Posted tagged ‘Light therapy’

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.

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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.

Bright light therapy: review of the GoLite

February 12, 2010

The GoLite is a nifty little lightbox at only 15 x 15 x 3cm, which makes it extremely portable.  It comes with extra international plugs and a padded carry case, and I have successfully used mine in Israel as well as the UK.  My version is not rechargeable, but the newer ones are, so that if you need to use it somewhere else, you wouldn’t have to scrabble around on the floor to unplug and replug cables.  The case has a clamshell design, so that when it’s closed the lid protects the LED panel, and when it’s open the lid acts as a base.  Unfortunately, the stand is not adjustable and I’ve found that it’s at the wrong angle when it’s placed on a table, so that I have to prop it up on my glasses case.  LEDs are a very directional form of light and you have to position LED lightboxes just right.  While the brightness of traditional fluorescent lightboxes is measured in lux, with 10,000 lux being ideal, the light produced by LEDs is so different that the lux measurement doesn’t apply.  I don’t think I’ve heard yet of an LED lightbox which was not bright enough, but do read reviews if you are looking at different models.

Unlike the lightboxes which came before it, the GoLite doesn’t just use LEDs, it uses blue LEDs. The manufacturers found through research that there’s one particular bandwidth of light that affects the circadian clock, at around 470nm, and luckily blue LEDs naturally peak in exactly that bandwidth.  (Despite what the manufacturers claim, all blue LEDs do this, so any lightbox with blue LEDs should do the same job.)  Traditional fluorescent lightboxes do contain some light in that bandwidth, but they don’t have very much of it.  By isolating the correct bandwidth, the idea is that you can get away with a smaller lightbox and a shorter treatment time, thus hugely increasing how effective it is.  My experience and all the reviews I’ve read of blue lightboxes appear to bear this theory out.  The manufacturers recommend a treatment time of 15-45 minutes, which for bright lightboxes is excellent, and even with stubbon sleep disorders I have always found 35-45 minutes to be sufficient.  The snag is that not everyone likes blue light, but most people are fine with it and it’s a pretty soothing light as such things go.  I have difficulty tolerating bright light and I’m absolutely fine using the light on full intensity.  The build quality appears to be good and the only problem I’ve had in five years of near-daily use is that one of the 66 LEDs now only lights up intermittently, which does not affect the efficacy or visual comfort at all.

Apart from the inability to adjust the stand and the high price, my only niggle with the GoLite that I own is that the settings are a nuisance to understand and the instruction manual wasn’t much help.  It does have various features, including a clock, treatment timer, variable light intensity, and the ability to save three different programmes, but you may need to ring up your seller or the manufacturer in order to learn how to do this.  It’s not intuitive to set, involving strange combinations of holding down several buttons at once, and you’re unlikely to remember how to do it.  After five years of use, I’ve sorted out my preferred treatment time and light intensity so that I just need to turn it on and hit “light” in order to get my treatment running, but I have no idea how to change the programme settings or even how to change the time when the clocks go back.  Thankfully I only use the one programme and don’t use it as my clock (it lives in a bedside drawer when not in use), so this doesn’t particularly matter.  I did try using Programme B for a shorter treatment time with lower light intensity for when I had a headache, but eventually I stopped bothering.  If I have a migraine, I skip the lightbox for that day, and if it’s only a mild headache, the light doesn’t seem to do me any harm.

The GoLite was my first big step in improving my sleep.  Before using it, my daily pattern was 25 hours, so that I would fall asleep an hour later every day.  I started using the GoLite when I woke up, and the pattern immediately stabilised at 24 hours.  With judicious occasional use of sleeping tablets, I could even move my bedtime and waking time back when they had crept too far forward, although I still tended towards late hours and had to accept that while the Non-24 Sleep-Wake Disorder was now firmly under control, the Delayed Sleep Phase Syndrome was only partially managed.  (Darkness therapy is what finally solved the latter.)  After some experimentation, I have settled on a 45 minute treatment time, although now that I am using darkness therapy as well I may be able to get away with less.  I found after a few years that even if I skipped my treatment for the odd day here and there, my sleep pattern remained stabilised at 24 hours, so it seems that to some degree my circadian clock has been retrained.

