C. Guilleminault et al., LIGHT THERAPY AS TREATMENT OF DYSCHRONOSIS IN BRAIN IMPAIRED CHILDREN, European journal of pediatrics, 152(9), 1993, pp. 754-759
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.