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Effects of Morning Bright Light Therapy on Sleep, Alertness, Mood, and Cognition in Healthy University Students: A Randomized Crossover Trial

Yu, C.; Zhang, C.; Tsang, H.; Li, L.; Santhi, N.

2026-07-06 psychiatry and clinical psychology
10.64898/2026.07.04.26357282 medRxiv
Show abstract

Objectives. To test whether one week of self-administered morning bright light therapy (BLT) improves sleep, daytime sleepiness and alertness, mood, and objective cognition in healthy university students. Methods. Thirty-three healthy students completed a two-week randomized within-subject crossover trial comparing one week of morning BLT (30 min of 10,000 lx; melanopic equivalent daylight illuminance of approximately 8,989 lx) with one week of usual-light control in counterbalanced order, with no washout. Sleep was assessed with wrist-worn Fitbit sleep tracking and daily diaries; daytime sleepiness (Karolinska and Stanford Sleepiness Scales), positive and negative affect (PANAS), mood (POMS), and a cognitive battery (Stroop, Flanker, Corsi, verbal span) were also assessed, alongside post-trial semi-structured interviews. Outcomes were analyzed with linear mixed-effects models, with Holm correction across five primary outcomes. Results. BLT reduced daytime sleepiness in a time-of-day-specific manner (condition x time-of-day interaction; largest reduction at 12:00, dz = -0.58, with a smaller but still significant reduction at 15:00), reduced night-to-night variability in sleep duration (dz = -0.52), increased Fitbit sleep efficiency (dz = 0.81), and increased PANAS positive affect (dz = 0.41). Objective cognition was unchanged across all measures. Interviews indicated that participants experienced BLT primarily as a sleep and alertness intervention, with minor tolerability issues. Conclusions. Brief morning BLT improved alertness, sleep regularity and efficiency, and positive affect, but not objective cognition, in healthy students, supporting morning light as a low-burden strategy for daytime functioning while cautioning against overstating cognitive benefits.

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