around) is the SRS320 by Morning Sunrise (Sunrise System), which not everyone likes as an overall unit.

I have now given in and realised that my body probably just wants more sleep by now, which can happen from time to time with ME.  I slept 16-20 hours a day the first year I was ill, not that I anticipate going back to that.  But someone on an ME forum did recently tell me that she feels best when she makes herself get about 11 hours’ sleep a day, which she guesses is due to her body’s increased need to do repair work during sleep, so I think trying some extra sleep is worthwhile.  I’m still aiming for my usual bedtime but am not too worried if we end up going to bed an hour later, though I’m occasionally lying awake for a little or waking up an hour before my alarm, something that’s less common for me these days.  The siestas are going OK, they range from 1-3 hours, though I suspect today may have been more like 4.  I originally tried sleeping with the curtains open and then went for closing them so that the room is pretty dark, in the spirit of having a proper sleep.  I think I’ll go back to leaving them open, I don’t want to end up messing up my sleeping pattern by getting my body to think that mid-afternoon is bedtime.  I’ve also gone back to herbal sleep aids at bedtime, since they never do me any harm, I just stopped them because at that point they were redundant.  I may as well get all the sleep I can if my body’s clamouring for it.

So far, my sleep at night is a little more broken as described above, but I no longer have the problem of having to torture myself to stay awake earlier in the day.  My overall energy levels are relatively low at the moment, so I think I made the right call on getting more sleep.  The only snag is that when I don’t remember to turn the phones off for my siesta I get woken several times (this is bringing back how awkward it is to sleep during the day), and when I do turn them off, I forget to turn them back on again!

Update

I’m definitely feeling better with more sleep, at least over the last few days.  I’m taking a fair bit of herbal stuff to knock myself out at night, last night it was one valerian formula, one 400mg valerian, and two 300mg passiflora/100mg chamomile capsules, but I’ve taken that sort of dose before and know that I’m absolutely fine with it, though I probably wouldn’t want to be relying on it long-term.  It’s far safer than temazepam in the short-term, though.  Last night it was mainly because I was concerned that my accidentally long siesta would mess up my treasured new sleep pattern and didn’t want to undo months of work. It took a little longer than my new norm to get to sleep (possibly – it’s really hard to tell), though far less than my old norm, and while I woke up at 7 am, I got back to sleep again.  Having a siesta has meant that I skip the stage of spending the afternoon trying to keep my eyes open, and while I’m still tired and ME-relapsy, I haven’t felt like a dead cat for a few days now.  It seems that I do indeed need this much sleep right now, even if my body has to be cajoled into getting it at the right times.

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Dawn simulation: review of the Sunrise System SRS100

February 23, 2010

The Sunrise System SRS100 is the second dawn simulator that I tried, after I found the Lumie Bodyclock to be too limited.  I like being able to choose exactly what sort of light I have by my bed and where it is positioned, and using a plug-in dawn simulator allowed me to do exactly that.  In fact, it even allowed me to take my partner’s light preferences into consideration.  If you use a multiway plug, you can hook up as many lamps as you like, provided that the total wattage does not exceed 300W (Europe model) or 200W (USA model).  You could light up the entire room on that, if you wished.  It needs to be straightforward lamp that does not include a dimmer function already (so touch lamps are out), and you have to use the right kind of bulb (standard incandescent and dimmable energy-saving halogen are fine; fluorescent, LED, or ordinary halogen won’t do), but apart from that, any lamp will do.  If you want to put in a “special daylight bulb”, which used to mean a “neodymium” incandescent bulb with a lavender coating but now means a dimmable halogen (both are meant to produce a whiter light, tbut he dimmable halogen does a better job and is a lot easier and cheaper to find, not to mention energy-saving), then you can.  I’d suggest using the energy-saving dimmable halogen, not just for those reasons but also because with the best will in the world, dawn simulators are prone to buzzing when standard incandescents are used, and they don’t do this at all with dimmable halogen.

