Phase advancing human circadian rhythms with morning bright light, afternoon melatonin, and gradually shifted sleep: can we reduce morning bright-light duration?
Open accessAbstract
Objective Efficient treatments to phase-advance human circadian rhythms are needed to attenuate circadian misalignment and the associated negative health outcomes that accompany early-morning shift work, early school start times, jet lag, and delayed sleep phase disorder. This study compared three morning bright-light exposure patterns from a single light box (to mimic home treatment) in combination with afternoon melatonin. Methods Fifty adults (27 males) aged 25.9 ± 5.1 years participated. Sleep/dark was advanced 1 h/day for three treatment days. Participants took 0.5 mg of melatonin 5 h before the baseline bedtime on treatment day 1, and an hour earlier each treatment day. They were exposed to one of three bright-light (~5000 lux) patterns upon waking each morning: four 30-min exposures separated by 30 min of room light (2-h group), four 15-min exposures separated by 45 min of room light (1-h group), and one 30-min exposure (0.5-h group). Dim-light melatonin onsets (DLMOs) before and after treatment determined the phase advance. Results Compared to the 2-h group (phase shift = 2.4 ± 0.8 h), smaller phase-advance shifts were seen in the 1-h (1.7 ± 0.7 h) and 0.5-h (1.8 ± 0.8 h) groups. The 2-h pattern produced the largest phase advance; however, the single 30-min bright-light exposure was as effective as 1 h of bright light spread over 3.25 h, and it produced 75% of the phase shift observed with 2 h of bright light. Conclusions A 30-min morning bright-light exposure with afternoon melatonin is an efficient treatment to phase-advance human circadian rhythms.
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Preliminary studies using transcranial magnetic stimulation targeting the DMN prior to sleep onset reduce cortical hyperarousal and facilitate sleep, but clinical efficacy for insomnia has not been established.
“Preliminary studies using transcranial magnetic stimulation targeting the DMN prior to sleep onset to reduce cortical hyperarousal and facilitate sleep, but clinical efficacy for insomnia has not been established [40].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [40]
The Methods (Participants; Procedures) and Discussion describe a study of morning bright light, afternoon melatonin, and shifted sleep in healthy adults. Searches for transcranial magnetic stimulation, DMN targeting, cortical hyperarousal, and insomnia efficacy found no passage addressing the attributed claim. Page numbers were not available in our copy. (LLM, conf=0.78)
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BackgroundSelf-citationShort blue light pulses (30 min) in the morning support a sleep-advancing protocol in a home setting
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“phase advancing therapies, could be successful also in changing chronotypes (45).”
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Musicians’ Natural Frequencies of Performance Display Optimal Temporal Stability
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“For example, Crowley has, in experimental settings, shown that 30 min of artificial bright light during early morning promoted 75% of a phase advance shift as compared to 2 h bright light exposure later [24].”
BackgroundMisiunaite, I., Eastman, C. I., & Crowley, S. J. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00099 · Cited by 35 · see citing works
“Past studies have successfully used morning bright light to advance circadian rhythms in adults (Rimmer et al., 2000; Burgess et al., 2003; Eastman et al., 2005; Revell et al., 2006; Paul et al., 2009; Smith et al., 2009; Burke et al., 2013; Crowley and Eastman, 2015), though the duration of light exposure, the number…”
BackgroundMethodSelf-citationMulti-etiological Perspective on Child Obesity Prevention
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Lighting scheme recommendation for interior workplace to adjust the phase-advance jet lag
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“Furthermore, 30 min of morning bright light together with exogenous melatonin in the evening has recently been suggested as an effective and feasible duration to use in the clinic (Crowley & Eastman, 2015).”
BackgroundThe implications of sleep disruption for cognitive and affective processing in methamphetamine abuse
Lipinska, G., Timol, R., & Thomas, K. G. F. (2015) · Medical Hypotheses · doi:10.1016/j.mehy.2015.09.010 · Cited by 16 · see citing works
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Shift Work, Shift-Work Disorder, and Jet Lag
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“These light parameters were selected as compromises of the 30 minutes to 2 hours in the morning (Corbett et al. 2012; Crowley and Eastman 2015; Geerdink et al. 2016) and 2–4 hours in the evening (Byun et al. 2018; Cajochen et al. 1998; Chang et al. 2015; Green et al. 2017, 2018; Munch et al. 2011;…”
BackgroundThe impact of training shifts in dancers’ chronotype and sleep patterns
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The role of sunlight in sleep regulation: analysis of morning, evening and late exposure
de Menezes-Júnior, L. A. A., Sabião, T. D. S., Carraro, J. C. C., Machado-Coelho, G. L. L., & Meireles, A. L. (2025) · BMC Public Health · doi:10.1186/s12889-025-24618-8 · Cited by 12 · see citing works
“On the contrary, insufficient exposure to natural light can delay this mid-point, leading to misalignment between biological and social time, often resulting in chronic sleep deficits [7–9].”
