Light Treatment for PTSD: A Systematic Review

Authors

  • Mohammad Hossein Ghaedamini Asadabadi
  • Amir-Hossein Ghaedamini Asadabadi
  • Fatemeh Aliakbari
  • Mobina Saleh

DOI:

https://doi.org/10.69980/ajpr.v28i5.577

Keywords:

light treatment; post-traumatic stress disorder (PTSD); trauma; systematic review.

Abstract

Background and objectives: Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by a terror-striking event, causing flashbacks, intrusive thoughts or images, nightmares, sleep disturbances, depressive symptoms, and anxiety. Light treatment has been identified as a possible alternative or adjuvant treatment for PTSD. The present study aims to systematically review the available evidence evaluating the effects of light treatment intervention on PTSD symptoms.  Methods: A systematic search was conducted in PubMed, Scopus, Cochrane Library, Web of Science, PsycINFO and ClinicalTrials.gov registry up to February 2024. Controlled trials involving light treatment for PTSD were sought for the review of clinical effectiveness.  Results: From 1,805 published and unpublished studies, five studies (n = 280) were included in this systematic review. Two studies used blue light treatment vs. placebo amber light treatment, one study used white bright light treatment compared to inactivated negative ion generator, a pilot trial delivered bright light treatment compared to a sham treatment, and another pilot trial delivered green bright light treatment compared to dimmed light treatment as an intervention for PTSD. Present data indicates favorable effects of blue light and bright light interventions for improving PTSD symptoms.  Conclusions: It is becoming increasingly evident that light treatments are effective in treating PTSD. Nevertheless, more studies with greater statistical power are required to provide a solid foundation for recommending light treatment for management of PTSD.

Author Biographies

Mohammad Hossein Ghaedamini Asadabadi

Student research committee, Shahrekord University of Medical Sciences, Shahrekord, Iran

Amir-Hossein Ghaedamini Asadabadi

Student research committee, Shahrekord University of Medical Sciences, Shahrekord, Iran

Fatemeh Aliakbari

Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran

Mobina Saleh

Student research committee, Shahrekord University of Medical Sciences, Shahrekord, Iran

References

1. Agorastos, A., and Miranda O. “Sleep, circadian system and traumatic stress.” European journal of psychotraumatology vol. 12,1 1956746. 28 Sep. 2021, doi:10.1080/20008198.2021.1956746

2. Ashbaugh A.R., Houle-Johnson S., Herbert C., El-Hage W., Brunet A. Psychometric validation of the english and french versions of the posttraumatic stress disorder checklist for DSM-5 (PCL-5) PLoS One. 2016;11:e0161645. doi: 10.1371/journal.pone.0161645.

3. Auxéméry Y. L'état de stress post-traumatique comme conséquence de l'interaction entre une susceptibilité génétique individuelle, un évènement traumatogène et un contexte social [Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context]. Encephale. 2012;38(5):373-380. doi:10.1016/j.encep.2011.12.003

4. Bajaj S., Raikes A.C., Razi A., Miller M.A., Killgore W.D.. Blue-Light Therapy Strengthens Resting-State Effective Connectivity within Default-Mode Network after Mild TBI. J Cent Nerv Syst Dis. 2021;13:11795735211015076. Published 2021 May 19. doi:10.1177/11795735211015076

5. Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep medicine, 2(4), 297–307. https://doi.org/10.1016/s1389-9457(00)00065-4

6. Bell C.C. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. JAMA. 1994;272(10):828–829. doi:10.1001/jama.1994.03520100096046

7. Blake D.D., Weathers F.W., Nagy L.M., et al. The development of a Clinician-Administered PTSD Scale. J Trauma Stress. 1995;8(1):75-90. doi:10.1007/BF02105408

8. Boeschoten M..A., Van der A. N., Bakker A., et al. Development and Evaluation of the Dutch Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Eur J Psychotraumatol. 2018;9(1):1546085. Published 2018 Nov 22. doi:10.1080/20008198.2018.1546085