I bought my GoLite in 2005, back when it was the only LED lightbox on the market and pretty new at that.  The version I bought was the P1 (the link takes you to the place I bought it from, which I highly recommend).  As you can see, it’s still for sale at quite a good price now, although some people may prefer to pay more for the newer, fancier versions.

Back then, the GoLite was made by an American company called Apollo Health who made a variety of fluorescent lightboxes as well and had done quite a lot of research into light therapy.  I loved their website.  It had some of the best information about bright light therapy for various conditions that I’d ever seen, and devoted plenty of space to sleep disorders, where most lightbox manufacturers just talk about SAD.  It even had a free test you could take to find out whether you had a circadian rhythm disorder, rather like the Morningness-Eveningness Questionnaire.  When I rang the company, there was an extraordinarily knowledgable chap I could speak to about exactly how I should treat my sleep disorders using light therapy.  Apollo Health has since been taken over by Philips, which means that you have a household name, you can speak to customer services in your own country, and it’s doubtless doing great things to get the product out there, but that wonderful resource of the Apollo Health website has been lost.

The new GoLite

Philips have redesigned the GoLite so that it now looks rather different.  I haven’t tried it out yet, but I’ve spoken about it in some depth to the National Light Hire Company.  It does look snazzier, but frankly I’m not that interested in its decorative value and it’s certainly not something I’d be willing to pay more money for.

The new GoLite BLU (no, Philips, misspelling words does not make your product more attractive to me) still lacks an adjustable stand, but it does feature a built-in battery, so that it is rechargeable.  I’ve always hated having to mess around with unplugging cables whenever I wanted to move my lightbox to the other room, so this would have been a very useful feature for me, and it would have made it easier to take over to my partner’s flat in the days before he moved in.  I’ve read that it has a much wider treatment angle than the older model, though I’ve not been able to confirm this.  When I talked to the National Light Hire Company, we discussed how it compared to the Lumie Zip, another popular LED lightbox, and they said that the new GoLite has a lot more features than the Zip and is generally more modern and high-tech.  They did not know whether it was easier to use, but judging from the user manual it’s still awkward.  It features a touchscreen, which I suspect may make it even more awkward when it comes to holding down two buttons at once, although at least the display looks nice and clear, in a blue that matches the bright light panel.  Abandoning the clamshell design of the older GoLite means that you no longer  have a back that can flip over to cover the screen. From having knocked mine onto the floor countless times over the years, I think the GoLite is sturdy enough that it doesn’t matter, and they do provide a nice slimline carry case.

The GoLite continues to be known as one of the highest-quality lightboxes around, and its small size and relatively short treatment time give it a big advantage over traditional fluorescent lightboxes.  It is no longer the only LED lightbox on the market, however.  Apart from the  popular Zadro (not available in the UK), all other LED lightboxes provide white light which peaks in the blue spectrum.  Blue provides a gentler light and possibly (but not necessarily) a slightly shorter treatment time, while white is likely to be more acceptable to anyone who is picky about their light colour, for instance if they need to make colour judgements.  Whether you prefer to pay more for the additional features and reliable brand name, or save money to get a more basic LED lightbox, is up to you.  If I were starting over with light therapy now, I think I’d buy a cheaper lightbox but make sure that it was from somewhere with a good returns policy in case of faults.