Youngstedt, S. D., Elliott, J. A., Patel, S. I., Mak, N. Z.-C., Raiewski, E. E., Malek, E. M., Strong, M. J., Mun, C. J., Peters, T. J., Madlol, R., et al. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.964681 · Cited by 9 · see citing works
“Research has shown additive effects of bright light combined with melatonin (45, 46) or exercise (37, 38).”
BackgroundNickla, D. L., Wang, X., Rucker, F. J., Chen, W. C., & Taylor, C. P. (2022) · Optometry and Vision Science · doi:10.1097/opx.0000000000001967 · Cited by 8 · see citing works
“Morning 200 lux 1086 (84) 636 (50)* 379 (24) 428 (40) −6 (8) 2 (9)”
Witt, R. M., Byars, K. C., Decker, K. M., Dye, T. J., Riley, J. M., Simmons, D. M., & Smith, D. F. (2023) · Seminars in Pediatric Neurology · doi:10.1016/j.spen.2023.101091 · Cited by 6 · see citing works
Jet Lag Recovery and Memory Functions Are Correlated with Direct Light Effects on Locomotion
Richardson, M. E. S., Parkins, S., Kaneza, I., & Dauphin, A.-C. (2020) · Journal of Biological Rhythms · doi:10.1177/0748730420947589 · Cited by 6 · see citing works
“Evaluating the role of both masking and phase shifting in jet lag recovery will likely strengthen current jet lag therapies (Arendt, 2018; Crowley and Eastman, 2015; Gooley, 2017).”
BackgroundInfluentialDoes sunlight exposure predict next-night sleep? A daily diary study among U.S. adults
Anderson, A. R., Ostermiller, L., Lastrapes, M., & Hales, L. S. (2024) · Journal of Health Psychology · doi:10.1177/13591053241262643 · Cited by 6 · see citing works
“…that the degree of morning light, even in indoor settings, was predictive of sleep quality and that artificial bright light in the morning has previously been used to adjust circadian rhythms experimentally (Crowley and Eastman, 2015; Du¨zgu¨n and Durmaz Akyol, 2017; Gradisar et al., 2011).”
Paech, G. M., Crowley, S. J., & Eastman, C. I. (2017) · PLoS ONE · doi:10.1371/journal.pone.0186843 · Cited by 6 · see citing works
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“Advancement of the circadian phase via morning bright light (BL), in combination with afternoon melatonin uptake, recently proved successful [17].”
BackgroundCircadian Rhythm Sleep-Wake Disorders
Bothwell, M. Y., & Abbott, S. M. (2022) · Respiratory medicine · doi:10.1007/978-3-030-93739-3_14 · Cited by 6 · see citing works
A causal and replication analysis of claims that jet lag affects team sport performance
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“We chose 1500 lux as representative average light input to the retina for an individual using bright light therapy of the kind used in interventions that showed phase-advancing effects (Crowley and Eastman, 2015; Gooley, 2008; Lack et al., 2007; Rosenthal et al., 1990).”
Spatiotemporal light exposure modeling for environmental circadian misalignment and solar jetlag
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“19,20 Using equations from Astronomical Algorithms by Meeus, 21,22 (4) sun-rise time (in units of hours, minutes, and seconds) is calculated at the target point and at the point location at the eastern-most boundary of the time zone in which the target point is located (holding latitude constant).”
MethodThe interplay between circadian rhythms and aging: molecular mechanisms and therapeutic strategies
Dhaka, P., Neha, N., Kumar, R., Hossain, C. M., & Parvez, S. (2025) · Biogerontology · doi:10.1007/s10522-025-10301-3 · Cited by 5 · see citing works
“Furthermore, greater overnight awakenings are typical among older persons (Crowley and Eastman 2015).”
