Are Light Therapy Glasses Right for Me?

By Brandon Peters, MD

They look a little futuristic, casting a blue light over the eyes and onto the face. In some ways, they are. Light therapy delivered via glasses also relies on science that is as old as time. The use of light therapy glasses may be helpful to manage circadian mood and sleep disorders like seasonal affective disorder (SAD), insomnia, and jet lag. They may offer a boost of energy on a winter morning. How do light glasses work and are they right for you? Learn about phototherapy, circadian rhythms, and the usefulness of artificial light delivered via glasses for several conditions.

What is Light Therapy?

Light therapy, or phototherapy, is the use of light to treat a medical condition. It may be helpful to treat problems that occur when the internal circadian rhythm is misaligned to the natural patterns of light and darkness. This may impact the ability to sleep, the release of hormones including melatonin, and even mood and energy levels.

Light therapy may be done by properly timed exposure to sunlight. Unfortunately, living at northern latitudes may make this more difficult in the winter months. In some cases, an artificial source of light may be needed.

There are certain medical conditions that respond extremely well to this treatment, but how is it delivered?

Light Boxes Versus Light Glasses

Historically, light boxes were used to artificially deliver phototherapy. Initially quite large, the technology has become more portable. In fact, there are now several brands of light glasses that are capable of performing the task:

Ayo

The smallest glasses are available for $299 from Ayo. With a well-integrated app, it is possible to personalize the program by providing information on sleep habits and lifestyle. The light intensity, timing, and duration varies based on the mode and purpose. Boost energy, optimize the sleep-wake cycle, or even beat jet lag and adjust to the new time zone faster. There is some built-in flexibility in the timing of their use. The glasses are comfortable, with a sleek visor-like design that is unobtrusive. It is easy to charge the glasses by placing them in a pill-shaped pod that connects to a computer with a USB cable.

Luminette

For a lower price point, consider the light therapy glasses offered by Luminette. For $199 to buy, or $39 for a trial, similar technology is used to deliver the light therapy directly into the eyes. Unlike a light box, which may require 10,000 lux to be effective, the blue light directed into the eye accomplishes the same treatment with a lesser intensity. There are 3 intensity levels offered: 500, 1000, and 1500. The glasses themselves are larger, broadly situated above the eyes. It is recommended that they be used for 30 minutes daily for best effect.

Re-Timer

Similarly priced, at $199, Re-Timer delivers blue-green light into the eyes for the purposes of phototherapy. Designed to frame the eyes, these glasses were developed at a university based on 25 years of research. It is recommended that the glasses be used for 60 minutes daily, the longest recommended usage of the three models.

Conditions That Respond to Light

The circadian rhythms of the body are mostly affected by exposure to blue light. This part of the light spectrum is present in full-spectrum sunlight. It can also be isolated and delivered at a lower intensity with equivalent effectiveness. What conditions respond best to light therapy delivered via light glasses?

Seasonal affective disorder

Also known as winter depression, it occurs seasonally when the lack of light availability leads to a deterioration of mood. It may be associated with increased sleeping, lack of initiative and social isolation, and changes in appetite and weight gain.

Insomnia

Difficulty falling asleep may be especially responsive to the use of phototherapy. Artificial light exposure in the evening may be a problem, but using light glasses in the morning upon awakening may help to realign the circadian rhythm.

Delayed sleep phase syndrome

Night owls experience this condition that leads to both difficulty falling asleep at a conventional time as well as difficulty waking in the morning at an earlier time. Bedtimes may be at 2 a.m. or later and waking may naturally occur mid-morning or even mid-day. Though it does not necessarily have to be associated with insomnia, it often does when social pressures require sleep-wake timing that is not consistent with this genetic tendency.

Morning sleepiness

Difficulty getting out of bed in the morning due to sleepiness may be relieved with phototherapy. Light naturally wakes us. It initiates the circadian alerting signal. Consistent use in the morning may help to align sleep’s place to the darkness of the night.

Jet lag

In the modern age, jet travel allows a rapid misalignment of the body’s circadian rhythms to the patterns of light and darkness in the environment. It may take one day to adjust to each time zone crossed, but light therapy may make this adjustment occur more quickly. 

Cautions and Side Effects

Phototherapy is generally well tolerated. If it is bothersome, it should be discontinued. Any perceived side effects should resolve once the light glasses are no longer being used. In some cases, the following side effects may occur:

Headaches

Artificial light therapy may trigger headaches or migraines in those predisposed. In this case, a lower light intensity for a more prolonged period may be useful.

Insomnia

Light at the wrong time may lead to difficult sleeping. For example, using light glasses at bedtime may cause a shift in the timing of sleep later. This will make it hard to fall asleep, and hard to wake. Avoid this by following the instructions associated with the light glasses program.

Photophobia

Sensitivity to light may occur. This may lead to pain or simply an aversion to exposure characterized by squinting. It will go away when the light stimulus is removed.

Fatigue

Rarely, fatigue may occur with phototherapy. This may have to do with the changes that occur in the sleep-wake schedule. Following the directions of the program should help to minimize this risk.

Hypomania

For those who have a history of bipolar disorder, light therapy needs to be used with caution. There is a risk that the light may lead to a state of hypomania. This may be associated with an elevated mood, increased productivity, hypersexuality, or other symptoms.

Irritability

Although mood would typically improve with light therapy, in some cases it may lead to irritability. Like the other side effects, it should resolve by stopping the use of the light therapy glasses.

Importantly, there is no ultraviolet (UV) light exposure with the use of light therapy glasses. Therefore, the risks associated with this—such as damage to the eye or cancer—would not be present.

Conclusion

If you are interested in learning more about your sleep, consider evaluation by a board-certified sleep physician. In some cases, consultation with this specialist may optimize your response to the light therapy glasses. Should you experience any problems with their use, seek further assistance by an expert.

Sources:

Peters, BR. “Irregular Bedtimes and Awakenings.” Evaluation of Sleep Complaints. Sleep Med Clinic. 9(2014)481-489.

Reid, KJ and Zee, PC. “Circadian disorders of the sleep-wake cycle,” in Principles and Practices of Sleep Medicine. Edited by Kryger MH, Roth T, Dement WC. St. Louis, Missouri, Elsevier Saunders, 2011, pp. 470-482.

Are You a Night Owl? Delayed Sleep Phase Syndrome Overview

By Brandon Peters, MD

Night owls rule the evening roost. What explains the natural desire to stay up late and sleep in, especially in teenagers? With this overview, discover the causes, symptoms, diagnostic testing, and treatments of delayed sleep phase syndrome. Consider the consequences, including insomnia and sleep deprivation, and what can be done to keep the condition in check.

What Is a Night Owl?

First, how is a night owl defined? Anyone who stays up later than most may be viewed as a potential suspect. However, those with delayed sleep phase syndrome may be birds of a different feather.