9. Boucsein W., Fowles D.C., Grimnes S., et al. Publication recommendations for electrodermal measurements. Psychophysiology. 2012;49(8):1017-1034. doi:10.1111/j.1469-8986.2012.01384.x

10. Brownlow J.A., Miller K.E., Gehrman P.R. Treatment of Sleep Comorbidities in Posttraumatic Stress Disorder. Curr Treat Options Psychiatry. 2020;7(3):301-316. doi:10.1007/s40501-020-00222-y

11. Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4

12. Campbell P.D., Miller A.M., Woesner M.E.. Bright light therapy: Seasonal affective disorder and beyond. Einstein J Biol Med. 2017;32:E13-E25.

13. Can İ.Ö., Demiroğlu Uyaniker Z., Ulaş H, Karabağ G, Cimilli C, Salaçin S. Mental Findings in Trauma Victims. Noro Psikiyatr Ars. 2013;50(3):230-236. doi:10.4274/npa.y6242

14. Chasens, E. R., Ratcliffe, S. J., & Weaver, T. E. (2009). Development of the FOSQ-10: A short version of the Functional Outcomes of Sleep Questionnaire. Sleep, 32(7), 915–919. https://doi.org/10.1093/sleep/32.7.915

15. Davis, G.C., and Breslau N. “Post-traumatic stress disorder in victims of civilian trauma and criminal violence.” The Psychiatric clinics of North America vol. 17,2 (1994): 289-99.

16. First, M. , Williams, J. , Karg, R. , & Spitzer, R. (2017). Structured clinical interview for DSM‐5 (SCID‐5 for DSM‐5) Arlington. American Psychiatric Association.

17. Fitzgerald J.M., DiGangi J.A., Phan K.L. Functional neuroanatomy of emotion and its regulation in PTSD. Harv Rev Psychiatry. 2018;26(3):116-128. doi:10.1097/HRP.0000000000000185

18. Glickman G., Byrne B., Pineda C., Hauck W.W., Brainard G.C.. Light therapy for seasonal affective disorder with blue narrow-band light-emitting diodes (LEDs). Biol Psychiatry. 2006;59(6):502-507. doi:10.1016/j.biopsych.2005.07.006

19. Higgins J. P. T., Altman D. G., G.Ã.¸tzsche P. C., J.Ã.¼ni P., Moher D., Oxman A. .D et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials BMJ 2011; 343 :d5928 doi:10.1136/bmj.d5928

20. Inoue C., Shawler E.., Jordan C.H., Moore M.J., Jackson C.A.. Veteran and military mental health issues. in: StatPearls. Treasure Island (FL): StatPearls Publishing; August 17, 2023.

21. Javidi, H., and M. Yadollahie. Post-traumatic Stress Disorder. The International Journal Of Occupational And Environmental Medicine vol. 3,1 (2012): 2-9.

22. Johns M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540–545. https://doi.org/10.1093/sleep/14.6.540

23. Julian L. J. (2011). Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care & Research, 63 Suppl 11(0 11), S467–S472. https://doi.org/10.1002/acr.20561

24. Kawamura, A., Yoshiike, T., Yoshimura, A. et al. Bright light exposure augments cognitive behavioral therapy for panic and posttraumatic stress disorders: A pilot randomized control trial. Sleep Biol. Rhythms 18, 101–107 (2020). https://doi.org/10.1007/s41105-019-00248-7

25. Killgore W.D.S., Vanuk J.R., Shane B.R., Weber M., Bajaj S. A randomized, double-blind, placebo-controlled trial of blue wavelength light exposure on sleep and recovery of brain structure, function, and cognition following mild traumatic brain injury. Neurobiol Dis. 2020;134:104679. doi:10.1016/j.nbd.2019.104679