CBT-I for patients with phase disorders or insomnia with circadian misalignment
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Fetal programming of adipose tissue function by gestational chronodisruption
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“In that case, it would be even more important to strengthen the circadian phase advance effect and to balance against the influence of night light [34–36].”
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“Melatonin plays an important role in the regulation of the circadian rhythm, especially the sleep-waking cycle [23].”
BackgroundElectrocortical temporal complexity during wakefulness and sleep: an updated account
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“In addition, it would be advisable to add bright light in the morning in order to try to enlarge treatment effects.(20,42,43)”
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“More recently, Crowley and Eastman (12,13) also reported that a similar advance of sleep-wake cycle induced a shift of DLMO either by 1.”
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Clinical Implications of the Timed Autonomic Nervous System
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Light and Melatonin Treatment for Jet Lag Disorder
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Self-citationPre-sleep arousal as a possible mechanism driving sleep problems in relation to ADHD traits
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Twenty-First Century: The 24/7 Society as an Environmental Mutation
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XV Latin-American Symposium on Chronobiology
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Stories from a life studying circadian rhythms and sleep
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“This illumination option is of particular interest in investigating the speci fi c dynamics of adaptation to the circadian light cycle (Crowley and Eastman, 2015).”
BackgroundMorning light exposure: a potential modifier of cardiovascular risk factor
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Chronotype and Health: The Role of Moderators and Mediators in Shaping Outcomes
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Chikungunya infection modulates the locomotor/flight activity of Aedes aegypti
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Circadian Rhythm Sleep–Wake Disorders: Mechanisms and Treatment
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Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice.
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What, how and (especially) when: chronoparmacological approach in cancer therapies
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Annual variation of daily activity patterns and its dependence on photoperiod: a quick overview
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Circadian modulation of motivation-related behavior
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The effect of pubertal development on the sleep-wake cycle
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Different latitude influences the habitat and reproductive patterns of Pinnipeds
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From the ruler to the smartphone tasks applied to identify sleep deprivation
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Light and Melatonin Treatment for Jet Lag Disorder☆
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Hanafi, M. I., Laksana, Z. A., Ardiyan, C. N. I., Arifianti, A., Islamiyah, W. R., & Fidiana, F. (2026) · Sleep Medicine Research · doi:10.17241/smr.2026.03426
“In addition, good public health awareness and access to health services will enable individuals with DSWPD to be easily diagnosed [53].”
InfluentialToo noisy, too dark: sleep environment at a typical stroke unit
Schuerch, N., Bassetti, C. L., Arnold, M., & Vorster, A. P. A. (2026) · European Stroke Journal · doi:10.1093/esj/aakag024
Circadian–immune crosstalk in insomnia disorder: mechanisms and therapeutic implications
Huang, Y., Wang, X., Chen, X., & Liu, Y. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1881195
“Morning light exposure helps advance sleep phase, enhance daytime wakefulness, and stabilize nocturnal melatonin rhythms (Crowley and Eastman, 2015).”
Circadian Biology and Phase Response: Fundamental Mechanisms and Clinical Applications
Fedele, M. L. M., & Cardinali, D. P. (2026) · Clocks & Sleep · doi:10.3390/clockssleep8030048
“Taking melatonin (3–6 mg) before going to sleep during the day can promote sleepiness and help shift the circadian phase [121].”
Romo‐Nava, F., Burgess, H. J., Blom, T. J., Cao, X., Williamson, B., Georgiev, G., Stoddard, J., Goertemoeller, M., Fu, J., Mori, N. N., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-10684280/v1
- Authors
- Crowley, S. J., & Eastman, C. I.
- Affiliations
- Rush University Medical Center (US)
- Corresponding author
- Crowley, Stephanie J.
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 16
- Issue
- 2
- Pages
- 288-297
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC4344919
- OpenAlex
- W2149442311
- Cited by
- 99
- References
- 101
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 5 · 2023: 3 · 2022: 12 · 2021: 5 · 2020: 21 · 2019: 8 · 2018: 7 · 2017: 4 · 2016: 9 · 2015: 5 · 2013: 1
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01 NR007677)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- melatonin, dim light melatonin onset, circadian misalignment, delayed sleep phase syndrome, jet lag, shift work, school start time, light duration, chronotherapy
- MeSH terms
- Adult, Circadian Rhythm, Female, Humans, Light, Male, Melatonin, Sleep, Time Factors, Actigraphy
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