If the natural tendency to fall asleep is delayed by at least several hours compared to the average person, with a sleep onset closer to 1 to 3 a.m., this fits the bill. In some cases, the delay may be even more extreme, with a night owl going to sleep closer to sunrise.

The desire to wake up is similarly delayed by at least several hours. Someone who is characterized as a night owl may not desire to wake until 10 a.m. or later. With a sleep onset closer to sunrise, the affected person may not desire to wake until into the early afternoon.

How Common Is Delayed Sleep Phase Syndrome?

It is estimated that 10 percent of the population could be characterized as night owls with delayed sleep phase syndrome. It may be more common among teenagers, who are susceptible to a slight delay in their sleep timing, but it can persist throughout life. There are many retired people who experience the condition once the alarm clock is silenced!

What Causes a Delayed Sleep Phase?

There seems to be a genetic predisposition towards developing delayed sleep phase syndrome. Some of this science is understood. For example, a mutation in the CRY1 gene alters the human circadian clock, delaying sleep by 2 to 2 1/2 hours compared to non-carriers. There will likely be more genes identified that have a role. 

Approximately 40 percent of people with delayed sleep phase syndrome report a family history of the condition.

Beyond genetic programming, there are environmental factors that may unmask the condition. Most importantly, light has powerful effects on the timing of the circadian system. It may provoke the delay in sleep timing, and may also be used to correct the condition.

Understanding the Circadian System and Sleep

Sleep is dependent on two processes: sleep drive and the circadian alerting system. If isolated in a constant environment, like a cave, the genetically determined circadian timing will become evident. It is controlled by the suprachiasmatic nucleus, a region of cells in the hypothalamus of the brain, and highly influenced by light exposure. Every cell, and organ, in the body follows a circadian pattern.

For most people, this internal clock is programmed to run a little long, perhaps resetting every 24 1/2 hours. In the cave, without exposure to light variance, an isolated person would naturally fall asleep and wake 30 minutes later, shifting later each and every day. In a week, the timing of sleep would move 3 1/2 hours. In a month, it would shift 14 hours, so that the person would want to sleep during the natural day and be awake in the natural night. This natural drift in the circadian timing is reset with morning sunlight.

Exposure to natural light in the early morning hours is a signal to the brain for wakefulness. It makes it easier to wake. It also slightly shifts the timing of sleep earlier, making it easier to fall asleep. This helps to align the desire for sleep to the natural period of darkness overnight. Without it, significant problems can develop with sleep and health.

What Are the Symptoms of Delayed Sleep Phase Syndrome?

People with delayed sleep phase syndrome will generally experience two symptoms: insomnia and sleepiness. Why would these seemingly contradictory symptoms occur in the same person? Again, it comes back to a question of when—it comes back to timing. 

Insomnia

Most night owls will experience significant insomnia if they attempt to go to bed earlier than their natural desire for sleep onset. Crawling into bed at 10 p.m. may result in hours of lying awake, tossing and turning. This can provoke anxiety, frustration, and anger—feelings that make the insomnia worse. When left to stay up late on weekends or during vacation breaks, it suddenly becomes much easier to fall asleep.

Morning sleepiness

In the early morning hours, it can be difficult to wake a night owl. It’s like trying to wake the dead. Teenagers have to be dragged out of bed, splashed with water, or roused with threats from despondent parents. This morning sleepiness can be profound. Depending on the hour, it is akin to waking someone with normal sleep timing in the middle of the night. It is extremely difficult to wake and function. By midday, however, the sleepiness abates. When the late evening rolls around, the night owl feels very awake, repeating the cycle again.

Social Pressure Leads to Sleep Deprivation

Unfortunately, night owls are not typically allowed to sleep and wake when their bodies tell them to. If they could always go to bed at 2 a.m. and wake at 10 a.m., there would be no sleep problem. They would fall asleep easily, without insomnia, and wake easily without conflict. Unfortunately, pressure from the rest of society—parents, spouses, bosses, school systems—may be quite disruptive. Without accommodation, chronic tardiness and absenteeism can lead to educational and professional dysfunction.

If someone does not naturally fall asleep until 2 a.m., but has to wake at 6 a.m. to be to work on time, sleep deprivation inevitably results. Unfortunately, 4 hours of sleep is not enough to meet even basic sleep needs. This can have profound effects on health and well-being. Consider some of the symptoms associated with sleep deprivation:

• Sleepiness

• Fatigue

• Difficulty concentrating

• Memory problems

• Mood changes (depression, anxiety, or irritability)

• Errors or accidents

• Physical pain

• Hallucinations

• Paranoia

There is some evidence this can be fatal. This is likely due to the chronic effects of sleep deprivation. One study suggests that people with delayed sleep phase syndrome have a 10 percent higher risk of dying compared to controls.

How Is Delayed Sleep Phase Diagnosed?

With proper education, it becomes fairly easy to recognize night owls who are likely experiencing delayed sleep phase syndrome. It may be a lifelong affliction, starting in adolescence and persisting for decades. How can it be diagnosed?

Fortunately, testing is not required to reach a diagnosis. A careful history by a board-certified sleep physician can typically identify the condition. In some cases, sleep logs kept over weeks may aid the recognition. Rarely is testing with actigraphy needed.

In research settings, the measurement of melatonin levels can help to identify the circadian timing. In particular, the dim light melatonin onset (DLMO) measured via blood or saliva can establish the pattern. Unfortunately, the repeated sampling requires a carefully controlled laboratory environment. This is virtually never done in a clinical practice. More recently, a blood test called TimeSignature has been developed, but it is not widely available.

Treatments of Delayed Sleep Phase Syndrome: Light, Melatonin, and More

If a condition is genetically determined, and potentially lifelong, it may seem like a life sentence. Fortunately, for delayed sleep phase syndrome, this is not the case! There are some effective ways to keep the timing of sleep in a normal phase. It may require a little extra effort, but consider these potential helpful interventions:

Sleep schedule consistency

There is good evidence that night owls can maintain a socially acceptable sleep timing. This requires consistency, especially in regard to the wake time. Get up at the same time every day, including weekends. Do not sleep in. Go to bed feeling sleepy, even if this initially requires a delay in the preferred bedtime. This will make it easier to fall asleep faster, relieve pressure to sleep, and reinforce the sleep quality.

Morning sunlight

It is especially important to reset the timing of sleep with morning sunlight. This is most effective immediately upon awakening. Try to go outside for 15 to 30 minutes upon awakening. Wake with an alarm, throw on clothes, and immediately get outside. Take a walk. Read the newspaper in the garden. Check social media while facing the sunrise. Light should hit the eyes, but don’t stare directly into the sun. Even a cloudy or rainy day, try to stick to the routine. In winter months, a light box may be necessary for phototherapy. The effects may take up to 1 month to become evident.

