Choosing a Bright-Light Therapy Device

Next year (2016) I'll add information to my site about how to use bright light therapy for depression and bipolar syndrome, in the meantime I refer you to the book Brighten Your Life by Krypke. 
bright light for depression
Bright light therapy is not just for people with SAD syndrome or winter blues depression it's actually a useful antidepressants for any type of depression. Like other antidepressant therapies bright light therapy can induce mania in people with bipolar syndrome, this does not mean to say that you should not use it to treat bipolar depression but you must use it as an appropriate measures dosage and counterbalance it by sleeping in total darkness along with other anti-mania treatments. 

The industry standard output for a white-light SAD light-box is 10,000 lux, this is based on its similarity to the light intensity of the midday sun with a clear sky.  These light boxes consist of fluorescent tubes in a box behind a diffuser.  You can buy a cheap SAD light-box producing 10,000 lux but the problem with these cheap devices is that they are often underpowered and to obtain the 10,000 lux intensity your eyes have to be as close as 9”/23 cm from the device.  As already mentioned light intensity falls off exponentially as you increase the distance from the source, what that means is as you increase the distance between the light-box and your eyes the brightness of the light falls off very quickly.  So if you going to buy a white-light light-box you need to get a large very powerful unit that will produce 10,000 lux at no less than 18”/45cm and 24”/60 cm would be more practical.  Unfortunately some manufacturers don't even tell you how far away from the device they measured the 10,000 lux level; make sure you investigate this before you make a purchase.  Generally specialist shops/websites dedicated to SAD lights and other health devices will be able to give you information about the strength of the light-boxes, as opposed to none specialist sites like amazon, see resources for recommended suppliers.  If you sit too far away to received 10,000 lux or buy a less powerful light-box you'll have to spend a lot time doing the treatment, perhaps 2-3 hours and all that time you have this annoying, dazzling headlight in your face.  My advice -if you going to buy a white-light light-box- is to get a very large, powerful unit, sit up close to it and get the treatment over with as quickly as possible.  Actually having the scheduled reading time is quite nice.  

There are some very expensive, attractive, “designer” bright lights sold alongside SAD light-boxes.  They may look nice in a brightly lit office but they have nowhere near 10.000 lux so I would not recommend them for early morning use to correct delayed sleep phase disorder or create an antidepressant effect, the treatment time would be too long.  These lights may be worth considering for people with advanced sleep phase disorder who want bright-light in the evening to prevent them falling asleep too early.  You’ll need to sit quite close to one off these lights for several hours to produce therapeutic effects.  Actually this is where the cheap SAD light-boxes mentioned above would work well.  You may find it easier to use a more powerful light-box for a shorter therapy time.

The much better alternative to the original white-light light-box are the new more sophisticated blue LED bright-light device devices.  

These devises produce more of the blue wavelengths that stimulate the ipRG cells in the retina that entrain our biological clock.  

Our understanding of the ipRG cells is still growing, some early studies showed their peak sensitivity to be around 470 mm (bluish) and the original blue Led bright-light devices used this frequency; other research suggested peak stimulation of the ipRG cells was achieved at 505 nm (a green/cyan colour) in response  some manufacturers have started to produce bright light therapy devices with a green/cyan colour. The manufacturers these devices  sometimes like to claim that  the blue light therapy devices carry a risk of eye damage and that their green light devices are therefore safer.  However  there really isn’t any evidence that  the blue light devices pose any risk whatsoever to the eyes,  is ultraviolet light that we want to protect our eyes from and the blue light devices emit less VU than outdoor light sunlight, are you afraid of 30 min a day outdoors on a sunny cloudless day without sunglasses.  

I have yet to try the effectiveness of green lights that emit 505 nm but I’m sure it will work  both to reset the biological clock and to produce  an antidepressant effect, if they turn out to be more or less effective than blue you can simply adjust the time. Some of the original green-light devices were very expensive but a new entry which I really like the look of is the Feel Bright Light which clips into a  visor or baseball cap.  (Available from Amazon.com http://www.amazon.com/Feel-Bright-Light-Portable-Rechargable/dp/B00H8XFDUO/ref=pd_sim_121_2?ie=UTF8&refRID=0DV5KKD9CZX7RX9YP7PR&dpSrc=sims&dpST=_AC_UL160_SR160%2C160_ ) There are advantages to this design, it positions the lights close to the eyes and above the eye line, it SAD light depressionmaintains the exact same distance and location in the visual field and it permits you to be  mobile and hands-free during the treatment.

