Sunlight, Outdoor Light, and Light Therapy in Disease Management

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Introduction[edit | edit source]

A lack of bright light and sunshine may lead to various medical disorders. This brief review highlights the role and practical application of light therapy, sunlight, and outdoor light exposure as an adjunct in managing pain, depression, and mood.

Since antiquity, many ancient cultures have worshipped the sun for a variety of reasons. Hippocrates wrote the first texts about the sun's benefits on mental health and mood and named this therapy "Heliotherapy."[1] Taber's Cyclopedic Medical Dictionary defines heliotherapy as "exposure to sunlight for therapeutic purposes" and phototherapy as "exposure to sunlight or to ultraviolet light for therapeutic purposes."[2] Phototherapy may be used to treat conditions such as extensive atopic dermatitis, extensive psoriasis, seasonal and nonseasonal depression, seasonal bipolar disorders, and neonatal hyperbilirubinemia.[3] From about the middle of the 19th century to the middle of the 20th century, sunlight, in combination with isolation, proper hygiene, fresh air, good nutrition, and physical exercise, was used to control and treat tuberculosis.[4] Moreover, Niels Ryberg Finsen (1860-1904) earned a Nobel Prize in Medicine in 1903 for his work on phototherapy to treat diseases such as lupus vulgaris.[5]

Light Therapy in Medicine[edit | edit source]

Sensible sunshine exposure plays an essential role in overall health. Michael F. Holick, Ph.D., MD, a researcher at the Boston University Medical Center, indicates that "vitamin D is the sunshine vitamin" and sunlight plays a role in vitamin synthesis.[6][7][8][9]Sunlight exposure may improve overall health,[10]control infections,[11]improve life expectancy,[12]reduce cognitive impairment,[13]help manage influenza pandemics[14][15]enhance the immune system,[16]manage coronavirus,[17]and improve employee mental health.[18]

Moreover, sunlight may have bactericidal potential[19]and help reduce fungal contamination in contaminated clothes.[20]Light therapy may be used to manage seasonal affective disorder,[21]for major depressive disorders and bipolar depression without seasonal pattern,[22]beneficial for improving sleep-wake cycles in individuals with Parkinson's disease,[23]and for multiple sclerosis-related fatigue.[24]

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References [edit | edit source]

