Bright Light Therapy for Psychiatry Residents: A Pilot Study of Feasibility and Perceived Impact on Wellbeing

Bright Light Therapy for Psychiatry Residents: A Pilot Study of Feasibility and Perceived Impact on Wellbeing | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Bright Light Therapy for Psychiatry Residents: A Pilot Study of Feasibility and Perceived Impact on Wellbeing Darren Sanders, Lauren Medlin, Danielle Lowe, Sahar Sabet, William Scheidler, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8256506/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Objective: Resident physicians often experience circadian rhythm disruptions due to long work hours and limited sunlight exposure, contributing to mood changes, fatigue, and reduced wellbeing, particularly during winter months. The objective of this study was to examine psychiatry residents’ attitudes toward bright light therapy (BLT) in clinical workspaces and evaluate perceived impact on wellbeing. Methods: From February to May 2025, 10,000 lux BLT boxes were placed in psychiatry resident workspaces at a major academic institution. Seventy-seven residents (Post Graduate Year (PGY)1–5, consult liaison fellows, and child and adolescent psychiatry fellows) were eligible. Residents received instructions on BLT use, benefits, and risks, and were asked to log daily use anonymously. At the end of study, usage logs and anonymous survey responses were collected to assess satisfaction, wellbeing impact, and suggestions. Results: Twenty-two residents participated, with 11 completing the post-study survey. Among those surveyed, 82% reported improved wellbeing and 82% were “mostly” or “very satisfied” with the intervention. Residents cited improved morning alertness, enhanced mood in dim environments, and ease of use as benefits. Common concerns included limited access and the light not fully replacing natural sunlight. Several expressed interest in continued use. Conclusions: BLT was well received and perceived as beneficial. This pilot study suggests that BLT is a feasible, low-barrier intervention that may support resident wellness. Future directions include broader implementation, extended use periods, and integration with mental health screening tools. Bright light therapy resident wellness medical education circadian rhythms Introduction Residency training often imposes long work hours, irregular schedules, and limited exposure to natural light, all of which contribute to disruptions in circadian rhythms [1]. Circadian rhythm disruptions have been linked to mood disturbances, fatigue, burnout and diminished overall wellbeing among residents, particularly during winter months [2]. Furthermore, chronic sleep deprivation among resident physicians has been linked to increased rates of depression, burnout, and reduced empathy which can impair clinical performance and compromise patient outcomes [3]. Depression is significantly more prevalent among resident physicians than in the general population, with a meta-analysis estimating prevalence around 28-32% [3]. Contributing factors include chronic sleep deprivation, work-related stress, emotionally demanding rotations, limited sunlight exposure and prior history of depression [3]. Depression among residents has been linked to increased medical errors, impaired performance, leaves of absence, and, in severe cases, suicide [4]. Despite these risks, many medical trainees avoid seeking treatment due to stigma, confidentiality concerns, and fear of professional repercussions [5]. Beyond fatigue, circadian misalignment is independently associated with increased risk of depression, anxiety, and other psychiatric symptoms, underscoring its relevance in residency training settings [6]. Shift Work Disorder, a circadian rhythm sleep–wake disorder characterized by insomnia and excessive sleepiness related to work schedules, has been reported in a substantial proportion of hospitalists [7]. Given the similar schedule demands of residency, this disorder may also contribute to impaired wellbeing among trainees. Bright light therapy (BLT), an established and low-cost intervention for improving mood and alertness, has shown effectiveness in treating conditions like seasonal affective disorder (SAD) and enhancing energy in general populations [8,9,10]. The efficacy of BLT is influenced by duration and timing of exposure, length of intervention, and light intensity. Prior studies exploring the use of BLT in long-term care settings have demonstrated that short-term interventions of 30–60 minutes using high-intensity light (≥10,000 lux) yielded the most favorable outcomes [11]. These effects are thought to occur through circadian entrainment and neurobiological mechanisms, including modulation of monoamine pathways and the stress-response system [12]. BLT has been shown to improve alertness and wellbeing among shift workers, a population that experiences circadian disruption similar to resident physicians [13]. In healthcare settings, BLT has also been shown to improve sleep quality and psychological wellbeing among shift-working nurses, further supporting its potential relevance to resident physicians [13,14]. Although the clinical benefits of BLT are well documented, its practical application and acceptability within residency training environments remains largely unexplored. Specifically, little is known about residents’ willingness to engage in BLT, their