From reading a large number of dawn simulator reviews, while a small number of people are choosy about the exact colour of the light they wake up to, far more are concerned with the brightness.  Reviewers of all-in-one models frequently complain that the light is not bright enough to wake them up (or read by), and very occasionally complain that it’s too bright for them.  The ability to select exactly how long the dawn simulation takes appears to be another key issue.  Nor does this type of dawn simulator ever cause problems with not liking the appearance of the lamp (several brands are frequently slated as producing ugly, cheap-looking lamps), or having to replace the entire unit when the built-in bulb dies (this problem appears to occur only with the Philips Wake-Up Light).  This unit is not going to win any art awards (I’ve yet to see any type of light therapy device which will), but it’s fairly standard-looking for this sort of gadget and is reasonably small and neat at 11.5 x 13 x 7.5 (base)/3 (top) cm.  The picture above is showing it next to a fairly small lamp.

Being able to choose exactly what sort of light you use, where you position it and how long it takes to come on, is a joy, especially if you have a partner and the two of you have slightly different tastes in this department.  I’m perfectly happy to be woken by a fairly strong light after half an hour, but my partner finds it much too bright when he’s still at that stage of waking up.  After some experimentation, we put a stronger bulb on my side of the bed than on his, and set the dawn simulation to take an hour so that we’re getting up while the light is still softer and don’t have to face bright light until we’re more awake.

Dawn simulation is originally intended to be used while asleep, but we’ve somehow ended up using it while we’re dozing and then getting up, as my partner prefers to have several sound alarms starting at the same time that the dawn simulation starts.  It still works: we wake up feeling more refreshed and we find it easier to wake up at the same time every day.  We both find that about fifteen or so minutes into it, we’re not at all keen on this whole morning idea and may even try to hide under the quilt if we’re awake enough, but by the time the light is fully on, we’re up and doing.  I’ve also used dawn simulation in the conventional fashion in the past, when it would feel as if I simply blinked and was peacefully awake, rather than being dragged painfully into consciousness by an alarm clock.

In the new model (more on this below), Morning Sunrise have put in a couple of features which I wasn’t sure about at first but now rather like.  The first is that when you simply turn the lamp on or off, it fades up/down over two seconds instead of coming on instantly.  This took me a while to get used to, but it can be soothing, and it’s mostly useful for when you want to turn the lamp off and then get out of the bedroom without tripping over in the dark.  The other feature is that if you let the dawn simulator come on and don’t do anything to it (I think this only applies when the sound alarm is off, otherwise you have to press a button), the light will stay on for an additional hour, turn off, and the dawn simulator will automatically come on the next day.  This is handy for people who may forget to turn their dawn simulator on every day, and also people who dash out of the house in the morning and can’t remember whether they turned the light off or not.  I presume the hour is to give you time to shower, dress, breakfast and so forth.  I’m often still in my bedroom after that hour, so I just turn the lamp on again using the snooze button.  I’ve also just been reminded that the extra hour is useful as a back-up if you’re not properly woken by the dawn simulation, for example if you snooze for a while after awakening.

This lamp also has a number of other features which I don’t use but other people may find useful.  There’s an optional nightlight which is adjustable, so that you can set it to come on as brightly as you please.  Obviously I’m not keen on nightlights that have any blue light in them as they will suppress melatonin production, but incandescent and dimmable halogen bulbs produce very yellow light when they’re that dim and there won’t be much blue in there, so most people will be happy with this.  (It’s certainly better than some of the nightlights you can buy which produce bluish white light, the last thing they should do.)  There’s a “security” setting that will put the lamp on at random intervals as a burglar-deterrent if you’re away.

The majority of these are features that you’re not going to get with an all-in-one dawn simulator, where you’re lucky if you can change the length of time the sunrise/sunset takes, and the cost of the Sunrise Syste, SRS100 is equivalent to the cheapest end of the all-in-ones, at least the decent models.  (There are a few cheap and nasty things out there, which can generally be spotted because they cost a tenner new on eBay and get diabolical reviews on Amazon.)  To compare to Lumie’s all-in-one range, you have to spend £99.95 with Lumie before you can vary the length of the sunrise/sunset (though they don’t offer 45  or 75 min) and £149.95 before you get seven-day alarm settings, and even then you may find that the lamp is too dim to read by.  On the other hand, the SRS100 doesn’t include sleep sounds, a radio or anything else like that.  Morning Sunrise offers more expensive models with those features if you want them, and come to that they also offer several fully-featured all-in-one models as well.