Since 2005 the consensus has been that the ipRG cells are the most sensitive to light in the region of 480 nm.  The Philips bright-light devise I use peaks at 470 nm which is close enough to 480 to be effective.  

It is possible to buy coloured LEDs that emit specific wavelengths and make your own ultra-efficient bright-light device, instructions are available online at: 

http://www.instructables.com/id/Blue-LED-light-box/

Cyan (505 nm) and blue (470 nm) LEDs pre-mounted and ready for soldering are available online from Luxeon Star for example.  A bright-light device made from a combination of these two coloured LEDs should produce highly effective stimulation of the ipRG cells.  LEDs admitting 480 nm specifically are harder to come by, interestingly they are used in dentistry to "light cure" white filling material.  Although all the above mentioned light frequencies are present in normal daylight and are thought to be safe because they do not include the eye damaging ultraviolet part of the spectrum, it has not been established beyond a shadow of a doubt that exposing your eyes to intense light in the region of 480 is safe.  I note that dentist working with this type of light shield their eyes with an amber coloured filter.  It is established however that the greener (cyan 505 nm) wavelength is very safe.  I intend to produce my own ultra-efficient/safe bright-light device using two thirds cyan and one third blue-light LEDs.

By producing  principally the wavelengths that regulate our circadian rhythm and reducing the wavelengths that have little effect  the modern blue bright-light devices don't have to be anything like as bright as the old full spectrum white-light light-boxes; this makes them much more efficient allowing the treatment time to be shortened.  In terms of being dazzling to the eyes the  new blue LED devices can be better or worse than the original white-light light-boxes depending on how  you set them up.  When switched  on in a completely dark bedroom the small point of light they produce can be un-usably dazzling, you can easily remedy this however by using a bedside-lamp near the device.  When used in a brightly lit room, next to a laptop for example  the new blue-light devices  are far less dazzling  and easy to use.  

Being LED-based they should last a lifetime and consume very little power  making them energy efficient.  

The blue led devices have come down in price and are now even cheaper than the powerful white-light light-boxes so there’s little point buying a white-light light-box today.  As we age the cornea (the front part of the eyes) gradually yellows which may eventually lead to less blue light being able to enter the eyes, see further reading.  If this has occurred the white-light light-boxes or the latest generation green-light devices may work better.  

At the time of writing I would unreservedly recommend the top of the range Golite Blu Energy light made by Phillips.  Its compact, beautifully designed and has a timer which I find invaluable, you can also vary the light intensity so that it’s not too bright next to your computer.  This device can be used as an alarm clock and switch the light on automatically, but as mentioned above this is far too dazzling in a pitch black bedroom.  I prefer to use a regular alarm clock then switch on my bedside light and then the Golite Blu.  

This devise also works flawlessly when positioned where you eat your breakfast if you spend enough time doing that and where you do early-morning reading/computer work.

For people who are concerned about electromagnetic radiation sensitivity this device can be charged up and run for 2 to 3 days at full power on the battery, when run on the battery only electromagnetic pollution is negligible.  The cheaper devices in the range do not have a rechargeable battery and must be run off the mains; the transformer in such a device will produce levels of electrometric radiation that may be a problem for people with hyper-electromagnetic sensitivity syndrome out to a distance of almost six feet (1.8 metres).  Hyper-electromagnetic sensitivity syndrome is recognised in Sweden and has been acknowledged but played down -probably for political reasons- by the World Health Organisation, it can disturb sleep and it makes no sense putting your head next to a device to treat you sleep that may disturb your sleep, buy the more expensive battery powered device.  

My one criticism of this device is that the Philips manual says the battery is not user exchangeable, however you can buy replacement batteries and a competent person could easily replace the old battery so that the whole device does not have to be discarded to landfill.  I'm not encouraging anyone to do this so don't blame me if you make a mistake and burn your house down.