Dawn simulation: Review of the Lumie Bodyclock Sunray

January 27, 2010

The Lumie Bodyclock Sunray is the starter model in the Lumie dawn simulator range, and I had one five years ago.  At that time they were being sold with 60W incandescent candle bulbs with a slight lavender tinge to the glass, which counteracted the natural yellowness of incandescents to produce a whiter light.  They’re now being sold with dimmable 42W halogen candle bulbs, and quite right too.  This bulb is meant to be equivalent to 60W incandescent but in my experience is more like 75W, and produces a pleasing warm light which is a little whiter than an incandescent.  That said, the main reason why I finally sold my Bodyclock on eBay is because by the time the light is shining through the plastic shell, it was too dim for me to find it comfortable to read by.  I decided to go for a dawn simulator which could be plugged into a lamp of my choice, and am very glad that I did so as I found the extra features useful in addition to being able to use my own lamp.  Nevertheless, the Bodyclock is still a nice little all-in-one dawn simulator.

At 18 x 14 x 18cm, this is quite small for a bedside lamp.  Perhaps this is one reason why I had trouble reading by it: the light wasn’t high up enough.  It’s fairly lightweight at 730g, and to my mind feels somewhat flimsy, although it held up well enough over a year or so of occasional use.  The entire case is made of plastic and looks rather cheap, especially the top part when the light is not on.  To be honest, I’ve yet to see an all-in-one dawn simulator which is a thing of beauty, but this is definitely one of the uglier ones in the Lumie range, if that is something which bothers you.

While I found that it did its job perfectly well, I notice that a number of Amazon reviewers have had problems with the build quality or have found faults appearing.  Such sites usually have a disproportionate number of negative reviews, but this is still something to bear in mind.  I do feel that for the money you’re shelling out, the quality could be better.  I’ve always found Lumie to be very helpful and they were great when I needed to return my Desklamp, though, so I’m sure their customer service would be good if a product was faulty.

But as I said, it does the job pretty well.  You can have a sunrise or a sunset and both are preset to be 30 min, which is the most popular length of time for dawn simulation to be effective.  I don’t know how many people prefer a different length of time.  I’ve learnt that I do through long experimentation, but hey, I’m fussy.  The Bodyclock always did a perfectly good job of getting me up in the morning, and as ever with dawn simulation, it was very pleasant to wake up to.  I seem to recall that the back-up alarm sound made an acceptable enough beep, which is one advantage it has over my Sunrise System, whose beep is so horrible I turned it off.

While its simplicity gives you fewer options, it does make it very easy to use.  As far as I can remember, there was only one setting for wake-up time, as opposed to being able to set different times for each day of the week.  The clock is green numbers on a black background, which shows up fairly well without giving off as much light as a black-on-green display, and is thus less likely to disrupt sleep.  It was, as I recall, fairly easy to use as a dimmable bedside light.

This is the cheapest all-in-one dawn simulator by a reputable manufacturer that I know, and while I have several gripes about it, it’s still a very useful product and I don’t think it’s worth spending a fortune just to get something a bit prettier.  Indeed, Lumie have brought out another starter model that is the same spec and usually the same price, but looks a little better.  It’s not as if the other manufacturers have made their dawn simulators  particularly attractive anyway.  In fact, some of them look worse!  If you want more functionality, for instance being able to use more than one lamp, have a brighter light, the ability to set different wake-up times throughout the week or a different length of time for the dawn/dusk simulation, try a Sunrise System SRS100.

There’s a kids’ version of this Bodyclock which has the shapes of a moon and stars cut out, so that the light forms pretty shapes on the wall and ceiling, and which also has an optional fade-to-nightlight function.  I’ve not seen it in person, but I think that these extra touches transform something that was rather clumsy into something charming.  While I would generally recommend using yellow light bulbs for a baby’s bedroom at night, especially for night feeds, incandescent bulbs produce very little blue light when they’re set on very dim, and it’s a good compromise.  Simplicity is also important in such a setting, and I doubt that your average baby will want to tweak the settings in order to have a lie-in on weekends.