26. Killgore W.D.S., Vanuk J.R., Dailey N.S.. Treatment with morning blue light increases left amygdala volume and sleep duration among individuals with posttraumatic stress disorder. Front Behav Neurosci. 2022;16:910239. Published 2022 Sep 12. doi:10.3389/fnbeh.2022.910239

27. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

28. Lee, R., Krakow, B., & Suh, S. (2021). Psychometric properties of the Disturbing Dream and Nightmare Severity Index-Korean version. Journal of Clinical Sleep Medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17(3), 471–477. https://doi.org/10.5664/jcsm.8974

29. Lin F., Su Y., Weng Y., et al. The effects of bright light therapy on depression and sleep disturbances in patients with Parkinson's disease: A systematic review and meta-analysis of randomized controlled trials. Sleep Med. 2021;83:280-289. doi:10.1016/j.sleep.2021.03.035

30. Mann SK, Marwaha R. Posttraumatic Stress Disorder. in: StatPearls. Treasure Island (FL): StatPearls Publishing; January 30, 2023.

31. McGowan J., Sampson M., Salzwedel D.M., Cogo E., Foerster V., Lefebvre C. PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. J Clin Epidemiol. 2016;75:40-46. doi:10.1016/j.jclinepi.2016.01.021

32. Milad M.R., Wright C.I., Orr S.P., Pitman R.K., Quirk G.J., Rauch S.L. Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert. Biol Psychiatry. 2007;62(5):446-454. doi:10.1016/j.biopsych.2006.10.011

33. Miller K.E., Brownlow J.A., Woodward S., Gehrman P.R.. Sleep and dreaming in Posttraumatic Stress Disorder. Curr Psychiatry Rep. 2017;19(10):71. Published 2017 Aug 22. doi:10.1007/s11920-017-0827-1

34. Morey R.A., Gold A.L., LaBar K.S., et al. Amygdala volume changes in Posttraumatic Stress Disorder in a large case-controlled veterans group. Arch Gen Psychiatry. 2012;69(11):1169–1178. doi:10.1001/archgenpsychiatry.2012.50

35. Mohammad Hossein Ghaedamini Asadabadi, Amir Hossein Ghaedamini Asadabadi, Fatemeh Aliakbari, Mobina Saleh. The efficacy of light treatments for post-traumatic stress disorder: a systematic review of randomized controlled trials. PROSPERO 2023 CRD42023439454 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439454

36. Nagashima S., Osawa M., Matsuyama H., Ohoka W., Ahn A., Wakamura T. Bright-light exposure during daytime sleeping affects nocturnal melatonin secretion after simulated night work. Chronobiol Int. 2018;35(2):229-239. doi:10.1080/07420528.2017.1394321

37. Ntini, I., Vadlin, S., Olofsdotter, S., Ramklint, M., Nilsson, K. W., Engström, I., & Sonnby, K. (2020). The Montgomery and Åsberg Depression Rating Scale - self-assessment for use in adolescents: an evaluation of psychometric and diagnostic accuracy. Nordic Journal Of Psychiatry, 74(6), 415–422. https://doi.org/10.1080/08039488.2020.1733077

38. Ousdal O.T., Milde A.M., Hafstad G.S., et al. The association of PTSD symptom severity with amygdala nuclei volumes in traumatized youths. Transl Psychiatry. 2020;10(1):288. Published 2020 Aug 17. doi:10.1038/s41398-020-00974-4

39. Padhi, A., Fineberg, N. (2010). Clinical Global Impression Scales. Stolerman, I.P. (eds) Encyclopedia of Psychopharmacology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68706-1_1422

40. Page M.J., McKenzie J.E., Bossuyt P.M., et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Published 2021 Mar 29. doi:10.1136/bmj.n71

41. Pail G., Huf W., Pjrek E., et al. Bright-light therapy in the treatment of mood disorders. Neuropsychobiology. 2011;64(3):152-162. doi:10.1159/000328950