As with all dawn simulators, there’s an optional back-up sound if light isn’t enough to wake you reliably every single morning.  The sound it makes is absolutely horrible.  It beeps once, then twice, then three times, and I don’t think I’ve ever been able to stand it for longer than that.  Some people prefer to have a good strong sound, even if it’s vile, so that they can guarantee that it will get them up, but personally I’d rather set the alarm on my phone.

The people at Morning Sunrise have gone to quite a lot of trouble to make this dawn simulator customisable.  I originally bought mine several years ago, and eventually it started showing a couple of minor faults.  Morning Sunrise suggested that I send it in for repair at the cost of £15, and that they’d either repair it and upgrade the software, or replace it if it was beyond repair.  They ended up replacing it, and told me that the damage had been caused by a power surge, so I bought a surge protector for my new model.  (I definitely recomend getting a surge protector, they’re cheap and it seems that dawn simulators may be particularly vulnerable to power surges.)  This does mean that I can compare the older and the newer software, and I know that they’ve changed things because of customer requests.  I’ve found their customer service to be excellent.

The snag is that they’re trying to pack a lot into a fairly small unit with only five buttons.  I feel that it’s time that they redesigned the unit slightly to add a couple more buttons and to make the display light up in a sleep-friendly colour (red or amber) rather than the melatonin-suppressing green.  To give an example of how things have changed:

Old model: backlight options were full, dim, or full for a few seconds after pressing a button and then dim afterwards.  This meant that there was an annoying light by your bed at night.  Customers complained about this, so it changed to:

New model: backlight options are the above three plus completely off or full for a few seconds and then off.  I went for the last option, so I no longer have to drape a cardigan over the display at night, but on the other hand I can’t see the display unless there’s a strong light on, and have trouble even then.  I’m looking at it now and I can just about see the time, but I can’t see the date or the little row of symbols at the top that show whether the dawn simulator is on and so forth.

What they should try next: programming it to illuminate the display during the daytime only, either on a timer or by following when the light was on.  I’ve mentioned this to them and they made interested noises.

That is, of course, a very minor quibble.  Complaints are more often about how long it takes to programme the device.  I find it straightforward and intuitive to programme, unlike the GoLite, as you simply cycle through a very long menu.  This does, however, mean that if you just want to change one thing that’s at the end of the menu, it’ll take a while to get there.  Being able to have an individual setting for each day of the week is great, but if you want to change your sunrise times then you will have to go through seven settings to do so, there’s no way to do them all at once.  Shift work would be a nightmare.  When my partner was on holiday this week we decided to have a bit of a lie-in but still get up at a reasonable hour, and instead of resetting all the sunrise times I actually ended up just moving the clock by an hour instead.  I’d really love to see a “holiday” feature where you could simply set all your sunrises to come on an hour later than usual.  This isn’t something that exists in other dawn simulators to the best of my knowledge, I’m just getting greedy because the device has such capabilities already.

The main thing that bothers me, since setting the device is something you only have to do occasionally, is that there aren’t enough buttons and they all mean different things at different times.  The ZZZ button is the main way to turn the lamp on and off, but when the sunrise is in action it’s the snooze button and will turn the light down to dim for seven minutes before turning it back onto full, as opposed to simply turning it off.  I often have to press the buttons twice to get a response, for some reason.  If you want to adjust the intensity of the lamp when it’s not mimicking a sunrise or sunset, you press the + and – buttons.  However, if you just leave the dawn simulation to come on every day automatically without turning it off (a little clock will show on the display), pressing the + button when the lamp is on will begin the sunset.  I also had to ring Morning Sunrise to find out how to get the dawn simulation to come on automatically every day without accidentally disabling it when I turned the light on or off, as it wasn’t in the manual.  The device really needs a couple of extra buttons so that the dawn simulation is controlled completely separately from the main lamp.  There have been quite a few occasions when I accidentally started the dusk simulation or disabled the next day’s dawn simulation.

