Treatment of attention deficit hyperactivity disorder insomnia with blue wavelength light-blocking glasses

Abstract

Background: The aim of this study was to examine a nonmedical treatment alternative to medication in attention deficit hyperactivity disorder (ADHD) insomnia, in which blue wavelength light-blocking glasses are worn during the evening hours to counteract the phase-delaying effect of light. Outcome measures included sleep quality and midsleep time. The capacity of ADHD subjects to comply with treatment using the glasses was assessed. Methods: Daily bedtime, wake-up time, and compliance diaries were used to assess sleep quality and timing during a baseline observation week and a 2-week intervention period. The Pittsburgh Sleep Quality Index (PSQI) was administered following baseline and intervention. The intervention protocol consisted of use of blue wavelength-blocking glasses and a moderate lighting environment during evening hours. Results: Partial and variable compliance were noted, with only 14 of 22 subjects completing the study due to nonadherence with wearing the glasses and diary completion. Despite the minimum 3-hour recommendation, glasses were worn, on average, for 2.4 hours daily. Lighting was reduced for only 58.7% of the evening. Compared with baseline, the intervention resulted in significant improvement in global PSQI scores, PSQI subcomponent scores, and sleep diary measures of morning refreshment after sleep (P = 0.037) and night-time awakenings (P = 0.015). Global PSQI scores fell from 11.15 to 4.54, dropping below the cutoff score of 5 for clinical insomnia. The more phase-delayed subjects, ie, those with an initial midsleep time after 4:15 am, trended towards an earlier midsleep time by 43.2 minutes following the intervention (P = 0.073). Participants reported less anxiety following the intervention (P = 0.048). Conclusions: Despite only partial compliance with intervention instructions, subjects completing the study showed subjectively reduced anxiety and improved sleep quality on multiple measures. The more sleep-delayed subjects trended toward an earlier sleep period following use of the glasses. Blue-blocking glasses are a potential insomnia treatment for more compliant subjects with ADHD insomnia, especially those with prominent sleep delay. Larger studies of blue light-blocking glasses in more phase-delayed groups could reveal significant advances in chronotherapeutics.