Bright light therapy: review of the Lite-Pad

January 27, 2010

This is my spare lightbox, which I picked up second-hand on eBay for a tenner.  I don’t know who the manufacturer is, but this looks like more or less the same thing.  It’s a cheap and cheerful version of a fairly standard lightbox, and while it’s my secondary one so I’ve never used it on its own for more than a few days at a stretch, it seems to do the job as well as my GoLite.  The size is about the same, although the LEDs are white rather than blue.  If anything, I think it might be a little stronger than my GoLite in effect, although perhaps I just wake up more thoroughly when I’m sewing than when I’m mooching online.  I keep it on my sewing desk, so that I have white light to sew by, and to save crawling around on the floor to unplug and move my GoLite.

There is only one brightness setting, and it’s pretty bright.  I spent the first few months using it with a blue filter taped over the top, although I don’t seem to need that now.  If you’re going to go for a filter, try a lighting gel (there’s a seller on the links page) and get one that’s blue or turquoise, since that’s the colour of light that is most important for resetting the circadian clock.  With the filter, you’ll get a very cold white light.  Without it, you’ll get a white light that is colder than standard incandescent light bulbs but would probably blend in quite well if the room lighting was fluorescent.  I haven’t had any trouble with colour matching for fabrics when quilting by this lightbox.

There are three settings for the length of time.  Pressing the On button once will put the lightbox on until you unplug it (there’s no Off button!), pressing it twice will set it for fifteen minutes, and pressing it three times will set it for thirty minutes.  There’s a little red LED by the word TIMER which flashes once for the fifteen minute setting and twice for the thirty minute setting, and continues to flash at intervals so that you know which setting you’re on.  It was months before I even noticed that it was doing this, so don’t worry that you’ll notice the red light, it’s too small and dim and you have to look at it directly to notice it.

One distinct advantage this lightbox has over my GoLite is that the stand sets it at the right angle when it is perched on a desk.  LEDs have a very narrow beam angle so you have to get them into exactly the right position, and this one is just right – at least, it is for me.  I’m short and I tend to hunch over while sewing, so it’s possible that if you’re a strapping lad or lass of over 6′ and you sit bolt upright, you might need to rest the front on a book or something to tilt it a little.  Since lightboxes are meant to be most effective when positioned above the eyes, and since my sewing desk is quite cluttered enough already, I’ve managed to hook it onto the set of stacked mini chests of drawers I keep my threads and such in, by tucking the flap which forms the stand into a drawer and then allowing the lightbox to fall forwards slightly to get the light at the right angle.  It’s been there for a few weeks and not fallen out yet!

The lightbox also has a facility for producing “soothing sounds”, presumably for relaxation or tinnitus.  They are all absolutely vile.  If you want something like that, invest in a proper tinnitus relaxer.  For the price of this lightbox, I really don’t care that this function isn’t worthwhile.  It does its job with the light, it has a basic timer function, and that’s all I really need.  It doesn’t have a clock, and it doesn’t have a display to tell you how much treatment time is left, but they’re far from essential.

It does have its quirks, this little thing.  When you first plug it in, the light flashes once very briefly, which can be a little disconcerting, and I have absolutely no idea how anyone could forget to install an Off button.  If you use a cordless or mobile phone by it, it tends to make that strange little noise that is, well, made by devices which are reacting to cordless or mobile phones.  It usually settles down after a minute, though, and I can keep my phones on the desk along with the lightbox while I sew, although I may put a little distance between them.

Since I can’t even track down who the manufacturer is, I would assume that if you buy this lightbox and it goes wrong, you’re highly unlikely to get good customer support from the manufacturer.  It generally costs £40 new, so this may not bother you, and after all, the seller will be responsible up to a point under the Sale of Goods Act.

I feel that lightboxes are generally hugely overpriced and that it is high time that cheaper models were widely available.  It’s not particularly high quality, and it certainly doesn’t have fancy features of the more expensive models, but for this price I think it does the job very nicely indeed.  That was £10 very well spent.

