Here in the northeast, it gets pretty dark pretty early these days (late November). The days can be rather gray as well. For people in higher latitudes, the days are even shorter. SAD (seasonal affective disorder) has already begun for those who are vulnerable to this issue. They often sit in front of a light box to life their mood.
But what if you don’t have SAD. You feel mentally fine. Your sleep isn’t terrific, and you have heard about getting enough full-spectrum light exposure in the morning to support a strong circadian cycle. In the northeast, you could wait all day for the sun and go to bed having never seen it peek out.
Should you get a light box?
Not necessarily.
Light boxes aren’t prescription-only. You can grab one on Amazon and it will be at your doorstep in a few days. You should know, however, that they do create risks for certain people, and aren’t helpful for even more folks. Most of us get far more sun exposure by going outside than using a light box for a short period in the morning will provide. Access to sunlight at the right time of the day should be sufficient for most people.
Light boxes need to be used at the right time of day to get the right results. Most people with SAD, depression, and advanced sleep phase disorder use them within 60 minutes of awakening. Use later in the day can push bedtime far later into the night. Using them inconsistently, for short periods of time, walking too far away from them during use, even turning away from them will make them ineffective.
Clinicians struggle to do research on light boxes because getting people to use them consistently and correctly is harder than simply handing out a pill.
Who should not use a light box without checking with a physician?
- Anyone with diagnosed retinal disorders. This isn’t nearsightedness. This would be macular degeneration and a few more things. Most people over 65 should speak directly with their eye doctor as well as their PCP.
- Anyone with bipolar illness. Strong full spectrum light can trigger a manic episode in some people. It isn’t the most common reaction, but because the cost of a manic episode can be high, a physician should be involved in choosing a protocol and monitoring use.
- Anyone that has a history of light sensitivity, including people with brain trauma, seizure disorders, etc. You have a lot to lose if things go south. A physician can help you decide what your risks are. Most clinical-grade light boxes filter out about 99% of UV rays. But that doesn’t mean ALL light boxes you can buy on Amazon do that. The clinical-grade light boxes run 3-4x the price of the cheapest boxes, and you get what you pay for.
- Anyone with conditions that can create retinal damage, such as diabetes. You don’t have damage yet. You don’t want to risk developing some.
- Anyone taking medications that render them more sensitive to light. This includes some antibiotics and seizure medications, but the list is far longer and includes some very common antidepressant meds and NSAIDs.
Who could benefit from using a light box?
People with circadian rhythm disorders and SAD, primarily. Some people with insomnia, shift workers, and people who aren’t able to get sun exposure for various reasons will also benefit. This is one of those treatments that should be used with input from a medical provider as well as a sleep therapist. Using a light box isn’t plug-and-play. Identifying the timing and the set up to get the best results mean that most people need more guidance than they can find online.
What are some alternatives?
There are light glasses and full-spectrum lightbulbs that allow people to have either more mobile exposure or less intense exposure. These should not be used in the evening if you want a good night’s sleep! And neither have been studied as treatment for SAD or circadian rhythm disorders due to their difficulty in measuring consistent light exposure to the retina. Blending sleep strategies that include strong wake up routines and wind down routines can be as effective as a light box for people who do not have circadian rhythm disorders or SAD.
Read more about sleep treatments here: Are You “Wired and Tired”? and How to Dim Your Screens to Reduce Blue Light at Night .
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