Avoid light at night

Artificial screen light should be minimized at night, especially in the hours preceding bedtime. It may shift the timing of sleep to occur later, causing insomnia and morning sleepiness. Devices may be switched to night mode, cutting out the blue light that can shift sleep timing. Blue blocker sunglasses (with an amber tint) or screen covers may be employed. Best yet, simply shut down the electronics in the 2 hours before bedtime. The buffer zone before the goal bedtime should be spent relaxing.

Melatonin

Melatonin is a hormone produced overnight by the pineal gland in the brain. It can be an external signal to the circadian system, most effective among the blind. If taken up to 6 hours before the desired bedtime, it may help night owls to fall asleep earlier. The effects may be somewhat weak, and certainly overpowered by the effects of light.

Cognitive behavioral therapy for insomnia (CBTI)

This effective treatment helps to improve the patterns of sleep and one’s relationship to it. Sleep consolidation, stimulus control, mindfulness, and relaxation techniques may be integrated into a program. It may be guided with help from a psychologist, class, online course, or book.\

Chronotherapy

Rarely, it may be necessary to adjust the timing of sleep incrementally in a structured environment. It is difficult to carry out at home and may require hospitalization. Over successive days, the sleep period may be delayed by 1 to 2 hours until the desired timing of sleep is achieved. Poorly timed light may complicate the efforts, and strict adherence to the final schedule must be observed.

Prescription medications

Sleeping pills and stimulant medication to enhance alertness have a limited role in this condition. Generally, they will be weakly effective. As a result, they may be overused and even abused. The risk of overdose in night owls, especially when these medications are used in combination with alcohol, is high. Instead of masking symptoms with a drug, the underlying timing of the circadian rhythm should be corrected.

Social awareness

Education may help parents to appreciate what their teenager is experiencing, to know that it is not laziness or defiance. High schools should continue to accommodate this natural timing among their students by shifting the school day. Later school start times enhance academic performance, reduce tardiness and truancy, and even diminish car accidents among teens. 

Conclusion

Sleep deprivation can have serious impacts on health and well-being. If you are struggling with delayed sleep phase syndrome, consider seeking the guidance of a board-certified sleep physician. Start with some simple advice: Go to bed feeling sleepy (even if later), keep a consistent wake time, and get sunlight upon awakening. If more help is needed, seek it out.

How the Best Sunrise Alarm Clocks Make Waking Easier

By Brandon Peters, MD

It is pretty normal to use an alarm clock to wake up. What is not as common, however, is for the clock to mimic a sunrise and wake you with a gradually increasing amount of light. How do the best sunrise alarm clocks make waking easier? Learn how a dawn simulation light works, why it might be preferable to an audible alarm, who benefits most from its use, and what alternatives exist that may help to enforce a circadian pattern, easing insomnia and making it easier to wake and get up.

What Is a Sunrise Alarm Clock?

A sunrise alarm clock, or dawn simulation light, is an artificial light source that is integrated into a standard digital clock. It is timed to gradually wake a person at a selected time. It does this by mimicking the steadily increasing light of sunrise, often over 30 to 40 minutes, but some models may allow the timer to be adjusted from 15 to 60 minutes.

These simulators may have a full-spectrum white or yellow LED lightbulb. The color spectrum, or color temperature (think of this as the “warmth”), of this light may vary slightly from one model to the next. Most are of modest intensity, often 100 to 300 lux, with less light than a standard light box.

There are a variety of models, most costing less than $25 to $100, including:

• Philips Wake-Up Light HF3520

• Philips HF3505

• Philips Somneo HF3650

• hOmeLabs Sunrise Alarm Clock

• Mosche Sunrise Alarm Clock

• INLIFE Wake Up Light Alarm Clock

• NATPLUS Sunrise Alarm Clock

• iHome Zenergy Bedside Sleep Therapy Machine

• totobay

• Sharp Sunrise Simulator

• Lumie

The add-on features also vary widely from one product to the next. Many have the ability to adjust the light intensity, snooze features, and associated standard alarm sounds or music. There may be USB ports integrated for charging devices. Beyond encouraging a gradual awakening, some can even dim light gradually (a so-called sunset feature), making it feel more natural to fall asleep.

How Do Dawn Simulation Lights Work?

Dawn simulation lights can make it easier to wake, but how do these devices work? It is important to consider the natural patterns of light and darkness and how the circadian rhythm enforces optimal sleep and wakefulness.

Humans, like most animals, have evolved to sleep overnight during darkness. Light, conversely, has a waking effect on the brain and body. It suppresses melatonin and activates the circadian alerting signal. Light at the wrong time, like from a screen prior to bedtime, may make it hard to fall asleep and contribute to insomnia. In the morning, when incorporated into a sunrise alarm clock, it may make it easier to wake.

Light exerts this impact by traveling from the eyes via the optic nerves to an area of the brain that regulates the body’s circadian rhythm. This area of the brain, called the suprachiasmatic nucleus, lies in the hypothalamus. It is the master clock of the body. Without it, the patterns of sleep and wakefulness, metabolism, hormone release, cortisol levels, body temperature, and other processes would run amok.

Fortunately, light at the proper time may help us to sleep and feel better. Even artificial light, if appropriately timed, may enforce the normal patterns of our body that would exist if we slept in a perfectly natural environment. A gradual increase of light in the morning hours, even in the natural darkness present in winter months at northern latitudes, may reinforce a normal pattern of waking.

Why Is Light Better Than Sound?

The sudden, blaring sound of an alarm clock will definitely wake someone. However, this abrupt shift from sleep to wakefulness can be disorienting. If full wakefulness is not attained, the snooze button may be pressed and sleep may quickly resume. Short awakenings, such as those lasting less than 5 minutes, may go unremembered. If the alarm clock is simply turned off—or smashed into 1,000 pieces—trouble may ensue!

Light may wake a person more gently and more gradually. The transition from sleep to wakefulness is more orderly. This may help to relieve sleep inertia, that profound sense of sleepiness that is difficult to shake when first opening your eyes. It is something that feels more natural. The sky does not go from pitch black to glaring sunshine. As the sun creeps over the horizon, the amount of light hitting our eyes (even through closed eyelids) steadily increases. It may reach a threshold where it finally wakes us. This may make it less likely a person would want to hit snooze repeatedly and fall back asleep. Even the thought of it seems more pleasant.

Who Should Consider a Sunrise Alarm?

Although there are certain groups who may benefit more from using a sunrise alarm, scientific research suggests that many of us could yield positive health impacts.

There are a surprising number of important benefits from the use of dawn simulation lights. Research suggests it may:

• Improve cardiac function and reduce the risk of heart attacks

• Provide a boost to the brain’s function (in select cognitive domains)

• Enhance performance in tasks done immediately after waking

Clearly there are certain conditions or groups of people who would likely enjoy the effects of a sunrise alarm even more. Consider these possibilities:

Night owls

Delayed sleep phase syndrome is a circadian disorder characterized by difficulty initiating sleep (insomnia) and profound morning sleepiness. It affects 10 percent of the population, usually starting in the teenage years. Most night owls feel naturally sleepy close to 2 a.m. and may not naturally wake until 10 a.m. The use of a dawn simulation light may make waking a little easier. In some cases, a light box may be more effective to reinforce an earlier circadian phase.

