LIGHT THERAPY AS TREATMENT OF DYSCHRONOSIS IN BRAIN IMPAIRED CHILDREN

Fourteen children aged 9 months-4 years with moderate to severe mental retardation and varying neurologic lesions were referred for severe a nd continuous nocturnal sleep disturbances and very abnormal day/night schedules. All children had previously been given hypnotic medication s and behavioral treatments which had little or no effect on nocturnal sleep. The severity of the sleep disturbances significantly affected family life and was a major handicap to the children. All children wer e treated with light therapy (minimum 4000 lux). Five children respond ed to treatment and had normal sleep-wake cycles at the most recent po st-treatment evaluation (2-5 years after the first treatment). Two of the patients' families were unable to follow the prescribed regimen. T reatment failed in 7 children. One of these seven children spontaneous ly improved 3 years later. In three of the failure children the neurol ogic problem progressively worsened, leading to death in one of them. Phototherapy is a treatment worth pursuing in children with very signi ficant sleep/wake disruption which is unresponsive to behavioral or ot her treatments. It has few side-effects and may lead to normalization of the sleep-wake cycle. Recent improvement in the technology used to monitor the 24-h temperature rhythm over several days and the present commercial availability of ''light boxes'' should render these therape utic trials easier than at the time of these initial investigations.