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Day and night light exposure are associated with psychiatric disorders: an objective light study in >85,000 people

Nature Mental Health volume 1, pages 853–862 (2023)Cite this article

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Abstract

Circadian rhythm disturbance is a common feature of many psychiatric disorders. Light is the primary input to the circadian clock, with daytime light strengthening rhythms and night-time light disrupting them. Therefore, habitual light exposure may represent an environmental risk factor for susceptibility to psychiatric disorders. We performed the largest to date cross-sectional analysis of light, sleep, physical activity, and mental health (n = 86,772 adults; aged 62.4 ± 7.4 years; 57% women). We examined the independent association of day and night-time light exposure with covariate-adjusted risk for psychiatric disorders and self-harm. Greater night-time light exposure was associated with increased risk for major depressive disorder, generalized anxiety disorder, PTSD, psychosis, bipolar disorder, and self-harm behavior. Independent of night-time light exposure, greater daytime light exposure was associated with reduced risk for major depressive disorder, PTSD, psychosis, and self-harm behavior. These findings were robust to adjustment for sociodemographics, photoperiod, physical activity, sleep quality, and cardiometabolic health. Avoiding light at night and seeking light during the day may be a simple and effective, non-pharmacological means of broadly improving mental health.

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Fig. 1: Flow diagram of the light-data study sample.
Fig. 2: Associations of day and night-time light exposure with psychiatric disorders and self-harm.
Fig. 3: Associations of day and night-time light exposure with symptom severity scales and wellbeing.

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Data availability

The data used in this study are available in the UK Biobank resource subject to project approval by the UK Biobank Access Management Team. The authors of the present study are approved for access under application 6818.

Code availability

Data organization and statistical analysis were performed in R (version 4.1.0). Data analysis code is available at https://github.com/dpwindred/Axivity_AX3_Light.

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Acknowledgments

This work was funded in part by the Australian Government Research Training Program (ACB) and National Health and Medical Research Council (NHMRC; project number = GNT1183472; S.W.C.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Author notes

  1. These authors contributed equally: Andrew J. K. Phillips, Sean W. Cain.

Authors and Affiliations

  1. Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia

    Angus C. Burns, Daniel P. Windred, Andrew J. K. Phillips & Sean W. Cain

  2. Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA

    Angus C. Burns, Richa Saxena & Jacqueline M. Lane

  3. Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

    Angus C. Burns, Richa Saxena & Jacqueline M. Lane

  4. Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA

    Angus C. Burns, Richa Saxena & Jacqueline M. Lane

  5. Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

    Martin K. Rutter

  6. Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

    Martin K. Rutter

  7. Action Lab, Faculty of Information Technology, Monash University, Clayton, VIctoria, Australia

    Patrick Olivier

  8. Department of Integrative Physiology, University of Colorado, Boulder, CO, USA

    Céline Vetter

  9. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Richa Saxena

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Contributions

A.C.B., S.W.C., and A.J.K.P. conceptualized the research idea and acquired funding. All authors contributed to the methodology and development of the analysis plan. A.C.B., D.P.W., S.W.C., A.J.K.P., M.K.R., R.S., and J.M.L. acquired the data. A.C.B. completed the formal analysis, visualizations of the data, and wrote the original draft of the manuscript. All authors reviewed the manuscript and provided critical comments. All authors approved the final manuscript.

Corresponding author

Correspondence to Angus C. Burns.

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Competing interests

A.J.K.P. and S.W.C. have received research funding from Delos and Versalux, and they are co-founders and co-directors of Circadian Health Innovations PTY LTD. S.W.C. has also received research funding from Beacon Lighting and has consulted for Dyson. P.O. was a co-founder of Axivity Ltd and a director until 2015. C.V. is a board member of the Working Time Society and a research committee member for DiME. All other authors have no competing interests.

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Nature Mental Health thanks Sarah Chellappa, Yuichi Esaki, Jamie M. Zeitzer, and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Supplementary information

Supplementary Information

Supplementary Figs. 1 and 2, Tables 1–17, and Methods.

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Supplementary Data 1

AX3 device validation data.

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Burns, A.C., Windred, D.P., Rutter, M.K. et al. Day and night light exposure are associated with psychiatric disorders: an objective light study in >85,000 people. Nat. Mental Health 1, 853–862 (2023). https://doi.org/10.1038/s44220-023-00135-8

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