Winter depression

Seasonal affective disorder, or winter depression, impacts people living in northern latitudes during the winter months when the nights are long and the days are short. Darkness can make it hard to wake in the morning. This may lead to increased depressive symptoms, lethargy, prolonged sleep, weight gain, and other symptoms. An artificial light may help the morning to start a little easier.

Teenagers

As noted above, teenagers are susceptible to delayed sleep phase syndrome. As a general rule, teens are more likely to have a slight delay in sleep timing, even with a less profound shift in the pattern. This can make it hard for adolescents to fall asleep at a desirable time. It can also make it very difficult to wake them in the morning. This can lead to early morning fights with parents, tardiness, absenteeism, and other problems like car accidents, inattention, and academic failure. Consider how desirable it might be to have a gentle light do the waking, and let the drama of the morning fade away.

Shift workers

Those who work atypical shifts—second, third, graveyard, rotating, or even call coverage—are subject to many sleep problems. When the desire for sleep and wake is forcibly misaligned from the patterns of darkness and light, it can be difficult to function optimally. This may lead to increased errors, accidents, and health problems (including a higher risk for cardiovascular disease, weight gain, and breast and colorectal cancers). Artificial light, if properly timed, may help to alleviate some of this misalignment.

Jet lag 

For every one time zone crossed, it can take one day to adjust the circadian rhythm. Traveling across a continent, or an ocean, can lead to significant disruption. The use of a sunrise alarm clock may make this transition easier. The optimal timing of this light exposure will depend on the distance traveled, and whether preparation was made prior to departing on the trip.

Hearing impaired

Finally, those with a hearing impairment may benefit from using a light to wake, rather than an audible alarm. The deaf may otherwise need to rely on others to wake on time. The use of a sunrise alarm clock may provide a new degree of independence.

Alternatives to Sunrise Alarm Clocks

Many people will be attracted to the possibility of easing insomnia and waking and getting up easier. Not everyone may want to use a sunrise alarm clock, however. There may be a handful of alternatives to consider. Consider how these additional options may make it easier to wake in the morning:

Natural sunlight

Throw the window shades open in your bedroom before retiring for the evening. This will let in natural light. After sunrise, the light will be able to stream through the windows and promote wakefulness. Unfortunately, this may not be ideally timed certain times of the year.

Light box

Consider a light box with 10,000 lux of intensity. It is powerful enough to shift the circadian rhythm, benefiting seasonal affective disorder as well.

Light therapy glasses

For those with a little extra buying power, light therapy glasses are a convenient and effective option. With a lower amount of light, shone directly into the eyes, these glasses can make it easier to wake.

Caffeine

A cup of coffee or tea can make it easier to get the morning started. Caffeine blocks adenosine, a signal for sleep, within the brain. With a half-life of 4 to 6 hours, it can get you through the morning.

Get motivated

Consider ways to motivate yourself out of bed. Morning exercise, quickly hopping in the shower, a special breakfast, or stepping outside to enjoy the early light may be helpful. In some cases, scheduling something you really enjoy for first thing in the morning may do the trick. 

Conclusion

There are many effective ways to wake and feel refreshed. A sunrise alarm clock may help to ease the transition to wakefulness. If you consistently struggle to wake, or have sleep of poor quality, consider getting evaluate by a board-certified sleep physician. Sleep disorders can be effectively resolved to the benefit of your health and well-being.

Sources:

Follum JD, Catchpole JM. “Sunrise alarm clock for the hearing impaired.” Biomed Sci Instrum. 2011;47:18-23.

Viola AU et al. “Dawn simulation light: a potential cardiac events protector.” Sleep Med. 2015 Apr;16(4):457-61. doi: 10.1016/j.sleep.2014.12.016. Epub 2015 Feb 26.

Gabel V et al. “Dawn simulation light impacts on different cognitive domains under sleep restriction.” Behav Brain Res. 2015 Mar 15;281:258-66. doi: 10.1016/j.bbr.2014.12.043. Epub 2014 Dec 27.

Thompson A et al. “Effects of dawn simulation on markers of sleep inertia and post-waking performance in humans.” Eur J Appl Physiol. 2014 May;114(5):1049-56. doi: 10.1007/s00421-014.2831-z. Epub 2014 Feb 11.

How Does Screen Light Affect Sleep?

By Brandon Peters, MD

In a world increasingly dependent on technology, bright screens are more commonly part of our everyday life. These screens range broadly in size and purpose: televisions, computers, tablets, smartphones, e-books, and even wearable tech. How does this artificial light, especially when viewed at night, potentially impact our sleep? Learn how light at night affects our body’s circadian rhythm and whether it might contribute to insomnia and difficulty awakening. In addition, consider ways to reduce light exposure and counteract its effects.

Before Thomas Edison and His Light Bulb

It is hard to imagine a time before artificial light existed. It is such an integral part of our lives that we consider ourselves deeply inconvenienced when we lose power in a storm. Think back to what life was like before modern technology like computers and televisions, before light bulbs, and even before electricity.

Primitive societies and people were highly dependent on the natural availability of light. The sun ruled life. It is no surprise that it was worshiped in ancient Egypt. When artificial light became possible, things dramatically changed.

The Influence of Light on the Body’s Functions

All life on Earth has developed patterns of activity dependent on the timing of day and night. When isolated from the natural environment, innate circadian patterns will be revealed. As an example, most humans have an internal clock that runs just over 24 hours in length. However, light profoundly affects the timing of sleep and wakefulness, metabolism, and hormone release.

Morning sunlight has a key influence on life’s functions. It promotes wakefulness and ends sleep. It can help shift the desire for sleep slightly earlier. In the winter, when sunlight comes later, we may want to sleep in or suffer from symptoms called winter depression.

Due to the length of our internal clock, our bodies have a natural tendency towards delay in the timing of our sleep. This means that we always find it easier to go to bed and wake later. Have you ever noticed how easy it is to stay up another 15 minutes but how difficult it is to wake just 15 minutes earlier? Morning sunlight can profoundly reset this internal clock.

How Artificial Light at Night Impacts Sleep

Unfortunately, artificial light at night can negatively affect the timing of our sleep. Light shifts sleep timing, and light at night can shift our desire for sleep later. This can result in difficult falling asleep, as occurs with insomnia. Night owls, or those with delayed sleep phase syndrome, may be especially susceptible.

Not everyone is sensitive to these effects. If you are especially sleepy, perhaps due to inadequate total sleep time or poor sleep quality, you are unlikely to be impacted.

There are several important factors to consider:

The Source of Light

Artificial light can come from light bulbs and many other sources, including televisions, computers, tablets, smartphones, e-books, and even wearable tech. Each of these can generate a different intensity of light. Near screens may have more impact that those across a room.