While I did have to spend a while relearning how to use this dawn simulator after I’d had it replaced, and grumble about a few details, in general I am very happy with it and trust that Morning Sunrise will continue to improve the product so that the snags are ironed out.  They appear to have noticed that green isn’t the best colour for a display judging from their more recent dawn simulators, for example, so hopefully the rest will follow.  Judging from the reviews I’ve read, product quality seems to be consistently good with this company.  This is their most basic model but it’s still feature-packed, and I understand that it’s an extremely popular dawn simulator worldwide.

Morning Sunrise have both UK and EU models, and will ship internationally.  At the moment, it’s cheapest to buy from the manufacturers rather than a reseller.  The same dawn simulators are sold in the US under the brand name BlueMax, although I still haven’t worked out which is the parent company.

Up early again

February 16, 2010

I’m still getting used to the incredible idea of being up before other people are.  Yesterday I woke up, got onto the computer, looked at my to-do list, thought, “I must ring the council about that damaged pipe in the main stairwell,” and then realised that it was still only 8.45.  Right now I’ve been up for an hour, my partner is still having a lie-in, and I should give it another half-hour or so before ringing my mother.  I never even knew what time she woke up before.

You know how it is when you are newly and mutually in love with someone, and you exist in a state of delighted astonishment that it’s really happening?  I’ve been like that about being able to sleep at conventional hours, and sleep more deeply at that.  Now I’m starting to come out of the honeymoon period and look more seriously at my sleep and energy patterns.

My sleep pattern is mostly solid to the point of being occasionally inconvenient.  I disgraced myself by falling asleep in the middle of a TV episode last night at midnight, and there have been quite a few times recently when my partner’s wanted to stay up later than I can and we’ve not been able to spend that time together.  I’m getting up at the same time as him on workdays, but he tends to go to bed later (he’s allowed to have a social life, after all, and is generally a night owl) and then pay off his sleep debt by having a long lie-in on his days off.  Maybe we’ll be able to work around this better with practice.

What has been more of an issue recently is that instead of getting more energetic as the day goes on, to the point where I’m bouncing around at 11 pm, my energy peak seems to have moved to the morning and I’ve been sleepier than I’d like in the afternoons and evenings.  One problem is that this makes me terribly anti-social when my partner gets home from work, and the other is that I just don’t like being sleepy for that much of the day, and have a feeling that my overall energy levels are less than they were a few weeks ago.  I’ve been waking at 6.30 and then going back to sleep or dozing for the last three days, although yesterday I gave in and got up at 7.30; no idea why, or whether it’s just a temporary blip, but this is not where I’d like my energy to be, especially since I’ve been even more tired than usual later in the day.

Of course, the ME goes up and down all the time anyway, and it’s been a stressful week, so perhaps that is what’s causing this.  Ten days ago I decided to try a little experiment just before bed.  I’d had my orange specs on since 9, but just before midnight I tried taking them off and putting the twig lights on instead.  These are fairy lights on twigs in a vase by the other side of the bed, and as they’re rice lights rather than LED lights, it’s a soft, warm light which I didn’t think would have enough blue in it to keep me awake.  I was wrong.  I suspect that by now I’ve sensitised myself to light levels, which is great when I’m deliberately manipulating them but means that I have to be more careful about accidental changes.  I missed that sleep wave and the next one, and at four was lying in bed tossing and turning, in the way that used to be normal for me for years but now seems intolerable.  I woke up at the usual time a few hours later, and in the interests of not losing my hard-won sleep pattern, stayed awake.  Sleep deprivation always  makes me groggy and generally worse the next day, and in particular heightens pain.  Usually the pain is a stabbed-in-the-eye-sockets type headache, but for some reason it’s gone for my joints and in particular my hands.  The pain has mostly gone if I don’t overdo it, but it’s still causing enough trouble that I haven’t gone back to quilting yet, and this is a very long hangover from one bad night’s sleep.  Ah well, the mysteries of ME, who knows.

