One hour wearing blue filters in the morning improves sleep quality

Joe A Taylor and John F Stein. Department of Physiology, Anatomy and Genetics, The University of Oxford

Current applications of coloured filters
Coloured filters, worn in spectacle frames or used as overlays, have been used in the
treatment of dyslexia, migraine and photosensitive epilepsy (Fowler et al, 1992; Wilkins
et al. 1999; Wilkins et al, 2002). Recently, 'blue-blocking' coloured filters have also been
shown to modulate the circadian pattern of melatonin output and sleep-cycle variables
(Sasseville et al, 2006; Sasseville et al, 2010).
Oxford Blue Filters (OBF) (Fig. 1) have been used in the treatment of Dyslexia in Oxford for
twenty years, although understanding of their mechanism of action has remained illusive.
OBF impact sleep quality and altertness
To determine the effects of daytime OBF use over sleep quality and continuity, we asked
eleven healthy adult volunteers to wear OBF filters for one-hour immediately after waking
each morning over a period of thirty days. In a randomised order, they also wore 'yellow'
filters, with an opposite transmission profile, for thirty days.
Each morning, participants completed visual analogue scales (VAS) to indicate their
perceived alertness on waking and the quality of their previous nights' sleep. They also
recorded the number of times they had woken during the night. Repeated measures
comparisons were made of responses between the period during which OBF were worn
Discussion and conclusions
The findings reported in Figures 3 and 4 support our hypothesis that OBF increase photic
influence over the SCN, and thereby improve sleep quality via the connections of the SCN
(Fig. 5).
The failure to reach significance for influence of OBF over the frequency of nighttime
waking may reflect either the low incidence of nocturnal waking in our healthy participant
group or the failure of participants to accurately recall each occurrence of waking.
The improvement in subjective sleep quality and alertness on wearing OBF for a short

Fig. 1: OBF are worn in spectacle frames and that during 'yellow' filter use against a thirty-day baseline period without filter use. period, raises the prospect that they may of use in the general population.
During the period of OBF use, participants reported improved sleep quality (p = 0.05) and
felt more alert when they woke (p = 0.05) (Fig. 3). No change was observed during 'yellow' Fig. 5: Pathways subject to modulation by OBF
filter use.

RETINA PPC aMT Melatonin

DMH Dorsomedial nucleus
Fig. 3: VAS scores at baseline against OBF use period HYPOTHALAMUS
IML Intermediolateral column of the spinal cord
SCN DMN LC PN LC Locus coeruleus
PIN Pineal gland
'Very good PN Pulvinar nucleus
'Very alert' 1.0 1.0
quality' PVN VLPo SC PPC Posterior parietal cortex
PVN Paraventricular nucleus
0.8 0.8
SC Superior colliculus
SCG Superior cervical ganglia
0.6 0.6
IML SCG PIN aMT SCN Suprachiasmatic nucleus
VLPo Ventrolateral preoptic nucleus
0.4 0.4

Excitatory input Inhibitory input Endocrine output

0.2 0.2

OBF influence retinohypothalamic drive 'Very sleepy' 0

'Very poor
quality'
0

Baseline OBF Baseline OBF

OBF block the transmission of longer-wavelengths of light. In addition, we previously

demonstrated that OBF use results in pupil dilation sufficient to increase the energy of short
Although not statistically significant, participants tended to wake less frequently in the night
Implications and further research
wavelength (WL) light reaching the retina (Fig. 2). On the basis of these changes, we have
(p = 0.08) during the period of OBF use, whilst no such trend was evident with the use of Further research employing objective measures of sleep quality and consolidation,
calculated that OBF use increases retinohypothalamic (RHT) drive by more than 35%.
'yellow' filters (Fig 4). including electroencephalography and actigraphy, are warranted on the basis of these
initial findings.
Fig. 2: OBF increase short WL light incident at retina Fig. 4: Sleep continuity at baseline against OBF use period
2.0 There are a large number of neurological conditions subject to circadian variation in
Mean number of nocturnal awakenings

expression of their symptoms and associated with sleep disturbance. These include
1.6

Alzheimer's Disease (AD), Diffuse Lewy Body Disease (DLBD), Parkinson's Disease (PD)
during period

1.2
and depression. In addition, there are many well-characterised disorders of sleep
0.8
regulation. We expect that OBF will improve sleep quality in a range of disorders and may
0.4
prove a means of influencing the pattern of primary symptom expression in some
neurological conditions.
0

Baseline OBF

Further research should initially focus on the effects of filter use in conditions known to
involve dysfunction of the SCN:

The RHT is dominated by short-wavelength sensitive ipRGCs and projects to the Fowler et al. Lancet. 1992;340:724. Sasseville et al. J Pineal Res. 2006;4(9):73. Seasonal affective disorder (SAD)

suprachiasmatic nucleus (SCN), which is the central circadian pacemaker. The SCN Sasseville et al. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(7):1236. Wilkins Cluster headache
projects to the medial preoptic area (MPA) and the ventrolateral preoptic area (VLPo), both et al. Seizure. 1999;8(8):444. Wilkins. Cephalalgia. 2002;22:711-19.
Sleep disorders
important in the regulation of sleep. It is via the RHT that light exposure influences the
Jetlag
sleep-wake cycle and circadian patterns of alertness. This work is supported by the Dyslexia Research Trust and Medical Research Council.