Light Therapy Offers Nonpharmacologic Treatment for Perimenopausal Depression
Sleep and light treatments have had prior therapeutic success in other depressive disorders relating to women’s reproductive cycles, including peripartum depression.
Light and sleep therapy designed to shift earlier, or phase advance, melatonin circadian rhythms was found to be a successful treatment for perimenopausal depression, according to study results presented at the 2018 North American Menopause Society Annual Meeting in San Diego, California.
Research has shown that plasma melatonin circadian rhythms are shifted later, or phase delayed, in women with perimenopausal depression. Understanding the therapeutic value of sleep and light treatment in other depressive disorders relating to women's reproductive cycles, researchers investigated whether women with perimenopausal depression and phase-delayed melatonin circadian rhythms would have improved mood and sleep after an intervention of sleep and light therapy compared with normal controls.
In a randomized parallel design study, 17 perimenopausal women were treated at home for 8 weeks with either a phase advance probe, involving morning bright white light for 60 minutes starting within 30 minutes of habitual wake time or a control phase delay probe, involving evening bright white light for 60 minutes ending 30 minutes before habitual sleep onset time. Objective sleep/activity, mood, and subjective sleep were measured. In addition, overnight urine samples were taken to estimate urinary melatonin levels, as well as time of onset, offset, and peak of melatonin secretion, or acrophase.
Multivariate and univariate analyses of data showed participants with perimenopausal depression who received the phase advance probe had a significant phase advance in overnight urinary melatonin offset (2 hours 15 min ± 12 min, P =.042) and a marginal advance in overnight urinary melatonin onset (1 hour 57 min ± 3 hours 21 min, P =.081). In contrast, participants with perimenopausal depression who received the phase delay probe showed nonsignificant phase delays in offset and onset. Regarding subjective sleep quality, normal control participants reported worsening sleep after receiving the phase advance probe (P >.05), and participants with perimenopausal depression reported nonsignificant sleep improvement (P >.05). Of note, after the phase advance probe, greater phase advance in acrophase was associated with greater improvement in mood score (P =.002). For participants with perimenopausal depression, mood scores improved significantly after both 2 and 8 weeks (P =.007).
The researchers noted some limitations because of the small cohort size and recommended repeating the study with a larger population to verify results.
“This study demonstrates that women with perimenopausal depression and sleep issues may now have a nonpharmacological and nonhormonal option that may help with sleep and improve their mood,” stated the researchers. The light treatments successfully corrected abnormal timing of melatonin circadian rhythms in perimenopausal women with depression and improved mood and sleep within 2 weeks. In practice, light and sleep therapies may be designed for personalized treatment in individual circadian rhythm pathologies.
Parry BL, Meliska C, Sorenson D, et al. Sleep and light therapy for peri-menopausal depression. Presented at: 2018 North American Menopause Society Annual Meeting; October 3-6, 2018; San Diego, California. Abstract S-19.