Light exposure in the natural environment: relevance to mood and sleep disorders

In addition to being necessary for vision, light also plays a primary role in circadian physiology. Humans are diurnal animals and their biological clock synchronizes their physiological functions in such a way that functions associated with activity happen in the daytime while functions associated with rest occur at night. A misalignment between the endogenous circadian clock and the desired sleep schedule is the main cause of circadian sleep disorders; it may be involved in certain mood disorders as well. Since light is the main environmental cue used by the biological clock to set its own timing in relation to the day-night cycle, inappropriate light exposure can be involved in the physiopathology of circadian disorders. Conversely, when handled properly, controlled light exposure can be used to treat some mood and sleep disorders. While the earliest studies in the field focused solely on exposure to bright light, contemporary studies aim at understanding how the entire profile of light-dark exposure can influence the circadian clock and, consequently, mood, sleep, and vigilance quality. Following a brief summary of the main concepts underlying the non-visual effects of light, this paper presents some studies using ambulatory measurements of light exposure to illustrate how these concepts apply in real-life situations and discusses the clinical relevance of light exposure in the natural environment for mood, sleep, and circadian disorders.