The Amount of Light

Most overhead lights generate a light intensity that varies from about 500 to several thousand lux. For comparison, full sunlight at midday may be 100,000 lux in intensity. Commercially available lightboxes often generate about 10,000 lux. The screen of your smartphone may create hundreds of lux of light, depending on the settings you use. Even smaller amounts of light, such as from a tablet screen, may have an impact in some people.

The Color of Light

Much is made of the fact that blue light is responsible for shifting circadian rhythms. Full spectrum light – what you might consider as “white light” or “natural light” – contains the blue wavelengths. Blue-blocker sunglasses (with an amber or orange lens) and screen filters are sold to block this light wavelength.

The Timing of Light

One of the most important variables is when you are exposed to light, including from artificial sources. There is evidence that light at night could shift your desire for sleep by about 1 hour. This delays your ability to fall asleep and may impact your desire to wake in the morning.

Therefore, it is very important to turn down the lights at night, especially preceding your bedtime. Some people may need to avoid excessive artificial light exposure for the 1-2 hours before going to bed. This means turning off the phone, powering down the computer, and avoiding light from tablets, e-books, and other sources.

Instead, try to stick to low-tech options: listen to some music, read a book printed on old-fashioned paper, or page through a magazine. By reducing and eliminating your exposure to light at night, you may find that you are able to sleep better. If you continue to struggle, speak with a sleep doctor about additional treatment options.

How Long Should You Wait Between Screen Light Exposure and Going to Bed?

By Brandon Peters, MD

There is some concern that light exposure at night may affect sleep. What is the evidence that artificial light from screens contributes to insomnia? How long should you wait between screen light exposure and going to bed? Explore this relationship and some of the science behind the rationale.

The Science of Sleep

When considering how optimal sleep occurs, it is important to understand the two primary contributors: homeostatic sleep drive and circadian rhythm. Sleep drive is the fact that the longer you stay awake, the sleepier you will become. This is due to a chemical that gradually builds in the brain with prolonged wakefulness. This chemical is called adenosine. High levels of adenosine contribute to the onset of sleep. Sleep, at least in part, is a process of clearing this chemical away until consciousness is restored. Interestingly, caffeine blocks this signal and alcohol enhances it.

The circadian rhythm is the complement to this system. It is predominately an alerting signal that strengthens during the daytime and is largely absent overnight. It becomes strongest in the late evening hours, when we would expect to feel fairly sleepy. There is a lull in the mid-afternoon, which can contribute to a desire to take a nap then.  The circadian rhythm is based in our genetics, persisting without external influences. It contributes to sleep-wake propensity, hormone release, and metabolism. These processes are linked to the day-night cycle of light and darkness via the eyes.

How Light Changes Sleep

A simple anatomy lesson reveals the importance of light exposure to sleep. The eyes perceive light via the retina and pass this information along the optic nerves, extensions of the brain itself. These optic nerves receive input from each eye and cross at a location called the optic chiasm. Just above this is an area of the brain called the hypothalamus, a functional area that is integral to the control of the processes described above.

Within the hypothalamus lies the suprachiasmatic nucleus. This is the control center of the body’s circadian rhythm. It is the central pacemaker, coordinating the activities of all the body’s organs, tissues, and cells. Therefore, light input can be directly linked to the influence of many of the body’s processes.

In particular, light exposure can suppress the desire for sleep. Morning sunlight exposure may help to wake us, initiating the circadian alerting signal. In the same way, artificial light at night may affect the timing of sleep. It may contribute to insomnia in susceptible individuals, especially among those with a tendency towards being a night owl (called delayed sleep phase syndrome).

Preserving Darkness in the Night

What impact did Thomas Edison have on sleep in inventing the light bulb? As society has evolved, the potential disturbances have only expanded. With electricity, our evenings are filled with activity: televisions, computers, tablets, e-books, and phones that flicker light into our eyes. Moreover, the activity itself may keep us awake, shorten our total sleep time, and interfere with a relaxing buffer zone before bedtime. There is some evidence that light at night may adversely affect sleep.

Research has demonstrated that in the spectrum that we perceive as light, the blue wavelength is the one that can change our circadian rhythms. Therefore, industries have developed to supply filters and glasses that block the blue light. It seems that even short bursts of light, especially when of higher intensity, can impact sleep’s timing.

The sun is much more powerful in intensity compared to light from bulbs or screens. Full sunlight may be 100,000 lux in intensity while overhead lights may be just 1,000 lux. Therefore, a blast of sunlight at night could profoundly impact sleep. For susceptible individuals, artificial light may also negatively impact sleep onset and contribute to insomnia.

As a result, it is recommended that people who have difficult falling asleep may benefit from reduced light exposure prior to bedtime. Preserve the last 1 hour, and perhaps longer in highly sensitive individuals, as an electronics-free zone. Power off your screens, especially those that are closer to your eyes. It is also advisable to keep your bedroom free of electronics to preserve sleep. This is especially important advice for teens and children.

Why might some people not be bothered by light at night? The complement system, characterized by sleep drive and building levels of adenosine, could counteract these effects. If you are sleepy enough, you may not be bothered by the light. If you struggle with persisting insomnia, consider speaking with a sleep specialist to help determine ways for you to improve your sleep.

When College Classes Start Late, Students Sleep and Drink More — and Get Worse Grades

At first glance, it sounds like the perfect solution to the student sleep crisis: start college classes later in the morning so students can get more rest. In theory, better-rested students should have sharper focus, stronger memory, and improved academic performance. And in some studies of high schoolers, that’s exactly what happens.

But research on college students paints a more complicated picture. In some cases, later class start times are associated not with better grades, but with worse grades — despite students sleeping longer. The difference lies in what students do with that extra flexibility and how college culture shapes their habits.

The Promise of Later Starts

Sleep scientists have long known that young adults, like teenagers, have a natural tendency toward later bedtimes and wake times. In high school, early start times often force students to wake before their biological clock is ready, leading to chronic sleep deprivation.

College seems like the ideal place to fix this: if students can choose later classes, they can sleep closer to their natural rhythms. On paper, this should mean:

• More total hours of sleep

• Better mood and alertness in class

• Stronger academic performance

And indeed, surveys confirm that students with later classes often report getting more sleep — sometimes an hour or more extra compared to their peers in early sections of the same course.

The Paradox: More Sleep, Lower Grades

However, large-scale studies have found that college students who take later classes often have lower GPAs than those with earlier schedules. A notable example is a University of Washington and University of California, Santa Barbara analysis, which showed that students with later first classes went to bed later, slept later, and engaged in more late-night activities — including drinking — that negatively affected academic outcomes.

Here’s the paradox: while these students may sleep longer, the timing of their sleep and their overall lifestyle may be less compatible with optimal learning.

