Seasonal Affective Disorder (SAD) By Bob Fairbanks, RPSGT Fairview Sleep Centers
Objectives • Review Circadian Rhythms • Symptoms of Seasonal Affective Disorder (SAD) • Review treatment options
Seasonal Sunshine • Sunlight diminishes in the fall • Making our days shorter • Limiting our exposure to sunlight
Artificial light • Thomas Edison invented the light bulb in 1879 • Giving us artificial light • This allowed us to stay awake longer and be more productive
Prior to the light bulb • Worked outside during the day • Got on average 9 – 10 hrs of sleep at night
Now • Majority of the work force works indoors • Get 6 – 8 hours sleep
Lack of Sunlight • We work inside • If we do go outside we have sunglasses that give us 100% UV protection • But why does lack of sunshine make us tired?????
Circadian Rhythm • Our sleep / wake pattern is based on a 24 hr cycle • Light plays an important role • Body temperature also plays a role in this process
What if you are blind? • If you are not able to use light to set your circadian rhythm then temperature takes over. • People who are blind have a 24.5 hour circadian rhythm
How it works • As it gets dark in the evening, Melatonin increases in our blood stream • This decreases our body temperature • This makes us feel tired • Our body temperature is lowest 4 hours after we fall asleep
Circadian Rhythm • If we are exposed to bright light, melatonin decrease in our blood stream • Lack of melatonin in our blood stream increases our body temperature • This makes us alert • Our body temperature decreases after lunch
Why is this so important? • Sunrise is 10,000 lux • Sunlight at noon is 100,000 lux • Indoor lighting is 500 lux
Symptoms of SAD • Change in appetite, craving sweet or starchy foods • Weight gain • Heavy feeling in the arms and legs • Drop in energy level • Fatigue • Oversleeping
Symptoms continued • Difficulty concentrating • Irritability • Increased sensitivity to social rejection • Avoidance of social situations • (Winter Depression)
Summer SAD • Summer (increased exposure to sunlight) – Poor appetite – Weight loss – Insomnia
Symptoms are seasonal • Symptoms of SAD tend to come back year after year • They start and finish about the same time every year
Treatment options • Light therapy (phototherapy) – Indirect bright light (10,000 lux) – 30 minutes every morning during fall and winter • Medications – Melatonin before bedtime – Wellbutrin XL • Behavioral Therapy
Light therapy • Blue light – works best – Need 10,000 lux for best treatment – Blue light is the correct wavelength – Less intense and smaller – Portable • White light – full spectrum – Extremely bright (10,000 lux) – Big and not portable
Resetting your clock • Combination of therapy’s might also work – Melatonin at night – Bright light in the a.m.
Obtaining Light Therapy • Every insurance is different for coverage of light therapy • Fairview Home Medical Equipment St. Paul 2200 University Ave West 651-632-9800
Remember to enjoy a Sunrise!