Proper Light Box Use
During phototherapy treatment with a light box, your eyes should remain open. It is best if the light is incidental to your sight. The benefits of a light box occur at the periphery of our vision. This means instead of staring directly into the light box, set it off to the side and look toward something else. You may want to watch television, use your computer, or read while you are using the light.
Light Exposure Can Be Varied
It is recommended that you start with one 10-15 minute session of light exposure per day upon awakening. Some light boxes come with a timer to help manage your sessions. This can gradually be increased to 30-45 minutes per day, depending on your response. Most people use the light box for 30 minutes daily upon awakening and typically see a response over several weeks.
For those with a misaligned sleep schedule from a circadian rhythm disorder, the use of a light box may be helpful to shift your sleep to the desired time. For example, if you are falling asleep too late and are sleeping in or excessively sleepy in the morning (a sign of delayed sleep phase syndrome), you should use the light box in the morning. If you are falling asleep too early and wake before you desire to (a sign of advanced sleep phase syndrome), the light box can alternatively be used in the evening. If effective, these treatments will be lifelong.
In the case of SAD, light box therapy should be continued until natural exposure to sunlight normalizes, sometime in the spring. If it is effective, individuals with SAD will require lifelong treatment restricted to the winter months.
Light therapy has very few side effects and is usually well-tolerated. If your symptoms are persistent, you may wish to increase the exposure to twice per day. It is typically recommended that you not exceed 90 minutes per day, however. If you have persistent problems, you may need further evaluation by your doctor and alternative treatment.
Chesson, AJ et al. "Practice parameters for the use of light therapy in the treatment of sleep disorders." Standards of Practice Committee, American Academy of Sleep Medicine. Sleep. 1999; 22:641.
Eastman, CI et al. "Bright light treatment of winter depression: a placebo-controlled trial." Arch Gen Psychiatry. 1998; 55:883.
Golden, RN et al. "The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence." Am J Psychiatry. 2005; 162:656.
Terman M et al. "A controlled trial of timed bright light and negative air ionization for treatment of winter depression." Arch Gen Psychiatry. 1998; 55-875.