Why Later Starts Can Backfire in College

1. Shifted Sleep Schedule

When the first class isn’t until 11:00 a.m. or later, many students push bedtime into the early morning hours. They still get their 8 hours — but much of that sleep occurs in a delayed cycle that can interfere with morning alertness and alignment with the day’s demands.

2. More Time for Late-Night Socializing

A later start means less pressure to wind down early. Parties, bar nights, and dorm hangouts can stretch into the small hours, with students feeling less need to cut themselves off because they “don’t have to be up early.” This can increase alcohol consumption and reduce sleep quality, even if total sleep time is higher.

3. Increased Alcohol Use

Multiple studies link later first classes with higher drinking rates among college students. The reasoning is simple: fewer morning obligations lower the perceived cost of staying out late and drinking. Unfortunately, alcohol disrupts the second half of the sleep cycle, leading to lighter, more fragmented rest that’s less restorative.

4. Lower Structure and Discipline

Early classes can serve as an anchor for the day — a reason to get up, get moving, and start on assignments earlier. Without that anchor, some students procrastinate on both waking up and starting work. Evenings fill with social activity, while afternoons may be spent catching up on sleep or idly passing time, leaving less total time for focused study.

5. Delayed Learning Window

Cognitive performance has daily rhythms, and for many people, attention and memory are strongest in the late morning. Students who push their academic work later in the day may be working during a lower-performance window, particularly if they’re also staying up past midnight.

The Role of Personal Responsibility

The impact of late starts varies by student. Self-disciplined students who use the extra rest to fuel productivity may see benefits. But for those still adjusting to the independence and distractions of college life, later classes can feed into a cycle of:

• Staying up late → Sleeping late → Less time for daytime study → Increased evening socializing → Staying up late again

This cycle isn’t inevitable, but it’s common — especially among younger undergraduates.

Alcohol, Sleep Quality, and Academic Performance

Even moderate alcohol use before bed can reduce the proportion of deep slow-wave sleep and REM sleep. For students in the “late start” group who drink more frequently, the benefits of longer sleep may be offset — or erased — by poorer sleep quality.

Poor-quality sleep leads to:

• Slower information processing

• Reduced working memory capacity

• Weaker problem-solving skills

• More difficulty concentrating in lectures

When those effects stack up over a semester, grades can take a noticeable hit.

What the Research Suggests

Several key findings emerge from the research on this topic:

• Later first classes = later bedtimes. Students rarely use the extra morning time to get more early sleep.

• Alcohol use increases. The absence of morning obligations removes a deterrent to late-night drinking.

• Grades can drop. The combination of later bedtimes, lower-quality sleep, and lifestyle changes appears to outweigh the benefits of extra rest for many students.

One study even found that for each hour a student’s first class started later, their GPA was slightly lower — largely explained by differences in sleep timing and alcohol use.

Navigating the Trade-Off

This doesn’t mean late classes are inherently bad — but it does mean students and educators should be aware of the trade-offs.

For students:

• Treat a late start as an opportunity for better rest and earlier academic work, not just more social time.

• Maintain a regular bedtime, even on nights without early obligations.

• Watch for creeping increases in alcohol use and late-night activity.

For colleges:

• Offer education on sleep hygiene and the risks of excessive alcohol use.

• Encourage balanced scheduling that avoids both extremely early and very late first classes.

• Provide quiet study spaces in the mornings to encourage productive use of time.

The Bottom Line

Late-start college classes offer the promise of more sleep — and in theory, more alert, higher-performing students. But in practice, the freedom they offer can lead to later bedtimes, more drinking, and weaker daily structure.

For some students, that means worse grades, even with extra rest. The lesson isn’t that late starts are bad for everyone, but that their success depends on how students use the flexibility. Sleep isn’t just about quantity; it’s about timing, quality, and the lifestyle choices that surround it.

In the end, the best academic results come when students combine healthy rest with consistent habits — whether their first class is at 8:00 a.m. or noon.

This article was created using OpenAI’s ChatGPT on August 15, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

When School Starts Late, Teens Sleep Great

It’s no secret that most teenagers don’t bounce out of bed at 6:30 in the morning with a smile on their face. In fact, for many high school students, early mornings can feel like a battle against biology. When schools start later in the day, something remarkable happens: teenagers actually get more sleep — and not just more, but better sleep. That extra rest can transform their health, mood, and performance.

The Biology of a Teenage Sleep Clock

To understand why later start times work so well, you need to know about adolescent circadian rhythms. During puberty, the body’s internal clock shifts. The natural release of melatonin — the hormone that signals “time to sleep” — is delayed by about two hours compared to childhood. That means a teen who used to get sleepy at 9:30 p.m. may now feel wide awake until 11:30 p.m. or later.

This isn’t laziness or bad time management; it’s a physiological change rooted in brain chemistry. Combine that shift with early school bells, and you have a recipe for chronic sleep deprivation. Even a conscientious teen who goes to bed “on time” may still be fighting their biology.

The Problem With Early Starts

The American Academy of Pediatrics (AAP) recommends that middle and high schools start no earlier than 8:30 a.m. so that students can get the 8–10 hours of sleep they need each night. Yet, as of recent data, many U.S. high schools still ring their first bell before 8:00 a.m. In some districts, classes start as early as 7:15 a.m.

For a teenager who can’t fall asleep until 11:30 p.m., a 7:15 start time may require a wake-up alarm at 5:30 a.m. — meaning they’re functioning on just 6 hours of rest, night after night. Chronic sleep loss in teens is linked to a wide array of issues, including:

• Lower academic performance

• Increased risk of depression and anxiety

• Weakened immune function

• Slower reaction times and higher accident risk (especially for teen drivers)

• Irritability and mood swings

It’s not that teens can’t adapt at all — they often do, because they have no choice — but the adaptation comes at a cost to their mental and physical health.

The Late Start Experiment

In recent years, some school districts have experimented with later start times, and the results have been eye-opening. For example:

• Seattle, Washington moved high school start times from 7:50 to 8:45 a.m. in 2016. Researchers found that students got an average of 34 minutes more sleep per night, their grades improved, and attendance increased.

• Edina, Minnesota was one of the first districts to delay high school start times back in the 1990s. Studies showed improved mood, fewer visits to the school nurse, and higher standardized test scores.

• California passed a state law requiring most high schools to start no earlier than 8:30 a.m. as of 2022, citing public health benefits.

The common pattern is that when the start time moves later, teenagers don’t just stay up even later — they actually gain net sleep time. That’s because their schedules finally align with their biological clocks.

Why the Sleep Is Better

It’s not just the total hours of sleep that matter — it’s also the quality of that sleep. Later start times help teens get more time in the crucial stages of deep and REM sleep, which are essential for:

• Consolidating memories (important for learning)

• Regulating emotions

• Physical recovery and growth

• Strengthening the immune system

When teens are forced to wake up in the middle of these deep cycles, the sleep they’ve had is less restorative. Pushing back the start time reduces that disruption, letting them complete more full sleep cycles.