Bright light therapy: review of the Lumie Desk Lamp

January 27, 2010

The Lumie Desklamp provides 10,000 lux of light at 20 cm.  20cm is closer than is recommended for visual comfort, so at a more sensible distance this will be a lower-powered lightbox  This light uses 55W of power, so don’t think that just because it’s a species of low-energy bulb it’ll save you power compared to your ordinary desk lamp, but you do get a very bright light for that wattage.  The height is 45cm, the head measures 45 x 18cm, and the base 27 x 21cm.  At 2.5kg, this is a hefty piece of kit, though at least that means it won’t fall over.

This is the first bright lightbox I tried, five years ago when the variety of lightboxes available was not as great.  I found Lumie (then Outside In) while reading up on light therapy and was impressed by the amount of research on their website.  The free trial, where you pay upfront but receive a refund if you return it within 30 days (6 weeks for ME sufferers), was a definite bonus.  I spoke to Lumie and we decided that this would be best for my needs, mainly because it is equipped with a dimmer. I expressed concern that the light would give me migraine, as it is a fluorescent bulb.  Lumie said that they’d eliminated the flicker that is one of the reasons why fluorescent light is uncomfortable for many people.  I don’t know whether they failed to do so entirely or whether it’s just that fluorescent light is uncomfortable because of the colour of the light as well as the flicker, but it gave me dreadful migraines, so I had to return it.  Lumie advised me to try building up gradually from a short period on a dim setting, but it made no difference.  Having spoken to them again just now, they still seem to be under the impression that this is a lovely comfortable light that no one could possibly object to, which I felt was a bit too heavy on the sales approach rather than the medical realities, as intolerance of fluorescent light is typical of ME sufferers, migraineurs, many dyslexics, epileptics, and occurs with lots of other people.   Apart from that, I have always found their customer service to be extremely helpful and highly knowledgeable.  Everything went smoothly and I received a full refund.  I would not recommend this lightbox for anyone who is sensitive to fluorescent light, but if this does not apply to you, read on.

The Lumie Desklamp has been designed so that it can be used as a lamp as well as a therapeutic lightbox, which is unusual.  One benefit of this is that it is more discreet: if you’re using it in the office, it’s far less likely to cause your colleagues to ask what it is and then embark on a discussion of your health problems.  The dimmer function (the knob on the base) and the adjustable neck means that it is easier to adjust for comfort while you are using it, and that you can then turn it down and angle it away from you to use as an ordinary desk lamp.  It looks simple and well-made.

Fluorescent lightboxes range from 2,500 lux to 10,000 lux.  10,000 lux is more common these days, as it requires a shorter treatment time (which will still be longer than the treatment time required by an LED lightbox).  This lightbox uses 10,000 lux and at that setting Lumie recommend a treatment time of 90 min for SAD.  (How long is needed for sleep disorders is an entirely individual matter, but I know that I need longer than the recommended treatment time with my LED lightbox.  Use the SAD recommendations as a way of comparing different lightboxes.) An alternative is to use it at a medium setting for longer than the recommended time to get the same overall effect, which again will be a bonus for some people who are more sensitive to bright light.  This is a lightbox which requires you to be sitting by it for quite some time, so it’s one to use while in front of a computer in the morning rather than while gulping down breakfast before dashing out.

Apart from this, it’s a fairly basic lightbox, without the bells and whistles of the GoLite, for instance.  It doesn’t have timer function or a display which could show, for instance, a clock, the time left for light therapy, or the brightness.  About the only one of those I’d consider to be essential is the timer, but you can easily just use a timer on your computer or mobile phone, or buy a kitchen timer.  That said, it would be handy if the dimmer knob was a dial with numbers instead, as it is useful to know the exact effects the different levels of brightness will have on you, especially when you’re at the beginning stage of working out how long to use it for and what brightness setting you prefer.

One of the definite advantages of this model is that the light is positioned exactly where it needs to be, above the eyes.  If you look at this picture, the light is positioned pretty ideally.  I also find it is easier to have the light off the tabletop and up out of the way of desktop clutter, although with such a big lamp base there is less of an advantage here.