However, this has made me wonder exactly what’s going on with ME and my levels of melatonin/serotonin/other relevant hormones.  I never did find a sleep specialist who knew a thing about circadian rhythm disorders, so I’m going to ask my GP, who is not a specialist in sleep or ME but is generally wonderful, open-minded, and interested in how I’ve been fixing my sleep.  I’m currently going for 11 hours of darkness plus 1 hour of dawn simulation, which is a fairly substantial change from what my body was used to for all those years before.  Perhaps it’s more melatonin than is actually optimal for me?  The general idea behind darkness therapy is that we’re evolved to need 12 hours of darkness and 12 of light in the 24, but I suppose that’s for healthy people, not people whose entire systems are in a mess and behaving differently.

Alternatively, it could be that 12 hours of darkness is exactly what I need, it’s just that I’ll have to go through an adjustment period.  There’s a lesser-known treatment for ME called the Marshall Protocol in which light is almost entirely restricted for the first two years of treatment.  This is done along with other major changes such as high doses of antibiotics, so it doesn’t reflect my situation that closely, but I think it’s worth popping into a Marshall Protocol forum and asking them about this.

I wish I had a nice friendly specialist to consult who knew about all of this.  All I can recall from my reading at the moment is that sleep disorders are the norm in ME, to the point where it’s been proposed that ME is actually a type of sleep disorder, and that morning cortisol levels are low in women with ME, which is where I hope that the dawn simulation (which raises cortisol levels in the preferred way) will be useful.  From what’s happened so far, I am getting the feeling that light and darkness could affect my health quite profoundly, and I’d love to know the best way to utilise them.  I don’t even know how much sleep would be the ideal amount for me, for all I know it’s more than 8 hours.

Meanwhile, yesterday I tried a second lightbox stint at 3.30pm, and I think it did the trick.  I had the odd energy dip, but I wasn’t tempted to fall asleep until helplessly doing so at midnight.  I’ll keep this up for a few days, and if it doesn’t continue to be helpful, I’ll follow my partner’s suggestion of starting the darkness therapy later.  My gut feeling is that brighter daytime light is a better approach to this particular issue than shorter nighttime darkness.

First discussion!

February 13, 2010

Welcome to all my new readers!  I’d like to open the floor to you here.  Tell me about your sleep, what you’ve tried for it, whether you’ve used light or darkness therapies for sleep or indeed for other purposes such as SAD, and of course you can just introduce yourself.  I’d love you to comment on my articles, reviews and blog posts as well, of course, but these discussion posts are especially for you.  If there’s anything you want me to post about, let me know.

Adventures in bathroom lighting

February 13, 2010

It’s odd how different people adjust to darkness.  I’ve found that I can manage pretty well in complete darkness for some things, such as finding a water bottle by the bed, and near-darkness for others, such as being able to shower by the light of a little red bike light.  I have another bike light in the toilet for nights, but I rarely even bother to turn it on any more.  Russell Johnston of Photoperiodeffect.com, who is an advocate of more extreme darkness therapy, has taught himself to do tasks from washing up to showering in complete darkness, and comments that if blind people can manage it, then so can we.

This is fair up to a point, but I don’t feel that complete or near darkness is really all that good an idea in some area.  My shower is over a bath and I need help getting out of it, which means that while I may be perfectly happy ambling about in low light levels, having already partially accustomed myself  by wearing the orange glasses for the earlier part of the evening, the person helping me climb out of the shower may not be so happy with suddenly being plunged into almost complete darkness. We managed to keep going for a surprising length of time, and then one evening my partner accidentally stood too close to the bath while giving me a hand out of the shower, I banged my leg on the side of the bath, and we realised that it was time to work something else out.

The simplest solution, of course, would have been to shower earlier in the day.  Unfortunately, while I’ve worked wonders with my sleep patterns, at heart I am still a night owl whose energy is greatest in the evenings.  The ME/CFIDS means that energy is not something I have enough of at any time, and showering is exhausting.  I’ll be curious to see if my energy patterns change significantly in the long term with the use of darkness therapy, because I do get sleepier earlier now, but at present there are also a few other factors which mean that evenings remain the most convenient time for me to bathe.

