Assessment and modification of a human subject's circadian cycle

• US 5,304,212 A
• Filed: 01/10/1992
• Issued: 04/19/1994
• Est. Priority Date: 06/26/1987
• Status: Expired due to Term

• Current Assignee: Brigham and Women's Hospital Incorporated
• Original Assignee: Brigham and Women's Hospital Incorporated
• Inventors: Allan, James S., Czeisler, Charles A., Kronauer, Richard E.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US07/819,403
• Time in Patent Office: 830 Days
• Field of Search: 607/88
• US Class Current: 607/88
• CPC Class Codes: A61M 2021/0044 by the sight sense
• CPC Class Codes: A61M 21/00 Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
• CPC Class Codes: A61N 2005/0648 the light being directed to the eyes
• CPC Class Codes: A61N 5/0618 Psychological treatment
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A method for modifying the human endogenous circadian pacemaker is disclosed. The method comprises the steps of determining the characteristics of a desired endogenous circadian cycle for a subject; selecting an appropriate time with respect to the presumed phase of physiological markers of the present endogenous circadian cycle for the subject during which to apply a light stimulus to effect a desired modification of the present endogenous circadian cycle of the subject; and applying said light stimulus at said selected appropriate time to achieve the desired endogenous circadian cycle for the subject. The method finds special utility in treating "jet lag" sufferers, shift workers, advanced circadian phase experienced by many elderly subjects, and those afflicted with delayed sleep phase insomnia.

Claims

1. A method of modifying a human subject'"'"'s endogenous circadian cycle to a desired state, comprising the steps of:

determining the characteristics of a desired endogenous circadian cycle for said subject;

selecting an appropriate time with respect to the presumed phase of physiological markers of the present endogenous circadian cycle for said subject during which to apply a light stimulus to effect a desired modification of said present endogenous circadian cycle of said subject; and

applying said light stimulus at said selected appropriate time to achieve said desired endogenous circadian cycle for said subject.

2. The method of claim 1 wherein said light stimulus is enhanced illumination.

3. The method of claim 1 wherein said light stimulus includes diminished illumination.

4. The method of claim 1 wherein said light stimulus includes ambient light.

5. The method of claim 1 wherein said stimulus includes a combination of enhanced illumination and diminished illumination.

6. The method of claim 1 further comprising the step of:

assessing the characteristics of the present endogenous circadian cycle of said subject, and wherein said appropriate time is selected based on said desired characteristics.

7. The method of claim 1 wherein said light stimulus includes light of an intensity greater than 2000 lux.

8. The method of claim 7 wherein said light intensity is inferred at a position approximately at the pupil of said subject.

9. The method of claim 1 wherein said light stimulus includes light of an intensity between zero and 100,000 lux.

10. The method of claim 9 wherein said intensity is inferred at a position approximately at the pupil of said subject.

11. A method of facilitating the physiological adaptation of a human subject to a reoccurring activity/rest-leisure schedule requiring said subject to be active during a portion of conventional sleep hours, comprising the steps of:

selecting a substantial episode of time during the activity portion of said subject'"'"'s activity/rest schedule to apply a light stimulus; and

applying, at said selected time episode, said light stimulus consisting of an episode of enhanced illumination;

whereby the physiological adaptation of said subject to a reoccurring activity/rest schedule requiring said subject to be active during a portion of said conventional sleep hours if facilitated.

12. The method of claim 11 wherein the selection of said time is based on a determination of the characteristics of a desired sleep time for said subject.

13. The method of claim 11 wherein the selection of said time is based on a determination of the characteristics of a desired wake time for said subject.

14. The method of claim 11 wherein said selected time occurs between the hours of 11:

30 p.m. and 7;

30 a.m.

15. The method of claim 11 wherein said selected time occurs during the entire activity portion of said subject'"'"'s schedule.

16. The method of claim 11 further comprising the step of:

exposing said subject to an ambient level of illumination during a second selected time of the activity portion of said subject'"'"'s schedule.

17. The method of claim 11 further comprising the step of:

providing said subject with appropriate equipment to enable said subject to diminish the level of illumination to which they are exposed during the rest-leisure portion of said subject'"'"'s schedule.

