Increased stress levels are a significant problem for many students and represent a risk factor for impaired mental and physical health as well as academic performance. Stress levels are particularly high during the preparation phase for major exams. There is good evidence that light therapy is an effective treatment option to improve mood in affective disorders. The present study aims at investigating the psychophysiological effects of a 3-week morning bright light exposure in reducing stress and stress-related problems in students preparing for major exams.
Increased students' stress represents a significant risk factor for impaired mental and physical health as well as academic performance. The World Mental Health Survey (WHO) reports a 12-month prevalence of mental illness of 20.3% among students, with anxiety disorders (14.7%), affective disorders (9.9%), and substance abuse (6.7%) being particularly prominent. Moreover, six out of 10 students suffer from impaired sleep quality. Offering an effective treatment for stress-related symptoms in students is a challenge. In situations of intense stress, conventional methods such as relaxation and mindfulness-based programs often fail because of poor prior practice. Only a few students apply cognitive behavioral interventions. Although medication might decrease stress symptoms within days, the side effects of drugs cannot be ignored. Therefore, there is a need for effective and efficient treatment of acute stress symptoms in students. Bright light therapy is an effective treatment for several mental disorders, e.g. affective disorders and sleep disorders. There is some evidence, that exposure to bright light may even reduce stress in patients with burnout symptoms. Thus, exposure to bright light may be a promising new option to reduce academic stress and improve mood and sleep parameters. In the present study, a large-area desk lamp, which emits diffuse light and is controllable in its luminance and correlated color temperature is used. Study participants are randomly assigned to one of three study arms: (i) exposure to polychromatic light of 5,000 lux and 5,300 Kelvin, (ii) exposure to polychromatic light of 50 lux and 2,200 Kelvin, or (iii) no light intervention. Data collection takes place in winter periods.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
125
Exposure with 5,000 lux at eye level for one hour and a Correlated Color Temperature of 5,300 Kelvin every morning for three weeks.
Exposure with 50 lux at eye level for one hour and a Correlated Color Temperature of 2,200 Kelvin every morning for three weeks.
University of Innsbruck
Innsbruck, Tyrol, Austria
subjective stress level - baseline/post
Perceived Stress Scale (PSS-10); scale: PSS-10 sum score; range:0 - 40; higher scores mean a higher subjective stress level
Time frame: Change from baseline PSS-10 sum score at the end of week 3
subjective stress level - baseline/post
Perceived Stress Questionnaire (PSQ-20); scale: PSQ-20 sum score; range: 20 - 80; higher scores mean a higher subjective stress level
Time frame: Change from baseline PSQ-20 sum score at the end of week 3
subjective stress level - on weekdays
Perceived Stress Questionnaire (PSQ-20); scale: PSQ-20 sum score; range: 20 - 80; higher scores mean a higher subjective stress level
Time frame: Change of daily PSQ-20 sum score at each weekday during the light intervention period up to 3 weeks
anxiety
State-Trait Anxiety Inventory (STAI - form Y) - 20 trait items; scale: STAI-trait sum score; range: 20 - 80; higher scores mean a higher subjective anxiety level
Time frame: Change from baseline STAI-trait sum score at the end of week 3
mood
Center for Epidemiologic Studies Depression Scale (CES--D); scale: CES-D sum score; range: 0 - 60; higher scores mean a higher subjective depression level
Time frame: Change from baseline CES-D sum score at the end of week 3
sleep quality
Pittsburgh Sleep Quality Index (PSQI); scale: global PSQI score; range: 0 - 21; higher scores mean a lower subjective sleep quality
Time frame: Change from baseline global PSQI score at the end of week 3
sleep quality - total sleep time
Wrist actimetry to measure daily total sleep time (TST); scale: sleep duration; range: \>0 (minutes); higher TST means longer sleep period
Time frame: Change of TST at each night during the light intervention period up to 3 weeks
sleep quality - sleep onset latency
Wrist actimetry to measure daily sleep onset latency (SOL); scale: duration to fall asleep; range: \>0 (minutes); higher SOL means longer period to fall asleep
Time frame: change of SOL at each night during the light intervention period up to 3 weeks
sleep quality - wake after sleep onset
Wrist actimetry to measure daily wake after sleep onset (WASO); scale: duration of being awake during sleep period; range: greater than or equal to 0 (minutes); higher WASO means longer wake periods after sleep onset
Time frame: change of WASO at each night during the light intervention period up to 3 weeks
sleep quality - sleep efficiency
Wrist actimetry to measure daily sleep efficiency (SE); scale: percentage; range: 0 - 100; higher SE means a higher undisturbed sleep
Time frame: change of SE at each night during the light intervention period up to 3 weeks
circadian rest/activity rhythm - interdaily stability
Circadian rest-activity cycle parameter interdaily stability (IS) derived from weekly wrist actimetry data; scale: real number; range: 0 -1; higher IS means a higher stability in daily rest-activity cycles
Time frame: change of IV at each of the three light intervention weeks up to 3 weeks
circadian rest/activity rhythm - intradaily variability
Circadian rest-activity cycle parameter intradaily variability (IV) derived from averaged wrist actimetry data over a period of 1 week; scale: real number; range: 0 - 2; higher IV means a higher variability in 24-h rest-activity cycle
Time frame: change of IS at each of the three light intervention weeks up to 3 weeks
physiological stress reaction
cortisol level measured from hair sample; scale: real number (pg/mg); range: \>0; higher hair cortisol level means higher physiological stress
Time frame: Change from baseline hair cortisol level at the end of week 3
adverse effects - short-term
astenopic complaints measured with 12 items; scale: sum score; range: 10 - 60; higher sum score means more astenopic complaints
Time frame: day 5
adverse effects - long-term
astenopic complaints scale measured with 12 items: sum score; range: 10 - 60; higher sum score means more astenopic complaints
Time frame: day 15
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