Circadian rhythm disturbances are common among children with cancer, and are associated with poor health outcomes. Social zeitgeber theory suggests that intervening in the cascade of events that disrupt circadian rhythms may improve health outcomes. Light, most potently sunlight, is a "zeitgeber," or environmental cue instrumental in maintaining entrainment of circadian rhythms. Bright white light (BWL) therapy, a proxy for sunlight, has been used successfully to prevent deterioration of circadian rhythms in adult cancer patients, and to reentrain these rhythms in adolescents with circadian rhythm disorders. This study aimed to develop and assess preliminary feasibility of a BWL therapy intervention for supporting circadian health of adolescent cancer survivors. We hypothesized that adolescents could independently manage BWL in their home, coordinated by nurses using a mail-, phone- and internet-based format, with minimal side effects. Adolescents were instructed to use BWL for 30 minutes daily on awakening, for 28 days. Actigraphs, measuring the circadian activity rhythms of sleep and wake, were worn for 7 days at baseline and Week 4. Adverse events were screened serially. Analyses were descriptive and nonparametric. Eight adolescents participated. On average, BWL was used on 61% of days, for 15 minutes per day. Adverse events were generally mild, although one participant discontinued BWL due to persistent BWL-related nausea. This nurse-guided remote BWL therapy intervention in adolescent cancer survivors demonstrated preliminary feasibility. Future studies with larger samples are required to verify the feasibility of this study, and to determine its safety and effectiveness in supporting circadian activity rhythms.

中文翻译：

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改善青少年癌症幸存者昼夜节律健康的晨光疗法干预：方法和初步可行性

昼夜节律紊乱在癌症儿童中很常见，并且与不良的健康结果有关。社会时代理论表明，干预一连串扰乱昼夜节律的事件可能会改善健康结果。光，最有效的阳光，是一种“时代”，或有助于维持昼夜节律的环境提示。明亮的白光 (BWL) 疗法是阳光的替代品，已成功用于防止成年癌症患者的昼夜节律恶化，并在患有昼夜节律紊乱的青少年中重新调节这些节律。本研究旨在开发和评估 BWL 治疗干预的初步可行性，以支持青少年癌症幸存者的昼夜节律健康。我们假设青少年可以在家中独立管理 BWL，由护士使用基于邮件、电话和互联网的格式进行协调，副作用最小。指导青少年每天醒来时使用 BWL 30 分钟，持续 28 天。Actigraphs 测量睡眠和清醒的昼夜活动节律，在基线和第 4 周佩戴 7 天。连续筛查不良事件。分析是描述性的和非参数的。八名青少年参加。平均而言，BWL 的使用时间为 61%，每天 15 分钟。不良事件通常是轻微的，尽管一名参与者由于持续的 BWL 相关恶心而停止了 BWL。这种在青少年癌症幸存者中进行的护士指导的远程 BWL 治疗干预证明了初步可行性。