The Ripple Effects

The benefits of well-rested teens ripple outward:

• Academic Gains: Sleep improves attention, working memory, and problem-solving — all critical for learning. Students are more likely to engage in class when they aren’t fighting fatigue.

• Mental Health Boost: Adequate sleep is strongly linked to lower rates of depression and anxiety in adolescents. Given rising concerns about teen mental health, this is a major public health argument for later starts.

• Safer Roads: Studies have shown a significant drop in car crashes involving teen drivers after districts delay start times. Sleep deprivation slows reaction time, and the morning commute is one of the most dangerous windows for young drivers.

• Better Behavior: Teachers often report fewer discipline problems and less classroom disruption when students are better rested.

The Pushback and the Practicalities

Of course, shifting school schedules isn’t without challenges. Common concerns include:

• Impact on after-school activities: Later dismissal times can affect sports practices, part-time jobs, and family schedules.

• Transportation logistics: Many districts stagger start times across grade levels to optimize bus routes, so changing one group’s schedule can create a domino effect.

• Parental work schedules: Some families rely on earlier school starts for childcare coverage in the mornings.

However, districts that have made the change often find creative solutions — such as adjusting practice times, using community facilities for late sports, or reorganizing bus routes. Over time, many communities report that the benefits outweigh the logistical hurdles.

What Families Can Do in the Meantime

Even if your teen’s school starts early, there are steps you can take to help them get better rest:

1. Limit late-night screen time. The blue light from phones and laptops delays melatonin release even further.

2. Create a wind-down routine. Dim lights, read a physical book, or do a relaxing activity before bed.

3. Encourage consistency. Sleeping in until noon on weekends can make Monday mornings even harder; a moderate weekend sleep-in is better.

4. Advocate locally. Join with other parents to petition your school board for a later start time.

The Takeaway

Teenagers aren’t just being dramatic when they say mornings are hard — they’re speaking from the experience of living in a body that’s wired for a later schedule. When schools start later, students sleep longer and better, with measurable benefits for learning, health, and safety. The science is clear: aligning school schedules with adolescent biology isn’t a luxury; it’s an investment in the well-being and potential of our youth.

This article was created using OpenAI’s ChatGPT on August 15, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

Night Owls or Delayed Sleep Phase Syndrome in Teenagers

Teenagers are often known for staying up late and struggling to wake up early. While this behavior is sometimes dismissed as laziness or poor time management, there is growing recognition that it may reflect a real biological condition known as Delayed Sleep Phase Syndrome (DSPS) or Delayed Sleep-Wake Phase Disorder (DSWPD). Teenagers with this condition are often referred to as “night owls,” not simply because of preference, but due to a genuine shift in their circadian rhythms. Understanding DSPS is essential for parents, educators, and healthcare providers to support teens who struggle to sleep and function on conventional schedules.

What Is Delayed Sleep Phase Syndrome?

Delayed Sleep Phase Syndrome is a circadian rhythm sleep disorder where a person’s internal body clock is significantly delayed compared to what is considered normal. In other words, individuals with DSPS naturally feel sleepy much later at night—often between 2 a.m. and 6 a.m.—and prefer to wake up correspondingly later, such as between 10 a.m. and noon.

In teenagers, this delay often becomes noticeable during puberty. Their biological clocks begin to shift, making it harder to fall asleep early even when they are physically tired. This change is part of a natural developmental phase, but for some teens, it becomes extreme enough to interfere with daily functioning, especially when school requires early wake-up times. As a result, teens with DSPS frequently experience chronic sleep deprivation, poor academic performance, and emotional challenges due to their misaligned sleep schedule.

Causes of DSPS in Teenagers

The exact cause of DSPS is not fully understood, but several contributing factors are known. Biological changes during adolescence play a significant role. During puberty, melatonin—the hormone that regulates sleep—begins to be released later in the evening. This delays the body’s natural cue to prepare for sleep. For most teens, this delay is mild and manageable, but for others, it becomes more severe, leading to DSPS.

Lifestyle factors can also exacerbate the condition. The widespread use of smartphones, computers, and other screens late into the evening exposes teens to blue light, which suppresses melatonin production and further delays sleep onset. Inconsistent sleep schedules, especially sleeping in late on weekends, can also disrupt the body’s natural rhythm and worsen the problem over time.

There may also be a genetic predisposition to DSPS. Studies have found that circadian rhythm disorders can run in families, suggesting a hereditary component. Furthermore, individuals with other mental health conditions, such as ADHD, anxiety, or depression, are more likely to experience DSPS, either due to shared biological mechanisms or behavioral factors.

Symptoms and Impact

The most obvious symptom of DSPS is the inability to fall asleep at a socially acceptable bedtime. Teens with DSPS often lie awake in bed for hours, unable to sleep until the early morning hours. Consequently, waking up early for school or other responsibilities becomes extremely difficult, and they often feel tired, irritable, or mentally foggy during the day.

Despite these struggles, teens with DSPS often sleep normally—sometimes even longer than average—when allowed to follow their natural schedule. For example, during vacations or weekends, they may go to sleep at 3 a.m. and wake up at 11 a.m. feeling fully rested. This can confuse parents and teachers, who may mistake the pattern for laziness or poor discipline, rather than a biological issue.

DSPS can negatively affect academic performance, social life, and mental health. Chronic sleep deprivation is linked to mood disorders, poor concentration, and increased risk of accidents. Over time, a teen with untreated DSPS may begin to feel isolated or depressed, especially if they are frequently scolded or misunderstood for their sleep habits.

Diagnosis

Diagnosis of DSPS typically involves a thorough sleep history, often recorded in a sleep diary over one to two weeks. Some doctors may recommend actigraphy, where a wearable device tracks sleep-wake cycles. A diagnosis is made when a consistent pattern of delayed sleep onset and difficulty waking aligns with the symptoms of DSPS, and other medical or psychological conditions have been ruled out.

It’s important to distinguish DSPS from insomnia. While both conditions involve difficulty sleeping, insomnia sufferers typically want to sleep but can’t, regardless of timing. In contrast, individuals with DSPS sleep well when their schedule matches their body’s internal clock—they just sleep at non-traditional times. Someone with DSPS may not necessarily experience insomnia.

Treatment and Management

Treating DSPS involves gradually shifting the sleep schedule earlier—a process known as chronotherapy. This is done by setting a consistent bedtime and wake time and adjusting them slowly, usually in 15- to 30-minute increments every few days. Over time, this can help reset the circadian clock.

Light therapy is another effective tool. Exposure to bright light (especially blue-enriched light) in the morning shortly after waking can help shift the body’s rhythm earlier. This technique may use a light box that mimics natural sunlight and suppresses melatonin production, encouraging earlier wakefulness.

Melatonin supplements may also be used, typically taken a few hours before the desired bedtime. When used correctly under the guidance of a healthcare provider, melatonin can help teens fall asleep earlier by signaling the body to begin its nighttime routine.