An interesting alternative to the Philips Golite which I have not tried but really like the look of is the Syrcadian Blue SAD light therapy device.  This is  another blue LED light device, its long strip design is intended to clip on top of your laptop or computer monitor.  It's clever positioning in the most efficient part of the visual field and its’ close proximity to the eyes will increase efficiency making this an excellent device as long as you to work on your computer soon after rising each day.  It draws power from a USB port alternatively you can buy a wall plug that you can plug the USB plug into so you could set it up separately to your computer say attached to a box or next to your bed: they also sell a car kit so that you can attach the LED strip to the sun visor in your car, I could see this working for a passenger, but shining light in your eyes while driving??  This device retails for about $70 from Amazon.com, it’s quite basic without timers and dimmers etc. but should give you highly efficient blue-light conveniently built onto your computer at a very affordable price.  If don’t want to spend the money on a more expensive blue light device get the Syrcadian Blue and either put it on your computer or using tape or plastic ties attach it to something like a box above your horizon eye-line and keep it close as you would a computer monitor.  Their website www.cyrcadianblue.com is quite informative regarding bright-light therapy. 

Another option is the Litebook Elite this is similar in size and shape to the Philips golite.  It consumes only 2.4 watts compared to 12 watts for the Philips so it is a less powerful light, but would be similar to the low setting on the  Philips I use next to a computer monitor.  It has a rechargeable battery and a timer with fixed 15 minute intervals compared to the Phillips that allows you to select any number of minutes up to 30.  It’s also currently more expensive on Amazon, despite this I’m sure it’s an effective device.  I particularly respect that on the Litebook website there is mention and warning of the very real risk of bright-light treatment inducing mania/hypomania in people with bipolar and cautioning to consult your doctor before commencing treatment.  

Another type of light treatment devices you'll see available are the so called dawn-simulators.  These are alarm clocks with a light-box attached that gradually grow in brightness to simulate a natural dawn sunrise.  The light they produce is less powerful than a 10,000 lux light-box, however it is claimed that they don't need to be that powerful because the dawn simulating effect resets the 24-hour clock more effectively.  Intuitively I like the concept of these devices, but as I’ve not used one so can't comment on them.  Kripke in Brighten Your Life quotes one study providing some evidence that simulating dawn is effective in treating seasonal affective disorder SAD.  

An interesting new device is called the Valkee.  Researched and developed in  Finland where SAD syndrome winter depression is a common occurrence this device looks like an iPod and shines a very bright light into the ear canals.  It may surprise you but bone is quite porous to light, so it's understandable how this will expose the brain tissue to light.  The obvious question however is does this have any physiological effects since as far as we know all light sensitive cells are situated in the retina of the eye and not in the brain itself.  Research has discovered that brain does possess photoreceptor proteins such as encephalopsin, but it has not been established that stimulating these proteins with light has an effect on our biological clock or depression in the same way it has been established that bright light entering the eyes does.  

The manufacturers of the Valkee claim full bright light treatment is achieved with just 8-12 minutes, which is very fast.  If this system works as well as bright-light devices it would be far superior in terms of ease of use and convenience.  At some point I'll try one of these devices and post a review on my websites, please send me a review if you try one.  

For further reading on the Valkee see: Can transdermal brain-targeted bright light treatment via ear canals be effective in relieving symptoms of seasonal affective disorder? on line.  This was just a pilot study however improvement in depression was observed in 10 out of 13 patients (76.9%) using the Valkee device, which is hard to dismiss as a purely placebo phenomena; it calls for more research.  

Another setup I've seen but not tried are blue LEDs positioned just above the eyes in specially made glasses.  Being positioned very close to the eyes in the ideal part of the visual fie THEld they may be able to deliver adequate light intensity despite running off small AAA batteries.  My question about such a setup would be is it easy to work at the same time or are these devices annoyingly dazzling.  Search on line for the Seqinetic or Luminette.  I'll review these at some point.  

Specialist Bright Light Device Suppliers 
www.electronichealing.co.uk  
www.sad-lighthire.co.uk 
www.syrcadianblue.com  
www.litebook.com   

 THE TEXT BELOW IS NOT MY OWN OR EDITED

I'm going to narrow the research findings down as much as possible for you. That way, you'll have the basic information you need to know for purchasing a light box for SAD. And you won't be overwhelmed with all the research from the science journals. 

Let me first say, I don't take any of this lightly (no pun intended). Depression is a serious topic, one that has greatly affected my own family. (Two first cousins—one was my best friend—committed suicide, and two other family members attempted suicide several times and almost succeeded.) 

