The following is a typical weekly Wake and Light Therapy treatment programme at the Priory Hospital North London. You may read of variations in the timetable, but it’s not known yet if one approach is better than another. The most important thing is to stay fully awake during the periods of sleep deprivation. Napping will ruin what gains you might have made resetting your bodily clock.
Day 1 (Monday)
Note: you can start on any day of the week and some people find it’s best done starting on a Friday, so they go to work easily on the following Monday.
Before you begin, we assess the severity and type of your depression and the pattern of your sleep.
On the first night, you stay awake with no naps. This is usually done with the support of a nurse and fellow patients in a small group. We plan activities for the night on the ward e.g., watching a film, a short walk in the grounds or (in non-COVID world) perhaps an excursion to an all-night venue. Patients have access to coffee/tea and snacks.
Day 2 (Tuesday)
You may experience an immediate improvement in your mood but unless you continue with the program in the way we describe you are very likely to relapse.
You receive Bright Light Therapy (please see separate blog for instructions) for 30 minutes in your room sometime between 6.45am and 9am. The exact timing will depend on the results of our initial assessment of your sleep programme. You sit about a foot (30cm) from the light with your eyes open. Ideally, the light screen should be tilted at a 15° angle toward you so that the light is projected over as you receive treatment. You should not stare at the light, but you may read, work, eat, etc. while receiving the light therapy. An alternative to Bright Light Therapy is to go outdoors first thing in the morning for natural sunlight especially in the Summer months.
You stay awake during the day and structure your activities as planned with your therapist. You should try not to have any naps. We encourage you to use amber glasses or lighting from 2pm as this provides virtual darkness and encourages the release of melatonin.
You then go to bed at 5pm and wake by 1am (i.e., about 8 hours sleep).
If you cannot resist a nap it should last no more than 10-15 mins before midday.
Day 3 (Wednesday)
You stay awake during the day, go to bed at 7pm and wake by 3am. After a light snack, the nursing staff on the ward provide some activity. Bright Light Therapy is provided as described with the same timing as on Day 2. We encourage the use of amber glasses or lighting from 4pm to prepare you for bed at 7pm.
There is a planned activity schedule and treatment as usual on the ward.
Day 4 (Thursday)
You stay awake during the day, go to bed at 9pm and wake by 5am. We encourage the use of amber glasses from 6pm.
You have Bright Light Therapy at the same time as you did on Day 2 with similar activities and treatment on the ward.
Day 5 (Friday onwards)
By this point your sleep schedule should be getting back to normal. You go to bed by 11pm and wake by 7am. We encourage the use of amber glasses from 4pm.
Bright Light Therapy is provided at the same time as on Day 2, and there are activities and treatment on the ward. In future you can carry on with the Bright Light Therapy in the morning but can discontinue with the amber glasses.