Light therapy led to improved pain, function in fibromyalgia

CHARLOTTE, N.C. — The use of morning light treatment in patients with fibromyalgia helped stabilize their sleep and led to improvements in pain and physical function, Helen J. Burgess, PhD, said at the SLEEP 2022 meeting.

“Fibromyalgia is a chronic, widespread pain condition associated with mood and sleep disorders, fatigue, cognitive function, high distress, disability, lost productivity and poor quality of life and affects more than 20 million Americans,” Burgess, co-director of the Sleep and Circadian Research Laboratory and professor of psychiatry at the University of Michigan in Ann Arbor, said in her presentation.

Treatment typically includes antidepressants, antiepileptics and opioids, she said. Cognitive behavioral therapy and exercise have demonstrated efficacy with minimal side effects, but they can be difficult to access and require significant patient effort.

Burgess said that in a previous pilot study, patients received 6 days of 1-hour morning bright-light treatment from a light box.

“There were clinically meaningful improvements in function and increased pain,” she said.

This current double-masked, randomized control trial involved 54 total adult patients. Exclusion criteria included a range of mental health disorders, retinal disease, history of eye surgery, light treatments in the past year, night shift work and crossing time zones.

Patients were divided into two groups: bright light and dim light, Burgess said. There was one male participant in each group, no significant racial differences, and most participants had BMI on the higher side. She noted that 39% of participants had an apnea-hypopnea index of 15 or higher.

Participants were asked to sleep on their regular sleep schedule for the first week.

“Then we assigned them a light start time, which started at the average baseline wake time or up to 1 hour earlier,” Burgess said.

The light was delivered via the commercially available Re-Timer therapy glasses (Re-Time), which participants wore for 1 hour with all room lights turned on.

Participants initially received phone calls from staff, then daily text messages and were seen once a week. Treatment adherence was monitored with an Actiwatch Spectrum Activity monitor (Philips) attached to the inside of the Re-Timer, and patients were assessed at baseline, 2 weeks and 4 weeks.

“We saw similar levels of improvement in both the dim and bright groups,” Burgess said. “Results suggest that 4 weeks of an advanced and stabilized sleep schedule can lead to meaningful improvements in pain and physical function in people with fibromyalgia.

“The average decrease in the Fibromyalgia Impact Questionnaire [which assesses function, overall impact and symptoms] was pretty meaningful, at 11.2,” she added. “Previous studies say cognitive behavior therapy and analgesics only improve the score 5.4 to 5.8 points, and exercise improves it 10.3 points.”

Burgess concluded that morning light therapy should be further investigated as a treatment for fibromyalgia. It has minimal side effects and improves symptoms in people with few interventions available to them. She added that a reduction in depressive symptoms may have contributed to the improvements in pain and physical function.