Dark Therapy

Increases melatonin release through melanopsin receptors in eye. Sleeping in dark room reduces weight and increases learning/neuroprotection.

Dosing

Active mania: Stay in pitch dark room or wear blue-light blocking glasses all night from 5pm to 8am. As mania improves, can slowly put on glasses later, such as moving start time up by 30 minutes every 3 days until they are wearing them 1-2 hours before bed for prevention.

Insomnia: Wear blue-light blockers 1-2 hours before bed and sleep in pitch dark room.

For shift work, deliver light when patient wakes up (artificial morning). Use dark therapy before they go to bed.

One time cost ($15-50).

Management

Treats mania with a large effect size. Emphasize to patient that the therapy changes brain chemistry, including melatonin signalling.

Warn patient not to wear glasses before 5 pm, even though they are relaxing to wear.

Warn patient that the therapy is unlikely to help them fall asleep. Instead, it deepens sleep quality and makes sleep cycle more regularly so that they feel better and think clearer the next day.

Emphasize the therapy can cause weight loss.

TOLERABILITY: No problems.

RISKS: Do not wear glasses while driving.

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