Does Daylength Affect Sleep and Mental Health Symptoms during Behavioral Interventions for Insomnia?

Hamill, Kellie, Porcheret, Kate ORCID: https://orcid.org/0000-0001-7832-9269, Facer-Childs, Elise R ORCID: https://orcid.org/0000-0003-4549-9266, Mellor, Alix and Drummond, Sean PA ORCID: https://orcid.org/0000-0002-9815-626X (2022) Does Daylength Affect Sleep and Mental Health Symptoms during Behavioral Interventions for Insomnia? Behavioral Sleep Medicine, 20 (5). pp. 556-569. ISSN 1540-2002

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Abstract

Background Approximately 11–33% of Australian adults experience Insomnia Disorder, which is associated with higher rates of psychiatric comorbidities, and lower quality of life. Non-pharmacological interventions are the front-line treatments for insomnia. Despite the known impact of light on the sleep/wake cycle via the circadian system, it is not yet known whether seasonal variations in environmental light levels (i.e., daylength) influence treatment outcome. We aimed to determine whether seasonal differences in daylength influenced baseline symptoms of Insomnia Disorder or treatment outcome. Participants One hundred treatment-seeking individuals with Insomnia Disorder (age: 49.3 ± 14.4y, range: 18–82 years; 58 F) enrolled in a Randomized Control Trial in Australia over a 29-month period. Methods Clients completed a seven-session behavioral intervention for insomnia over a maximum of 12 weeks. Individuals completed questionnaires assessing insomnia symptoms, diurnal preference, depression and anxiety symptoms, and daily sleep diaries. Objective rest/activity patterns were monitored using wrist actigraphy for the duration of the treatment period. Results Baseline daylength, sunset and sunrise times, and change in daylength over treatment, were not related to baseline insomnia severity or mental health symptoms. However, longer daylength at baseline predicted greater improvements in insomnia symptoms and anxiety, but not depression, symptoms. These improvements were also associated with later sunset and/or earlier sunrise at baseline. Conclusions Our results show, greater treatment-related improvements in subjective sleep and mental health symptoms during spring and summer months. This suggests that daylength could have a role to play in the outcomes of a behavioral insomnia treatment. Future research is needed to provide recommendations.