While I’m not madly keen on fluorescent light in general, as it really isn’t the best thing to be exposing your eyes to and will cause medical problems in a number of people, it does have one advantage over LEDs in that it covers a broad area, whereas LEDs are highly directional.  This plus the completely adjustable neck means that you really can have the light exactly where you want it.

It’s not the quickest lightbox to use, but if you are in the market for a fluorescent lightbox then I think this one has many advantages worth considering, and it is reasonably priced.

Bright light therapy

January 26, 2010

This is best known for treating Seasonal Affective Disorder, where it has been found to be as effective as anti-depressants, although the most effective treatment of all is to combine light therapy with anti-depressants.  What is less well-known is that bright light therapy is almost as effective in non-seasonal depression and is extremely useful for circadian rhythm disorders.

The main myth about bright light therapy is that it’s about full-spectrum lighting. It isn’t.  There are quite a few myths about light therapy which have been set up by rivalrous product manufacturers, and this one is an attempt to sell certain fluorescent lightboxes by claiming that they are in some way better than the others, which has somehow turned into the myth that all you need is a standard full-spectrum bulb.  The most effective wavelength for resetting the circadian clock is 470nm, blue light, so you need either blue light or white light which has plenty of blue in it.  (A couple of manufacturers favour green light for rather complicated reasons which you can read about here, where it’s concluded that they’re not worth trying unless you are at high risk of maculuar degeneration.)  The other important thing is the intensity of the light.  When a traditional fluorescent lightbox is used, 10,000 lux is preferred, though there are a few models around which use 5,000 or even 2,500 and require proportionately longer usage times.  Merely installing a full-spectrum/natural daylight bulb into your domestic light fittings will not make a blind bit of difference, as the light isn’t anywhere near strong enough.  Full-spectrum bright lightboxes were probably introduced because so many people find fluorescent light to be visually unpleasant, and there is a demand for a better colour temperature.  If you are going for a fluorescent lightbox, you may want to see if you can view a normal and a full-spectrum version to find out if you do prefer one or the other, but to be honest I think very few people are bothered about this, and that you’re better off using an LED lightbox if you don’t like fluorescent light.

Lightboxes are used for periods ranging from 15 min to 2 hours, depending on the type and the patient’s needs.  Unless you have Advanced Sleep Phase Syndrome, where you fall asleep too early in the day, the usual time of treatment is first thing in the morning, just after you get up (which for some people isn’t actually morning!), whether this is for sleep disorders or depression.  If you have DSPS or Non-24 Sleep-Wake Cycle, using bright light therapy in the morning has a high chance of stabilising your circadian clock and can even move it backwards so that you are falling asleep and waking up earlier.  I found that using a bright light box just after awakening immediately stabilised my sleep pattern at 24 hours instead of the 25 it had been on for years, and I started this four and a half years ago.  However, if my bedtime and waking time were too late, I needed to combine bright light therapy with a few days of sleeping tablets, taking the tablets an hour earlier each evening.  After that, the morning light therapy would serve to keep my waking time where it should be.  This has worked pretty well for me, although my sleep pattern wandered out of synch a few times a year and needed to be chased back.  Adding darkness therapy into the mix seems to have stabilised it completely.

There are two main types of lightbox, compact fluorescent and LED.  Fluorescent are the traditional ones and have been around for longer.  They are larger, require a longer treatment time, produce white light, and may cause medical problems for people sensitive to fluorescent light, such as migraine, visual problems, dizziness and so on.  The manufacturers try to dodge here and say that they have better ballast, but in my experience they’re just as bad as strip lighting and can cause nasty migraines. Perhaps they are better constructed, but since the light is so much brighter and it’s right by your face, it’s still more than enough to cause problems if you have difficulty with fluorescent light.  On the other hand, because they’re larger and the light is not as directional as LED light, they permit a little more freedom of movement when you are in front of them, though you still can’t move far away.  The light is also more likely to end up in the optimal position above your eyes, though since fluorescent lightboxes take much longer to use than LED lightboxes despite this, the advantage is probably cancelled out.  When looking at the stats for a fluorescent lightbox, most will say that they produce 10,000 lux, but you should also check at what distance that measurement is accurate.  If it’s 10,000 lux at 20 cm, that’s far too close to the light to be comfortable.  60 cm is more sensible, or alternatively just realise that you will need to use the lightbox for longer.  I think that this is how manufacturers are getting around the problem that everyone is told to look for 10,000 lux, but no one is quite sure what it really means and don’t realise that it’s only the measurement of the light intensity at a certain distance.