42. Pjrek E., Friedrich M..E, Cambioli L., et al. The efficacy of light therapy in the treatment of seasonal affective disorder: A meta-analysis of randomized controlled trials. Psychother Psychosom. 2020;89(1):17-24. doi:10.1159/000502891

43. Prajjwal P., Inban P., Natarajan B., et al. Current treatments of post-traumatic stress disorder and Amygdala Ablation as a potential cutting-edge therapy in its refractory cases. Cureus. 2022;14(11):e31943. Published 2022 Nov 27. doi:10.7759/cureus.31943

44. Qi W., Gevonden M., Shalev A. Prevention of post-traumatic stress disorder after trauma: Current evidence and future directions. Curr Psychiatry Rep. 2016;18(2):20. doi:10.1007/s11920-015-0655-0

45. Raikes A.C., Dailey N.S., Shane B.R., Forbeck B., Alkozei A., Killgore W.D.S. Daily morning blue light therapy improves daytime sleepiness, sleep quality, and quality of life following a mild traumatic brain injury. J Head Trauma Rehabil. 2020;35(5):E405-E421. doi:10.1097/HTR.0000000000000579

46. Regier D.A., Kuhl E.A., Kupfer D.J. The DSM-5: Classification and criteria changes. World Psychiatry. 2013;12(2):92-98. doi:10.1002/wps.20050

47. Richter, P., Werner, J., Heerlein, A., Kraus, A., & Sauer, H. (1998). On the validity of the Beck Depression Inventory. A review. Psychopathology, 31(3), 160–168. https://doi.org/10.1159/000066239

48. Seber A. Shed some (sun)light on vitamin D deficiency. Rev Bras Hematol Hemoter. 2014;36(3):167-168. doi:10.1016/j.bjhh.2014.03.017

49. van der Rhee H.J., de Vries E., Coebergh J.W. Regular sun exposure benefits health. Med Hypotheses. 2016;97:34-37. doi:10.1016/j.mehy.2016.10.011

50. Wang Y., Marling S.J., Beaver E.F., Severson K.S.., Deluca HF. UV light selectively inhibits spinal cord inflammation and demyelination in experimental autoimmune encephalomyelitis. Arch Biochem Biophys. 2015;567:75-82. doi:10.1016/j.abb.2014.12.017

51. Whalley M.G., Kroes M.C., Huntley Z., Rugg M.D., Davis S.W., Brewin C.R. An fMRI investigation of posttraumatic flashbacks. Brain Cogn. 2013;81(1):151-159. doi:10.1016/j.bandc.2012.10.002

52. Wilkins K.C., Lang A.J., Norman S.B.. Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions. Depress Anxiety. 2011;28(7):596-606. doi:10.1002/da.20837

53. Vanuk J.R., Pace-Schott E.F., Bullock A., Esbit S., Dailey N.S., Killgore W.D.S. Morning blue light treatment improves sleep complaints, symptom severity, and retention of fear extinction memory in post-traumatic stress disorder. Front Behav Neurosci. 2022;16:886816. Published 2022 Sep 12. doi:10.3389/fnbeh.2022.886816

54. Youngstedt S.D., Kline C.E., Reynolds A.M., et al. Bright light treatment of combat-related PTSD: A randomized controlled trial. Mil Med. 2022;187(3-4):e435-e444. doi:10.1093/milmed/usab014

55. Zalta A.K., Bravo K., Valdespino-Hayden Z., Pollack M.H., Burgess H.J. A placebo-controlled pilot study of a wearable morning bright light treatment for probable PTSD. Depress Anxiety. 2019;36(7):617-624. doi:10.1002/da.22897

56. Zhang Y., Xie B., Chen H., Li M., Guo X., Chen H. Disrupted resting-state insular subregions functional connectivity in post-traumatic stress disorder. Medicine (Baltimore). 2016;95(27):e4083. doi:10.1097/MD.0000000000004083

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Published

2025-08-30