Commercially available lightboxes for SAD

[aim-agm]

For patients that have seasonal affective disorder and bad/no insurance, are there any quality, affordable 10k lumen light boxes that are commercially available that you would recommend?

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[Monocles]

10,000 lux lamps are like $20-30 on amazon. They're all the same.

 

[medhead1990]

I dont see the one i have but ive used the same $30-40 lamp from amazon for the last 6 or 7 years (wow amazing how long its been- got it first year or med school) and it continues to work great, I use it in the AM for mood, and to help wake me up. Its also been great for switching back and forth from nights and such.

Amazon.com : sad lamp

www.amazon.com

 

[Merovinge]

10,000 lux lamps are like $20-30 on amazon. They're all the same.

Is this actually true? I've done a fair amount of reading recently and it seems like there are a number of concerns with these cheap boxes. 1) listed lux not true lux 2) listed lux falls off considerably at recommend distance of 18-24" from face 3) some concerns that LED light is not as effective as florescent bulbs that initial SAD light box research was done on. Any SAD/light box guru's on the board have thoughts on these lights?

 

[romanticscience]

DayLight Classic (folding stand)

DayLight Classic Plus (solid stand)

These two were used in clinical trials. Both have the same light just one has a stand. I use the first one.

 

[tr]

(Disclaimer: not a guru)
Sunbox brand was also used in clinical trials, and I used to recommend this brand back when it was not as straightforward to obtain these.

Light Therapy Lamp - Seasonal Affective Disorder Lights

Resolve Seasonal Affective Disorder (SAD) with bright light therapy lamps.Our lamps help with sleep disorders, winter blues, & light deprivation depression.

www.sunbox.com

But it seems like plenty of my patients have had good results with Amazon light boxes. Just make sure to warn them that it has to be 10K lux and they should check the directions and make sure they maintain the recommended distance from the lamp to get 10K lux for the entire exposure time.

 

[clausewitz2]

Just make sure to warn them that it has to be 10K lux and they should check the directions and make sure they maintain the recommended distance from the lamp to get 10K lux for the entire exposure time.

Staying "pretty darn close" for "a long time" is usually the limiting factor for most of my patients. They become much less enthusiastic about lightboxes when told that no, setting it up on the other end of your desk as you putter around in your office or having it perched on your vanity while you get dressed in the morning is probably not going to help you feel better.

 

[usoggyojimbo]

If you're familiar with Slate Star Codex, this is the same author. This is a post on his psychiatry practice website. Light Therapy – Lorien Psychiatry

It seems most lamps you'll find are basically the same, as long as you are getting the right amount of lux. However, lux is a function of distance from the light, so some lights that advertise a high lux may not be clear with how close you need to be to get that lux. Some may have the correct amount of lux, but at a impractical distance.

 

[FlowRate]

When I last reviewed the literature, it seemed like dawn simulation had similar amount of evidence and is a heck of a lot easier to adhere to vs proper bright light therapy. It is hard to find devices that fully replicate the dawn simulation study protocols (IIRC it was gradual increase over an entire hour before desired wake time.) Most of the phillips branded and chinese knock-off light-up clocks on Amazon do about 30 minutes. FWIW I personally find it helpful during months where I'm getting up before dawn.

 

[clozareal]

The review article below rates a few light boxes (aka phototherapy devices). Some devices advertised as “10,000-lux” devices produced this intensity only at unreasonably close distances, over a restricted field, or with unacceptable glare or unevenness of illumination. They seem to be much bigger than what people are typically buying on Amazon.

Psychiatry Online

prcp.psychiatryonline.org

These are the light boxes that exceeded their criteria:
SunRay II (The SunBox Company): SunRay II Bright Light Therapy Lamp on Sale!

NorthStar 10,000 (Alaska Northern Lights): http://www.alaskanorthernlights.com

Day-Light Classic (Model DL930; Carex Health Brands): www.day-lights.com

 

[FlowRate]

I'm curious, the sunlight day-lights company remarks on proportionally increasing duration of use with distance from the light (lower lux values). Did anyone catch any existing research on use of lower-intensity lights for longer periods of time? Or are they just extrapolating without evidence?

 

[DynamicDidactic]

I'm curious, the sunlight day-lights company remarks on proportionally increasing duration of use with distance from the light (lower lux values). Did anyone catch any existing research on use of lower-intensity lights for longer periods of time? Or are they just extrapolating without evidence?

A lot of the earlier research was basically guessing on how much and for how long. Seemingly, there was similar evidence for efficacy for lower lux for longer periods. However, there does not seem to be much advantage to doing that and 10,000 lux for 30 minutes is considered the standard dosage.

When I last reviewed the literature, it seemed like dawn simulation had similar amount of evidence

I don't think there is as ample evidence for dawn stimulation. Literally, just less studies on it. There have been numerous reviews of light therapy across numerous conditions (primarily depression-related stuff). There are still people that study and publish on light therapy. Dawn stimulation seems to have had much fewer studies for less problems. I often worry this is due to the file drawer effect. Negative ion therapy seems to have a similar fate. Some promising studies and then it all just went away.

It seems most lamps you'll find are basically the same, as long as you are getting the right amount of lux. However, lux is a function of distance from the light, so some lights that advertise a high lux may not be clear with how close you need to be to get that lux. Some may have the correct amount of lux, but at a impractical distance.

People can actually buy a lux meter as well. Though, I don't know how well calibrated they are out of the box.

I typically recommend using a trusted source (as already posted, I recommend the DayLight boxes) and marking at a breakfast table the recommend distance. Then I tell folks to sit in a way that reliably allows them to get the correct distance (e.g., body right up to table and a spot marked with tap on the table for the lamp).

 

[DynamicDidactic]

10,000 lux lamps are like $20-30 on amazon. They're all the same.

I find these cheaper boxes to not be as trustworthy or easy to set up to get the most effective exposure. I do not have evidence but, as other mentioned, some of these require like 6-8 inches to get 10,000 lux, which is a bit too close. Also, some are so small I have a hard time believing they can actually generate the advertised lux. Finally, people forget that these bulbs dim over time and need to be replaced periodically. I worry that the cheaper ones are just that, cheaper and will dim more quickly.

Generally, I always recommend something that has a stand, can provide exposure from above the eyes to replicate sun exposure, and is from a more reputable company.

I also recommend the white light boxes rather than dimmer blue light boxes (which are cheaper, smaller, and do not require 10,000 lux). Exposure from a blue light for that long is just wacky on the eyes.