Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting.\

Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history.

Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition.

Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.