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  1. Choukroun J, Geoffroy PA. Light therapy in mood disorders: A brief history with physiological insights. Chronobiol Med. 2019; 1(1):3-8. doi.org/10.33069/cim.2018.0009https://www.chronobiologyinmedicine.org/journal/view.php?number=5
  2. Venes, D. Taber’s Cyclopedic Medical Dictionary, 23rd ed. Philadelphia, A: F.A. Davis Company; 2017, pp. 1016, 1087, 1490, 2548.
  3. Porter RS, Kaplan JL, Lynn RB. The Merck Manual of Diagnosis and Therapy, 20th edition. Kenilworth, NJ: Merck Sharp & Dohme Corp, 2018; 1023, 1072, 1741, 1757, 1761, 1767, 2729.
  4. McCullough PJ, Lehrer DS. Vitamin D, cod liver oil, sunshine, and phototherapy: Safe, effective and forgotten tools for treating and curing tuberculosis infections - A comprehensive review. J Steroid Biochem Mol Biol. 2018;177:21‐29. doi:10.1016/j.jsbmb.2017.07.027
  5. Grzybowski A, Pietrzak K. From patient to discoverer--Niels Ryberg Finsen (1860–1904) --the founder of phototherapy in dermatology. Clin Dermatol. 2012;30(4):451-455. doi:10.1016/j.clindermatol.2011.11.019
  6. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl):1678S-88S. doi:10.1093/ajcn/80.6.1678S
  7. Holick MF. The Vitamin D Solution. New York, NY: Plume; 2010: 157-196.
  8. Holick MF. Biological effects of sunlight, ultraviolet radiation, visible light, infrared radiation and vitamin D for health. Anticancer Res. 2016;36(3):1345‐1356.
  9. Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol. 2013;5(1):51-108. doi:10.4161/derm.24494
  10. Baggerly CA, Cuomo RE, French CB, et al. Sunlight and vitamin D: Necessary for public health. J Am Coll Nutr. 2015;34(4):359‐365. doi:10.1080/07315724.2015.1039866
  11. Hobday RA, Dancer SJ. Roles of sunlight and natural ventilation for controlling infection: historical and current perspectives. J Hosp Infect. 2013;84(4):271-282. doi:10.1016/j.jhin.2013.04.01
  12. Lindqvist PG, Epstein E, Nielsen K, Landin-Olsson M, Ingvar C, Olsson H. Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort. J Intern Med. 2016;280(4):375-387. doi:10.1111/joim.12496
  13. Kent ST, McClure LA, Crosson WL, Arnett DK, Wadley VG, Sathiakumar N. Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: a REGARDS cross-sectional study. Environ Health. 2009;8:34. doi:10.1186/1476-069X-8-34
  14. Hobday RA, Cason JW. The open-air treatment of pandemic influenza. Am J Public Health. 2009;99 Suppl 2(Suppl 2):S236-S242. doi:10.2105/AJPH.2008.134627
  15. Schuit M, Gardner S, Wood S, et al. The influence of simulated sunlight on the inactivation of influenza virus in aerosols. J Infect Dis. 2020;221(3):372-378. doi:10.1093/infdis/jiz582
  16. González Maglio, D. H., Paz, M. L., & Leoni, J. (2016). Sunlight effects on immune system: is there something else in addition to UV-Induced immunosuppression?. BioMed Res Int, 2016, 1934518. doi.org/10.1155/2016/1934518
  17. Tang L, Liu M, Ren B, et al. Sunlight ultraviolet radiation dose is negatively correlated with the percent positive of SARS-CoV-2 and four other common human coronaviruses in the U.S. Sci Total Environ. 2021;751:141816. doi:10.1016/j.scitotenv.2020.141816
  18. An M, Colarelli SM, O'Brien K, Boyajian ME. Why we need more nature at work: effects of natural elements and sunlight on employee mental health and work attitudes. PLoS One. 2016;11(5):e0155614. doi:10.1371/journal.pone.0155614
  19. Fahimipour AK, Hartmann EM, Siemens A, et al. Daylight exposure modulates bacterial communities associated with household dust. Microbiome. 2018;6(1):175. doi:10.1186/s40168-018-0559-4
  20. Amichai B, Grunwald MH, Davidovici B, Shemer A. "Sunlight is said to be the best of disinfectants:" The efficacy of sun exposure for reducing fungal contamination in used clothes. Isr Med Assoc J. 2014;16(7):431‐433.
  21. Terman M, Terman JS, Ross DC. A controlled trial of timed bright light and negative air ionization for treatment of winter depression. Arch Gen Psychiatry. 1998;55(10):875‐882. doi:10.1001/archpsyc.55.10.875
  22. Penders TM, Stanciu CN, Schoemann AM, Ninan PT, Bloch R, Saeed SA. Bright light therapy as augmentation of pharmacotherapy for treatment of depression: a systematic review and meta-analysis. Prim Care Companion CNS Disord. 2016;18(5):10.4088/PCC.15r01906.
  23. Videnovic A, Klerman EB, Wang W, Marconi A, Kuhta T, Zee PC. Timed light therapy for sleep and daytime sleepiness associated with Parkinson disease: a randomized clinical trial. JAMA Neurol. 2017;74(4):411‐418.
  24. Mateen FJ, Vogel AC, Kaplan TB, et al. Light therapy for multiple sclerosis-associated fatigue: a randomized, controlled phase II trial. J Neurol. 2020;267(8):2319-2327. doi:10.1007/s00415-020-09845-w