I am a teacher, so I have to go to work early in the morning. I use a dawn simulator, and a light box, for 20 minutes in the morning when I first wake up. This maintains my ability to get up early and feel energetic during the day. However, because my job is demanding, I would like to sleep a few extra hours on the weekends. From experience, napping in the afternoon is a mistake as I feel groggy. Also, I know missing my regular wake up time is a big mistake. I would like to get up and do my regular light time, and then go back to sleep for a few hours. Would this seriously disturb my overall sleep pattern? I want the extra sleep but not at the expense of my mental wellbeing.

In general, it is best to maintain a regular bedtime, and wake up time, even on the weekends, to ensure you remain in sync with the environment. In your situation, more »

I have been using my light box for 30 minutes per day for 3 days in the morning and have noticed an increase in baseline anxiety. If i have baseline anxiety that seemed worse in the winter, is light therapy recommended or contraindicated?  I don’t have any history of hypomania. Should I stick it out for 2 more weeks and see if it resolves? Or do you recommend decreasing duration in front of lights to 15 minutes per day? At what point is light therapy contraindicated?

Another really good question.  First off, we want to emphasize a general point about clinical questions of this kind:  specific therapy  recommendations for a given individual in a given situation more »

I am 60 years old. For 16 years I have successfully treated my Seasonal Affective Disorder (SAD) with light therapy and a low dose of Paxil.  My first signs are anxiety, sleep disruption, and social withdrawal.  This year the light therapy is not working, and I am a mess from depression and anxiety.  Does light therapy become ineffective?  I have tried changes, and new, clinically approved lights, with no help.  Any thoughts?

Sorry to hear that you’ve been having trouble maintaining good effect from your light + medication regimen. There could be numerous reasons, unfortunately impossible to sort out from the limited more »

Dr. Terman, I have read with great interest the summaries of your research, and some of your blog postings. I am wondering if you have ever come across patients whose sleep time and wake time are incredibly reliable, who don’t have a mood disorder, but who have an abnormally low afternoon dip? I have long had this problem — no issues with falling asleep, staying asleep, or waking up, but a dip after lunch that is so severe that I find myself walking across the street with my eyes closed. I am as perky as can be in the morning, but it is the most uncomfortable fight to try to stay awake in the afternoon. Nothing I have ever tried, other than an actual prescription stimulant, has had any effect, and I don’t like how I feel on the stimulant. I recently traveled to Israel, where I thought I’d be incredibly jet lagged, but, surprisingly, I felt far better than at home in the DC area. The only things I could think of were that it was so incredibly blindingly bright all day long every day, or that the time of my afternoon dip would literally have been while I was asleep because of the time change, and that my rhythms didn’t adjust in the week that I was there. I purchased a light box on the advice of my doctor, but I can’t find any information on how I should use it. I’m wondering if you’ve ever met anyone like me? It would be the greatest gift if I could have my afternoons, and not have to plan my days around needing a nap. Doctors have long told me that it’s healthy to take a nap, but it’s one thing to decide to take one, and it’s another to absolutely require one.

You had the correct insight.  The afternoon slump can occur with or without depression. If you measure the interval between the slump and the midpoint of nighttime sleep, they’re about more »

I’ve been using light therapy for SAD for about a month and have found it tremendously helpful for my mood. I suffered with SAD for about 6 months out of the year during winter for the past six years and just recently read Winter Blues by Rosenthal and realized that the 30 min I had stuck to for light therapy probably hadn’t been enough. I now do about an hour right when I wake up, and about an hour later sometime before 2 or 3 PM. Lately my body has been waking up between 4:30 (yikes!) and 5:45, which has not been great for me. I have shifted my bedtime earlier and I fall right asleep, but am tired of waking up so early and not being able to fall back asleep- and, I am okay with bed at 9:30 or 10, but don’t want to sleep earlier because then I miss so much of my evening, but since my body wakes me up so early, I am seriously exhausted by 8 PM. I’m 28 years old, active, and by 8 PM I feel like I’m 90 years old!!! Is there any way to alter my light therapy so that I can sleep in later? Try less or at a different time? Thanks for your help!

You are making a big mistake with self-treatment.  See Dr. Terman’s book, Reset Your Inner Clock, for a detailed explanation of setting light therapy parameters: duration of the session, timing more »

My two year old goes to sleep between 7 and 7:30 pm, and often wakes up before 5 am. He usually takes a 2 hour nap. If he naps for less than 2 hours, we try for an earlier bedtime. Staying up later or going to bed earlier does not change his wake-up time. We have blackout shades plus blackout curtains in his room. He gets no illumination from sun at dawn, and after waking up he only gets artificial light because it’s still dark outside until about 7 am now. His pattern didn’t differ in the summer. I am following the standard advice such as putting him to bed while drowsy but still awake, but he still usually wakes before 5 am. Can any of the techniques on this website be useful for helping a toddler with early wakening?

It’s relatively difficult to answer such a question without knowing the patient, for example, the temperamental characteristics of the patient. It sounds as if he might be a morning type, more »