Bright light therapy for CPAP-resistant OSA symptoms

Sleep fragmentation and daytime sleepiness often persist in patients with sleep apnea despite correctly administered CPAP. Our proof-of-concept study tested acceptability and efficacy of morning bright light therapy (BLT) to improve sleep, circadian rhythms and CPAP-resistant daytime symptoms in patients with sleep apnea.In this within-subject cross-over study, 14 individuals completed 4 weeks of BLT and sham BLT in randomized order. Outcomes included actigraphy-based objective sleep measures, sleepiness, depressive symptoms and sleep-related functional impairment, analyzed with multilevel models.Patients experienced greater reductions in WASO and increased amplitude of rest-activity rhythms in shorter photoperiod with BLT compared to sham. Patients also reported reductions in subjective sleepiness and depressive symptoms with BLT compared to sham only during the early stages of treatment and shorter photoperiod.These results suggest the potential for novel applications for existing chronotherapeutic interventions for improving symptoms and quality of life for those patients that experience residual symptoms with current available treatments.Registry: ClinicalTrials.gov; Identifier: NCT04299009; URL: https://clinicaltrials.gov/ct2/show/NCT04299009.