Morning Light Intervention for Fibromyalgia May Improve Mood and Pain Outcomes

A session of bright or dim light treatment in the morning was found to be associated with clinically meaningful improvements in pain and mood among patients with fibromyalgia, according to results of a study published in Pain Medicine.

Study authors report that “[m]eta-analyses have indicated that morning bright light treatment can reduce depressive symptoms, and improve sleep.” 

Therefore, to further investigate these findings, they conducted a randomized controlled trial (ClinicalTrials.gov Identifier: NCT03794908) in which they recruited 57 individuals with fibromyalgia and provided them with an activity monitor. Study participants were instructed to log sleep and medication use and were randomly assigned to undergo receive bright (n=29) or dim (n=28) morning light interventions for 4 weeks. The light interventions were self-administered for 1 hour in the morning using the wearable Re-timer® device at a set time, depending on activity logs. The outcomes of this study were change in Fibromyalgia Impact Questionnaire-Revised (FIQR), Patient-Reported Outcomes Measurement Information System (PROMIS), and Patient Health Questionnaire-9 (PHQ-9) scores and actigraphy-derived sleep measures. Response to treatment was defined as a 16.8-point or greater decrease in FIQR score from baseline.

The mean ages of recipients of the bright and dim light interventions were 41.3 (standard deviation [SD], 13.7) and 42.4 (SD, 13.1) years, most were women (97% and 96%) and White (90% and 78%), and mean body mass index (BMI) values were 32.4 (SD, 8.1) and 30.9 (SD, 7.9) kg/m², respectively. Antidepressant use was reported by 55% and 43%, gabapentinoid use by 17% and 25%, and cannabinoid use by 14% and 11%, respectively.

At baseline, FIQR scores indicated that 25.0% of patients were in remission for fibromyalgia; 28.6% had mild, 33.9% moderate, and 12.5% severe fibromyalgia symptoms.

Treatment adherence was high for both groups and ranged from 92.6% to 94.7%.

Study authors reported that the light interventions were associated with improvements in FIQR (mean difference [MD], -11.2), PHQ-9 (MD, -4.3), Morningness-Eveningness Questionnaire (MD, -4.3), PROMIS-pain interference (MD, -3.8), PROMIS-pain intensity (MD, -2.7), PROMIS-physical function (MD, 2.9), and sleep disturbance (MD, 2.0) outcomes from baseline among all study participants.

Treatment response was observed among 29.8% of participants, and this outcome did not differ on the basis of intervention (χ², 0.04; P =.84).

No significant group-by-time interactions were observed for FIQR (χ², 1.87; P =.39) or any PROMIS (all P >.25) outcomes.

In general, sleep onset and wake-up time changed throughout the study (both P ≤.02). In a post hoc analysis, these changes were not related with changes in outcome scores (all P >.28).

Two recipients of the dim light intervention described experiencing a side effect as “bothered quite a bit” or “bothered extremely.” The average reported satisfaction scores were 6.2 for bright light and 7.0 for dim light (P =.27).

The results of this study may have been limited by recruiting patients with differing severity of fibromyalgia symptoms, including those in remission.

These data indicate that a morning light intervention may be a safe and inexpensive approach for clinically improving pain, mood, function, and self-reported sleep quality among patients with fibromyalgia.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.