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J Clin Sleep Med. 2018 Jan 15;14(1):31-39. doi: 10.5664/jcsm.6874.

The Effect of Systematic Light Exposure on Sleep in a Mixed Group of Fatigued Cancer Survivors.

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Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Department of Psychology, Reykjavik University, Reykjavik, Iceland.
Department of Psychiatry, University of California, San Diego, California.
Department of Medicine, University of California, San Diego, California.
Department of Clinical and Social Psychology, University of Rochester, Rochester, New York.



Sleep disturbances are commonly reported by cancer survivors. Systematic light exposure using bright light has been used to improve sleep in other populations. In this secondary data analysis, the effect of morning administration of bright light on sleep and sleep quality was examined in a mixed group of fatigued cancer survivors.


Forty-four cancer survivors screened for cancer-related fatigue were randomized to either a bright white light or a comparison dim red light condition. Participants were instructed to use a light box every morning for 30 minutes for 4 weeks. Wrist actigraphy and the Pittsburgh Sleep Quality Index were administered at 4 time points: prior to light treatment (baseline), 2 weeks into the intervention, during the last week of the intervention, and 3 weeks postintervention. Thirty-seven participants completed the end-of-intervention assessment.


Repeated-measures linear mixed models indicated a statistically significant time × treatment group interaction effect with sleep efficiency improving more in the bright light condition over time compared with the dim light condition (F3,42 = 5.55; P = .003) with a large effect size (partial η2 = 0.28). By the end of the intervention and 3 weeks postintervention, mean sleep efficiency in the bright light group was in the normal range. Medium to large effect sizes were also seen in sleep quality, total sleep time, and wake after sleep onset for participants favoring the bright light condition.


The results suggest that systematic bright light exposure in the morning may have beneficial effects on sleep in fatigued cancer survivors. Larger scale efficacy trials are warranted.


Registry:, Title: Treating Cancer-Related Fatigue Through Systematic Light Exposure, Identifier: NCT01873794, URL:


actigraphy; cancer; fatigue; light therapy; sleep disturbance; sleep efficiency; sleep quality

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