LED lightboxes have been around for a few years and may produce either white or blue light, which you can read more about here.  They are smaller and require a shorter treatment time.  Not everyone gets on with coloured light, and as the LED panel is composed of lots of little LEDs that look like dots, some people report getting spotting in front of their eyes, although I suspect that they were using the lightbox incorrectly.  You’re not meant to stare into it, you’re meant to position it at the side, or even better above your eyes, so that it hits your peripheral vision. LED lightboxes do have the disadvantage of needing to be placed more exactly and requiring you to stay in the same position, as the light produced by LEDs has a very narrow beam angle.  I use mine by my laptop or while sitting at my sewing desk, and while sometimes I need to prop up the lightbox to get it at the right angle, after that it’s fine.

I have a GoLite, previously made by Apollo and now made by Philips, which is a blue LED lightbox and very highly thought-of.  I also have a Lite-Pad, which is a cheap white LED lightbox I picked up on eBay for a tenner.  I use this one by my sewing table to save messing around with cables when I want to quilt during my morning lightbox stint, and also so that it doesn’t affect my colour judgement.  The GoLite does have a lot more bells and whistles, such as a clock and the ability to set both the light intensity and the length of time for up to three different preset programmes, but you’re paying a lot for them.  The Zadro looks like the best of the cheap lightboxes if you’re in the US, and indeed looks like a very good lightbox in its own right.  You can also buy combination lightbox/dawn simulators, of which more later.

There’s another type of bright light therapy around, known as the light visor, where the unit is placed in a sort of cap worn on the head, and the light is shone into the eyes from above.  Lumie makes a few, and there’s one which produces blue-green light around.  Their one advantage is that you don’t have to be tethered to your lightbox, you can move around.  Psycheducation.org is doubtful about them, and I agree.

Since you can’t tell which lightbox you will get on with in advance, or even if it will work for you, and since these things are very expensive, find a company who will offer either hire-purchase (e.g. the National Light Hire Company) or a free trial (e.g. Lumie).  You may need to spend a while working out the right amount of time to use the lightbox for.

Of course, an entirely free alternative is simply to make sure you get outside for at least one hour every morning.  It doesn’t matter if it’s cloudy.  I’ve run into a woman online who managed to get the same effect by using a 150w fluorescent light (that’s actually 150w, not the equivalent to 150w incandescent), such as this grow light, in her overhead light during the whole day, not just for an hour.  This is far, far brighter than normal domestic lighting, and while it won’t save you energy and many people (especially with ME) will find it uncomfortable on the eyes and/or likely to provoke migraine, for some people it’s a good solution.

Another possible solution is to buy an LED bulb in white or blue and sit with it at a level just above your eyes for a couple of hours a day.  The blue bulb will be exactly the right wavelength, and while the white won’t have as much blue, white LEDs peak at the right wavelength so it will have a lot of it.  It won’t be as strong as a therapeutic lightbox but if you use it for long enough and keep it close to the top of your eyes, you may be able to get a decent result out of it.  If anyone tries this, do let me know how you get on.  I’ve got one of the blue bulbs which I’ve used for experimenting with moonlight simulation (this is popularly known as Lunaception and is meant to improve menstrual cycles, although for me it just wrecked my sleep), and I’ve noticed that I tend to feel wired after looking at it, and that using it for half the day was enough stimulation that I had a great deal of trouble sleeping that night.  So I reckon there’s quite a bit of potential with those little blue bulbs, and they’re better filtered than lightboxes so you don’t get spotting even if you look straight at them.