Maintaining strict sleep hygiene is crucial. This includes avoiding screens in the evening, limiting naps, creating a dark and quiet sleep environment, and using the bed only for sleep. Consistency is key; even on weekends, wake-up and bedtimes should not vary significantly, as this can undo progress.

In some cases, if DSPS significantly impairs daily functioning and does not respond to behavioral changes, professional help from a sleep specialist may be necessary. Cognitive behavioral therapy for insomnia (CBT-I), modified for circadian rhythm disorders, can also be beneficial.

Supporting Teens with DSPS

Parents, teachers, and caregivers play a vital role in helping teenagers manage DSPS. Understanding that the problem is biological—not behavioral—can reduce blame and conflict. Advocating for school policies like later start times and providing a supportive environment can make a significant difference.

It’s also important to involve teens in their treatment plan. Encouraging self-awareness and responsibility over their sleep habits empowers them to take control of their health. With the right combination of strategies and support, most teenagers with DSPS can shift their sleep schedules and experience better rest and daytime functioning.

Conclusion

Delayed Sleep Phase Syndrome in teenagers is a real and often misunderstood condition. It goes beyond simple night owl behavior and represents a significant misalignment between a teen’s internal clock and societal expectations. With the right diagnosis and a combination of behavioral strategies, light therapy, and consistent routines, teens can manage DSPS effectively. Recognizing and addressing this condition not only improves sleep but also enhances academic performance, mood, and overall well-being.

This article was created using OpenAI’s ChatGPT on May 16, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

How to Wake and Get Up Early

By Brandon Peters, MD

It can be downright painful to drag yourself out of bed at an hour earlier than you are used to waking. Sometimes it is simply necessary to wake and get up early, however. What are the best ways to wake and get up early? Discover how to accomplish this with simple changes—such as alarm clocks, morning sunlight, and caffeine—that you can implement immediately that may have lasting benefits.

Changing Your Wake Time May Depend on the Purpose

Consider whether you need to wake up early once, such as to catch an early flight, or if you are adapting to a new schedule that shall persist. This will help determine what solutions or techniques should be considered to help you get up early. It may also be helpful to reflect on what your relationship to your alarm clock says about your personality. Difficulty waking may suggest underlying problems with the amount or quality of sleep.

Making Long-Term Changes to the Timing of Sleep

If possible, especially if this is a long-term adjustment to your sleep schedule, try to make changes gradually. For children or adolescents getting ready to resume school as the summer draws to a close, it is much easier to plan ahead and start waking earlier in the week or two before the first day back.

Begin by setting an alarm in the morning that is close to your current, natural wake time. Then, day by day, move the wake time earlier by 15 minutes. This could be adjusted as quickly as necessary or as slowly as comfortable. As a general rule, it takes 1 day to adjust to every 1-hour change in the timing of sleep (such as with jet lag). The wake time may be comfortably moved earlier every few days, for example.

Try to keep a regular bedtime and go to bed when feeling sleepy to avoid insomnia. It will not be helpful to crawl into bed early without feeling sleepy: it will just take longer to fall asleep. This desire for sleep will gradually shift earlier in increments, too. Listen to your body, spend time relaxing in the hour before your bedtime, and go to bed when you naturally feel sleepy. These incremental adjustments may help you to wake up more easily.

To optimize your sleep, maintain a regular sleep schedule (with consistent bedtimes and wake times) even on weekends or days off. To reinforce the wake time, get 15 to 30 minutes of morning sunlight upon awakening. If possible, roll out of bed, throw on clothes, and immediately go outside. Do not wear sunglasses or a hat; let the light hit you in the face (especially your eyes). The fresh air will wake you and the light will help to align your circadian rhythm and sleep pattern. If necessary due to where you live, consider the use of a specialized light box. Getting morning light exposure can be especially helpful for night owls with delayed sleep phase syndrome.

Reinforcing the Wake Time with Solutions and Determination

Beyond making gradual adjustments and reinforcing the circadian rhythm with light exposure, there can be other solutions that may prove helpful to wake and get up early. Consider these potential options and solutions:

• Set a loud, obnoxious alarm that is disruptive to your sleep.

• Put the alarm clock across the room so that you physically have to get up to turn it off. Don’t go back to bed once you are up.

• Consider setting multiple alarms on different devices (alarm clock, phone, etc.).

• Set the alarm as late as possible so that you don’t have an option to hit snooze, but have to get up immediately—or be late.

• Recruit others to help you wake up, such as members of the household who may already be awake or someone who can call you until you are up.

• Once out of bed, immediately go to the shower.

• Morning exercise or getting outside may also help to keep you awake.

• Consuming caffeine may clear morning sleepiness until you naturally start to wake.

• Avoid the use of sleeping pills as these may cause morning hangover effects.

Once you are awake and out of bed, you may still have a desire to return to sleep due to sleep inertia. This may be profound if you are waking significantly earlier than your usual wake time. It may feel like the middle of the night, and you may just want to crawl right back into bed. If this persists, you may consider reasons that your sleep is not as restful as it should be.

Make certain that you get enough hours of sleep to feel rested. Sleep needs vary, but most adults need 7 to 9 hours of sleep. As we get older, beyond the age of 65, the average sleep need may decrease slightly to 7 to 8 hours. If you don’t get enough sleep at night, it will be more difficult to wake up.

Treating sleep disorders may also be necessary to make it possible to wake and get up early feeling rested. Insomnia may insidiously undermine sleep, reducing the total amount and compromising the quality. Restless legs syndrome (RLS) may make it hard to fall asleep. Obstructive sleep apnea may also fragment sleep, leading to excessive daytime sleepiness and other symptoms. If one of these conditions is present, testing and treatment may be necessary to resolve the difficult waking.

In some cases, morning sleepiness may require further treatment. When it is due to a sleep disorder (sleep apnea, narcolepsy, or shift work sleep disorder) and interferes with daytime function, prescription stimulant medications may be used. These medicines may include modafinil (Provigil), armodafanil (Nugivil), or others such as methyphyenidate (Ritalin). Speak with a board-certified sleep medicine physician if you feel like you are struggling more than you should be.

As you adopt these changes to wake and get up early, initially have a fallback plan. Don’t just start by setting one alarm 2 hours before you naturally wake up and expect to jump out of bed refreshed; it may not go well. Consider ways to adjust gradually and use the recommendations above to help reinforce this change. Get help from others, including a sleep doctor if needed, to keep you on the right path. It can also be helpful to acknowledge that with determination and grit you can do it. Don’t allow yourself to go back to bed. The first few days will be the most difficult, but it will get easier.

Brandon Peters, MD, is the author of Sleep Through Insomnia, a neurology-trained sleep medicine specialist at Virginia Mason Medical Center in Seattle, and former adjunct lecturer at the Stanford Center for Sleep Sciences and Medicine.