Public Release:  Light-emitting e-readers before bedtime can adversely impact sleep

Light-emitting electronic devices keep readers awake longer than those reading print

Brigham and Women's Hospital

BOSTON, MA - Use of a light-emitting electronic device (LE-eBook) in the hours before bedtime can adversely impact overall health, alertness, and the circadian clock which synchronizes the daily rhythm of sleep to external environmental time cues, according to researchers at Brigham and Women's Hospital (BWH) who compared the biological effects of reading an LE-eBook compared to a printed book. These findings of the study are published in the Proceedings of the National Academy of Sciences on December 22, 2014.

"We found the body's natural circadian rhythms were interrupted by the short-wavelength enriched light, otherwise known as blue light, from these electronic devices," said Anne-Marie Chang, PhD, corresponding author, and associate neuroscientist in BWH's Division of Sleep and Circadian Disorders. "Participants reading an LE-eBook took longer to fall asleep and had reduced evening sleepiness, reduced melatonin secretion, later timing of their circadian clock and reduced next-morning alertness than when reading a printed book."

Previous research has shown that blue light suppresses melatonin, impacts the circadian clock and increase alertness, but little was known about the effects of this popular technology on sleep. The use of light emitting devices immediately before bedtime is a concern because of the extremely powerful effect that light has on the body's natural sleep/wake pattern, and may thereby play a role in perpetuating sleep deficiency.

During the two-week inpatient study, twelve participants read LE-e-Books on an iPad for four hours before bedtime each night for five consecutive nights. This was repeated with printed books. The order was randomized with some reading the iPad first and others reading the printed book first. Participants reading on the iPad took longer to fall asleep, were less sleepy in the evening, and spent less time in REM sleep. The iPad readers had reduced secretion of melatonin, a hormone which normally rises in the evening and plays a role in inducing sleepiness. Additionally, iPad readers had a delayed circadian rhythm, indicated by melatonin levels, of more than an hour. Participants who read from the iPad were less sleepy before bedtime, but sleepier and less alert the following morning after eight hours of sleep. Although iPads were used in this study, BWH researchers also measured other eReaders, laptops, cell phones, LED monitors, and other electronic devices, all emitting blue light.

"In the past 50 years, there has been a decline in average sleep duration and quality," stated Charles Czeisler, PhD, MD, FRCP, chief, BWH Division of Sleep and Circadian Disorders. "Since more people are choosing electronic devices for reading, communication and entertainment, particularly children and adolescents who already experience significant sleep loss, epidemiological research evaluating the long-term consequences of these devices on health and safety is urgently needed."

Researchers emphasize the importance of these findings, given recent evidence linking chronic suppression of melatonin secretion by nocturnal light exposure with the increased risk of breast cancer, colorectal cancer and prostate cancer.

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This research was supported by National Institutes of Health (NIH) grant R01HL77453 and in part by National Center for Research Resources (NCRR) grant UL1RR025758.

Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in Massachusetts and employs nearly 15,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $650 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation's first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information, resources and to follow us on social media, please visit BWH's online newsroom.

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