18. The method of claim 11 wherein said enhanced illumination is light having an intensity greater than 2000 lux.

19. The method of claim 18 wherein said intensity is inferred at a position approximately at the pupil of the subject.

20. A method of facilitating the physiological adaptation of a human subject to an activity/rest schedule requiring said subject to be active during a portion of the conventional sleep hours by modifying said subject'"'"'s present endogenous circadian cycle to a desired state, comprising the steps of:

determining the characteristics of a desired endogenous circadian cycle for said subject;

selecting an appropriate time episode with respect to the presumed phase of physiological markers of the present endogenous circadian cycle for said subject during which to apply a light stimulus to effect a desired modification of said present endogenous circadian cycle; and

exposing said subject to said light stimulus at said selected time episode;

whereby the endogenous circadian cycle of said subject is modified to a desired state, thereby facilitating the physiological adaptation of said subject to an activity/rest schedule requiring said subject to be active during a portion of said conventional sleep hours.

21. The method of claim 20 wherein said selected time occurs between the hours of 11:

30 p.m. and 7;

30 a.m.

22. The method of claim 20 wherein said selected time occurs during the entire activity portion of said subject'"'"'s schedule.

23. The method of claim 20 further comprising the step of:

exposing said subject to a diminished level of illumination during a second selected time of the rest portion of said subject'"'"'s schedule.

24. The method of claim 20 wherein said light stimulus includes light of an intensity greater then 2000 lux.

25. The method of claim 24 wherein said intensity is inferred at a position approximately at the pupil of said subject.

26. The method of claim 20 wherein said light stimulus includes light of an intensity between zero and 100,000 lux.

27. The method of claim 26 wherein said intensity is inferred at a position approximately at the pupil of said subject.

28. A method of improving the physiological adaptation of the endogenous circadian pacemaker of a human subject to a desired wake time by resetting the phase of said endogenous circadian pacemaker, said method comprising the steps of:

estimating the phase of the endogenous circadian cycle of said subject based on characteristics of said subject'"'"'s habitual sleep/wake cycle;

selecting an appropriate time during said estimated phase of said circadian cycle of said subject based on the presumed phase of physiological markers of the circadian cycle of said subject during which to expose said subject to a stimulus including an enhanced level of illumination; and

exposing said subject to said stimulus at said selected time to thereby reset the phase of said endogenous circadian pacemaker of said subject.

29. The method of claim 28 wherein said subject is exposed to said stimulus at a time preceding said subject'"'"'s desired bedtime to thereby delay the endogenous circadian pacemaker of said subject.

30. The method of claim 28 wherein said subject is exposed to said stimulus at a time following said subject'"'"'s desired wake time to thereby advance the endogenous circadian pacemaker of said subject.

31. The method of claim 30 wherein said subject is awake during exposure to said stimulus.

32. The method of claim 28 wherein said stimulus includes light of an intensity greater than 2000 lux.

33. The method of claim 32 wherein said intensity is inferred at a position approximately at the pupil of said subject.

34. A method of improving the physiological adaptation of the endogenous circadian pacemaker of a human subject to a desired wake time by resetting the phase of said endogenous circadian pacemaker, said method comprising the steps of:

determining the characteristics of a desired endogenous circadian cycle for said subject;

selecting an appropriate time with respect to the presumed phase of physiological markers of the present endogenous circadian cycle for said subject during which to expose said subject to a stimulus including an enhanced level of illumination; and

exposing said subject to said stimulus at said selected time to thereby reset the phase of said endogenous circadian pacemaker of said subject.

35. The method of claim 34 wherein said subject is exposed to said stimulus at a time preceding said subject'"'"'s desired bedtime to thereby delay the endogenous circadian pacemaker of said subject.

36. The method of claim 34 wherein said subject is exposed to said stimulus at a time following said subject'"'"'s desired wake time to thereby advance the endogenous circadian pacemaker of said subject.

37. The method of claim 36 wherein said subject is awake during exposure to said stimulus.

38. The method of claim 34 wherein said stimulus includes light of an intensity greater than 2000 lux.

39. The method of claim 38 wherein said intensity is inferred at a position approximately at the pupil of said subject.