title: Advancing human circadian rhythms with afternoon melatonin and morning intermittent bright light.
abstract: BACKGROUND
  Both light and melatonin can be used to phase shift the human circadian clock, but the phase-advancing effect of the combination has not been extensively investigated.
  
  
  OBJECTIVE
  The objective of the study was to determine whether phase advances induced by morning intermittent bright light and a gradually advancing sleep schedule could be increased with afternoon melatonin.
  
  
  METHODS
  Healthy adults (25 males, 19 females, between the ages of 19 and 45 yr) participated in the study.
  
  
  METHODS
  There were 3 d of a gradually advancing sleep/dark period (wake time 1 h earlier each morning), bright light on awakening [four 30-min bright-light pulses (approximately 5000 lux) alternating with 30 min room light < 60 lux] and afternoon melatonin, either 0.5 or 3.0 mg melatonin timed to induce maximal phase advances, or matching placebo. The dim light melatonin onset was measured before and after the treatment to determine the phase advance.
  
  
  RESULTS
  There were significantly larger phase advances with 0.5 mg (2.5 h, n = 16) and 3.0 mg melatonin (2.6 h, n = 13), compared with placebo (1.7 h, n = 15), but there was no difference between the two melatonin doses. Subjects did not experience jet lag-type symptoms during the 3-d treatment
  
  
  CONCLUSIONS
  Afternoon melatonin, morning intermittent bright light, and a gradually advancing sleep schedule advanced circadian rhythms almost 1 h/d and thus produced very little circadian misalignment. This treatment could be used in any situation in which people need to phase advance their circadian clock, such as before eastward jet travel or for delayed sleep phase syndrome.
authors.affiliation: Biological Rhythms Research Lab, Rush University Medical Center, Chicago, Illinois 60612, USA.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Revell
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Burgess
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Gazda
authors.forename: Mark R
authors.initials: MR
authors.lastname: Smith
authors.forename: Louis F
authors.initials: LF
authors.lastname: Fogg
authors.forename: Charmane I
authors.initials: CI
authors.lastname: Eastman
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D002940:Circadian Rhythm / Q000187:drug effects* / Q000528:radiation effects*; D005260:Female; D006801:Humans; D020179:Jet Lag Syndrome / Q000523:psychology; D008027:Light; D008297:Male; D008550:Melatonin / Q000494:pharmacology*; D008875:Middle Aged; D010349:Patient Compliance; D012890:Sleep / Q000187:drug effects / Q000528:radiation effects; D011795:Surveys and Questionnaires
chemical_list: D000975:Antioxidants; D008550:Melatonin