The difficulty, of course, is that I have a wide selection of colour light bulbs by now, and a snazzy pair of orange glasses, but I can’t wear the glasses in the shower and I can’t plug in a lamp in the bathroom due to the water-electricity hazard (and the resulting absence of sockets).  I spent several days going through every possibility I could.  First of all I looked at battery-operated LED lighting in yellow or orange, thinking I might sit a light source on the laundry basket.  I looked into fairy lights, LED tea lights, even a solar-powered lamp (though round here I’d need to recharge the batteries in a battery recharger).  LEDs in the orange-yellow spectrum tend to be a vile street-lamp orange, but I was getting desperate.  I even ordered a set of six tea lights which I was promised were a pleasant yellow-amber and as bright as ordinary candles.  Neither of these assertions proved to be correct, and they weren’t bright enough to light up a fuse box, let alone a bathroom.

After that I turned my thoughts to real lamps.  We shower with the bathroom door ajar anyway to minimise condensation, so I even tried putting a clip-on lamp on the bathroom door, running two extension cables through the hall to a kitchen socket.  But I wasn’t sure that this was entirely safe, I didn’t like having to move the lamp on every time I wanted a shower, the clip wasn’t wide enough for the door and would only fit on the handle, and the trailing cables looked ghastly.

Eventually I found a good solution.  I swapped over the shoe rack in the hall, which is in the line of sight when the bathroom door is ajar and which conveniently has a socket on the wall behind it, with one of the hall half-height bookcases.  I’ve put an ordinary lamp and a clip-on lamp on the bookcase, which both take 60W yellow bulbs, and pointed them in the direction of the bathroom.  I have to shower with the door a little more open now, which does get a bit chilly although it’s probably better in terms of condensation, and there’s a fair amount of warm golden light shining through.  It’s not perfect, but it’s more than enough light to shower by and for someone to help me get out of the shower, and the positioning means that there aren’t any trailing cables, lamps sticking out where we could bump into them, or things requiring to be moved when I need a shower.  Next time I’m doing up a bathroom, however, I think I’ll put in a bathroom wall light or two with yellow bulbs.

How to shift your bedtime/waking time to earlier

February 12, 2010

When I was using light therapy alone, I found that my 25 hour pattern shifted to 24 hours beautifully but that sooner or later, I would stay up too late and would end up stuck on falling asleep at 4 am or so again.  DSPS is a tough nut to crack.  This was in the days before I found darkness therapy, which has made my sleep/wake pattern rock solid, so here’s how I treated it at the time.

My preferred sleeping tablet when I need one is 20mg temazepam; many people find that 10mg is enough, but I need a higher dose.  While my GP advised me that I should be able to take it for up to a week, I found that taking it for a week straight caused rebound insomnia when I stopped, presumably because the ME/CFIDS makes me over-sensitive to medication.  I find that taking it for three consecutive nights is fine, so I work with that.  It’s entirely possible that I’d be fine with five nights, but I’ve never needed to try.

I would always recommend strongly that you discuss this with your GP.  They should be made aware of your sleeping problems anyway, even if you’re trying to solve them yourself, and sleeping tablets are fairly serious things, even the over-the-counter ones.  Discuss which sleeping tablets will best meet your needs, and if you’ve had a sleep problem for a while you’ve most likely tried several by now anyway.  Do tell them that you will only be using the tablets for a few nights in order to shift your sleep pattern, as otherwise they will be a lot more reluctant to let you have any meds.  I’ve managed to convinced a GP who’d never met me before to let me have four sleeping tablets for this purpose when it was an emergency (missed flight, unexpected night flight), and I doubt that he’d have let me have anything at all if I’d just wandered in to say that I was a bad sleeper and wanted some drugs please.

I’ve always been able to move my sleep back enough over three days using this method, but if I had needed to control a larger shift I would probably have done three days, waited a week, and then repeated the process.  My general lightbox treatment time is 45 minutes, but for this I would sometimes use a longer treatment time to help reinforce the circadian shift.  As far as I can recall, I used an ordinary alarm clock to make sure I got my light therapy at the right time the next morning, but dawn simulation would probably be even better.