Here's what scientists know
about light boxes for SAD

Without question, light relief therapy is a highly effective method for overcoming the seasonal depression that occurs in the fall and winter months. 

Over the past several years, the standard recommendation for the best light therapy was for light boxes containing fluorescent bulbs that put out a white light. White light does work and is designed to mimic the effects of natural daylight. 

But some of the claims for these lights sometimes refer to them as “full spectrum lights.” And they also claim they are the "best light therapy." 

Here's what Dr. Daniel Kripke, an expert on sleep, sleep medications, and bright light therapy has to say about full spectrum lights: 

“A lot has been written about natural lighting and whether one should use lighting with a "full" spectrum. I suspect this spectrum of claims is largely baloney! I doubt that any of the commercial sources really produces a light spectrum which could be mistaken for the rather smooth spectrum of natural sunlight.” 

What does appear to matter for
the best light therapy is this:

Light intensity. 
Whether the light box is free of UV light.
How long a person may need to sit in front of the lights to get relief. 
Whether you respond better to light therapy first thing in the morning or whether evening light helps you better. 
The color of the light. 

So let's first address light color
for the best light therapy

Light comes in colors, as you've seen if you've ever viewed a prism. For the purposes of seasonal affective disorder light therapy, the colors of interest are white, blue, green, red. 

Forget about red for seasonal affective disorder light therapy. White and blue are better for SAD. 

Green light therapy is an interesting, fairly recent development in light therapy for SAD over the past 10 years or so. However, I haven't seen any substantial evidence that green light is better than blue light (and green light boxes are far more expensive). 

What I have seen is that green light has been touted as being safer for the eyes than blue light. 

Why? 

The thought is that light causes macular degeneration in the eyes. So over a lifetime of exposure to the sun, there is potential damage to the retina of the eyes. 

What does this have to do
with light boxes for SAD?

Light boxes are designed to put out a certain amount of light intensity, known as lux. The thinking is, sitting in front of a light box may lead to macular degeneration. And some discussion has speculated that blue light is worse than green light or white light. 

I'm not convinced of this. 

Here's the thing. 

All you have to do is keep this in mind: DO NOT stare into any light box! You don't stare directly at the sun and you should never stare into a light therapy box. 

Also keep in mind that white light does contain a lot of blue light and blue-green light. 

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So what about intensity of a light therapy lamp?

The standard advice when dealing with white lights is “get a light box with 10,000 lux.” For a white light therapy lamp, that's good advice. 

However, new light therapy research shows that blue-enriched light, which has a lower intensity, may be just as effective as the high intensity white light boxes. 

I know I know. All of this sounds confusing and you're sitting there thinking, “What the heck am I supposed to buy for the best light therapy!” 

For now, I think your best bet is to go with either a white box or the new smaller blue light boxes. Green light therapy is expensive right now and I'm not convinced the potential benefit is worth the price. 

If you have any eye disorders, such as glaucoma, cataracts, or susceptibility to macular degeneration, don't use a light box without consulting an eye doctor. If you don't have eye concerns, light boxes for SAD should be safe. 

The key to solving SAD
depression is...do something!

I think it's far better to try something in the way of light therapy for depression, even if all the facts about different types of lighting are not known. 

It's clear that whether blue light is better than green light is better than white light as the best light therapy still needs more research to determine. 

In the meantime however, just do something about your seasonal depression! 

The people who get somewhere in this world are the ones who take action, even in the face of depression and setbacks. 

So don't let confusion stop you from getting help that is available. 

Recommendations for buying
the best light therapy box

There are companies all over the Internet that sell light boxes for SAD. You can spend hours searching around (as I have). 

If you want to save yourself some time, I think the easiest thing to do is start by clicking below to view one of the Philips blue lights from Amazon.com. 

They're clinically tested, which is essential for choosing a light box... 
They're small and compact, yet effective... 
They're endorsed by the prestigious National Sleep Foundation... 
They're free from UV light, which is absolutely critical in choosing a light box for SAD... 
They're small and compact so you can put the box above your eyes, perhaps on a shelf, and let the light filter down to you. Research is now showing that due to the structure of your eyes, if the light is above your head, and filters down on you, the effect on your seasonal depression is better. 
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