Let’s assume that my bedtime is usually 1 am but has shifted to 4 am.

Day 0 – bed at 4 am, wake the next day at 12 pm.
Day 1 – sleeping tablet at 2.30 am for 3 am bedtime, bright lightbox at 11 am.
Day 2 – sleeping tablet at 1.30 am, lightbox at 10 am.
Day 3 – sleeping tablet at 12.30 am, lightbox at 9 am.
Day 4 – no sleeping tablet, lightbox at 9 am.

After that I would relax and use the lightbox whenever I woke up, instead of setting an alarm clock.  This method worked for me every time, including when I had to go on a night flight and deal with a 3 hour time difference to boot.

If you are using darkness therapy, you may not need the sleeping tablets at all.  Just put on the tinted glasses/switch over to orange lighting an hour earlier every evening.  The usual recommendation is to commence darkness therapy three hours before your desired bedtime, though some people find that they get sleepy too early if they do this.  Obviously getting sleepy too early is not a deterrent for DSPS sufferers!

For the above problem, I’d suggest starting the darkness therapy three or four hours before your current bedtime to begin with, and seeing what happened.  It may take a few nights to kick in fully.  Use the bright lightbox when you wake up.  You can wait until you wake up naturally, depending on how effective the darkness therapy is for you, or you can set an alarm so that you make yourself use the lightbox an hour earlier every day.  Since you’re not using sleeping tablets and therefore don’t need to worry about getting the process completed in a hurry, you can try shifting your sleep more slowly, even by 15 min a night.  Keep a diary of what you’re doing so that you don’t lose track.

If you have Non-24 Sleep-Wake Disorder, I’d suggest waiting until your circadian clock has shifted around to your ideal bedtime and waking time before trying anything, then hitting it with light therapy, darkness therapy and/or sleeping tablets to stabilise it there.  The sleeping tablets are a short-term measure, but the light and darkness therapies can be continued full-time and indeed should if you have a circadian rhythm disorder.

If your problem is jet lag or shift work, rather than a misbehaving body clock, you’ll have to experiment to find out what suits you best, and you may only need to use light/darkness therapies occasionally.  Sleeping tablets are best reserved for occasional use, so if you are going to be moving your sleep pattern every week or so, I wouldn’t advise them, and I would certainly suggest that you discuss this with your doctor.  Some companies give their night shift workers yellow safety goggles to wear when they go home in the daytime, so that the light on their journey won’t keep them awake.

If your problem is instead Advanced Sleep Phase Syndrome, then use bright light therapy in the evenings instead to keep you awake for longer.  I have absolutely no idea how darkness therapy would factor in here, but if you’re using it for other purposes (e.g. sounder sleep), I would imagine you would want to be careful not to start it too early in the evening, and remember that darkness therapy alone is unlikely to shift your body clock in the desired fashion.  Light therapy will be the key here.

For any of these problems, dawn simulation alone is unlikely to be enough to shift your body clock, at least in my experience, but may be very helpful in sticking to a good pattern once you have one in place.  I recently went back to dawn simulation, and while I had already stabilised my body clock using light therapy and darkness therapy by now, I think it may be adding a little extra help, and my partner is certainly finding that the dawn simulation makes it much easier to get up in the mornings.

What colour should I use for darkness therapy?

February 12, 2010

By now you may be feeling rather overwhelmed by all the colours I talk about for darkness therapy.  Between my own visual comfort and what is actually available, I use products in a variety of colours.  The one thing they all have in common is that they either block/filter out blue light, or they product light which does not have any blue in it.  This means you can use yellow, orange, amber, red, or brown.  You may find that you have strong preferences concerning colour to the point where the wrong one for you makes you feel unwell, particularly if you have dyslexia, migraine, ME/CFIDS, Meares-Irlen Syndrome, epilepsy, and possibly severe myopia (short-sightedness).  Make sure you can try out a colour before committing to anything expensive.

Yellow

This is the lightest colour of the set.  When used to tint glasses, it increases contrast in a way some people can find disconcerting.  It’s often available as a standard tint for sunglasses, though be sure to ask your optician whether it blocks 100% of blue light.  I have seen some websites selling yellow lenses that claimed that they would work for darkness therapy, but this study suggests that they may not.

I’ve seen two shades of yellow used as a coating for incandescent light bulbs.  Most often it’s the slightly more orangey one.  The light is a little more orange than you’d expect from looking at the bulb coating, and may be described as a marigold yellow.  I personally find it very pleasant.

Reflector bulbs can be sold with a yellow coating, but unless you are going to be using tinted glasses as well, I don’t recommend these as the coating is only translucent and I think it permits some blue light to come through.

Fluorescent bulbs can be bought with a yellow coating as well.  I don’t know what they’re like as I’ve never tried one.  They’re often sold as “bug lights”.

Yellow is rarely used for LEDs, and on the two occasions when I bought something that was sold to me as containing yellow LEDs, they turned out to be a horrible orange.  I’ve been told by lighting specialists that yellow is a tricky colour for LEDs, which is why you don’t see it often.

Candle flames are mostly yellow, although these is a small amount of white light in there as well which may or may not be enough to influence your circadian rhythm.

Orange

This is the colour I chose for my tinted glasses, mainly because it’s directly opposite blue on the colour wheel and I already knew that I got on with it from using an orange monitor filter on my laptop.  Objects viewed through orange lenses appear golden yellow, for some reason.  I find it quite a pleasant colour for lenses, it doesn’t increase contrast, and as apparently is true for many people, it makes it easier for me to read.  The colour distortion may bother you, however.

Orange-coated incandescent lightbulbs are likely to be sold as “amber”, but the coating looks pinkish-orange to me.  The light is a fair bit darker than that produced by yellow-coated incandescent bulbs, being an orange that is almost closer to pink.

Orange-coated reflector bulbs are also usually sold as “amber”.  The coating is again translucent, but I think it probably cuts out most, if not all, blue light.  It’s not the best light source, though, I wouldn’t recommend it.

Orange LEDs are commonly used for appliances, such as on electrical sockets.  Again, there seems to be difficulty in getting a pleasant colour, although the light on my kettle is not bad.

If you wish to buy a salt lamp for decorative purposes, the thick layer of salt looks pink when it is not illuminated and glows orange when you put a bulb in it.  I suspect that a small amount of white light is still getting through mine, so I put in a pink-coated 15W bulb instead and it nows glows a deep salmon colour.

Amber and brown

Amber may be used to refer to orange, or it may be a shade of brown (orange + black).  Amber and brown are common colours for sunglasses, although it has been suggested that not all sunglasses which claim to block all blue light actually do so.  I have no idea whether this is true, I suspect that it may be a marketing myth, but again, check with your optician.

The main advantage of brown is that it doesn’t distort colour in the way that orange does, and the disadvantage is that in order for it to be strong enough to block blue light, it will be quite a bit darker than the equivalent orange.  I tried a pair of amber fitover blue-blocking glasses and not only did everything appear very dark through them, but they completely hid the parts of my face which were behind them.  My orange glasses do nothing of the sort.

Red

Red is the darkest pure colour of the set, and anything viewed by red light or through a red filter will appear monochrome.  This will be off-putting for many people.  On the other hand, there’s a school of thought that red is far more effective than orange or yellow for darkness therapy, so you may prefer to use it for that reason.  However, this site claims that “red is a very uncomfortable color to look through”, so you may prefer to restrict its use to light bulbs.

Red-coated incandescent bulbs exist, but I have not tried them.  You can also buy incandescent bulbs with red (translucent) glass called “fireglow” which will give off more light than the solid-coated bulbs, but I don’t know if the translucent coating is enough to filter out blue light.  Red reflector bulbs are probably similar to these.

Red LEDs are cheap to produce and give off a pleasant colour, so they’re commonly seen in remote controls and so forth.  If you want to use a bike light as the equivalent of a torch, it will probably be red.

Red glass is a popular option for tealight holders.  While the jury is still out on whether candlelight is acceptable for darkness therapy, I would guess that putting the candle into a red candle holder should be enough to compensate for the small amount of white light that may be present.