perceptions of its value, and potential logistical or cultural barriers to integrating BLT into high-stress and time-constrained training environments within clinical settings. This gap is particularly relevant given the 2017 ACGME revisions to Common Program Requirements, which mandate that residency and fellowship programs more directly address physician wellbeing [15]. In an effort to address this important mandate, we implemented bright light boxes in psychiatry resident workspaces at a major academic medical center and surveyed residents about their experiences, including usage patterns, satisfaction, and perceived impact on mood and wellbeing. Our goal was to identify practical, scalable wellness strategies that meet the unique needs of resident physicians, especially during the winter months, with the broader aim of enhancing wellbeing and mitigating burnout in medical training. Methods This descriptive, mixed-methods pilot study was conducted at a major academic institution in the Department of Psychiatry from February to May 2025. The study protocol was reviewed and deemed exempt by the IRB. Eligible participants included 77 psychiatry residents across all levels of training: (PGY-1 through PGY-5), including consultation-liaison and child and adolescent psychiatry fellows. Participation was voluntary, and formal informed consent was not required by IRB. Potential participants received an email with instructions explaining the purpose, safe usage, and potential benefits and risks of both BLT and the study. Authors also attended a residency education meeting to introduce the project and answer any questions prior to the start of the intervention. No monetary incentives were offered for participation. 10,000 Lux Bright light therapy boxes (LASTAR Sunlight Lamp, Shenzhen. China, https://lastarhome.com/products/10000-lux-sunlight-lamp ) were placed in shared psychiatry resident workspaces at the hospital. Printed BLT instructions, including a user log and information on safe use, risks and benefits, and research details were placed beside each BLT device. Residents voluntarily recorded each use on a sign-in sheet using a unique anonymous personal identification number (PIN) and date of use for tracking purposes over three months. At the conclusion of the three month period, all eligible participants were invited to complete an anonymous REDCap survey evaluating satisfaction, perceived impact on wellbeing, and a free-response section for feedback (e.g., “what were the most and least helpful aspects of the intervention?”). Results Twenty-two psychiatry residents (28.6% of eligible individuals) reported that they participated in the study, with 20 recording that they used the light boxes at least once and 11 responding to the survey. Over 25% of surveyed participants recorded using the light boxes at least on five occasions. Twenty residents recorded BLT use on the logs. Of the 11 residents who completed the post-study survey, one reported not using the BLT, and two reported use but did not record on the use logs. Eighty-two percent (9/11) indicated that BLT helped their wellbeing “somewhat” or a “great deal”, and none reported a negative effect. Satisfaction levels were similarly high, with 82% (9/11) reporting they were mostly or very satisfied with the intervention (Table 1 ). Table 1 Participant BLT Usage and Survey Responses Variable N (%) Residents who recorded BLT use 20/77 (26%) Residents who completed survey 11/77 (14%) Reported BLT helped wellbeing (overall) 9/11 (82%) ... Helped somewhat 7/11 (64%) ... Helped a great deal 2/11 (18%) Reported negative effect 0/11 (0%) Mostly or very satisfied with BLT 9/11 (82%) BLT – Bright Light Therapy; N - Number In response to the free-text survey question, “What was helpful about utilizing the bright light?”, residents described a range of benefits including feeling more energized and alert, particularly in the early morning hours or when starting shifts after limited sleep. Several participants noted that BLT helped them transition into the workday. Participants also valued the added brightness in windowless or dimly lit workrooms, noting that BLT improved their physical environments. In addition to individual benefits, some residents highlighted incorporating the lights into a team routine, which fostered a sense of shared structure and support among colleagues. When asked “What did you most like about the bright light project?”, residents emphasized the convenience and accessibility of BLT. Many noted how easy it was to incorporate the therapy into their routine without disrupting their workflow. The simplicity of setup and use made participation feel manageable, even amid busy clinical schedules. Several participants also expressed gratitude for any effort aimed at improving the resident work environment, particularly in response to the lack of natural light in windowless offices. Beyond convenience, some residents shared that they were surprised by the effectiveness of BLT. One resident also mentioned that after experiencing BLT firsthand, it increased their confidence in recommending it to patients. Others noted that the project felt like a tangible expression of institutional support for resident wellness, reinforcing a sense that their wellbeing was being acknowledged and prioritized. In response to “What did you least like about this bright light project?”, the most frequently reported concern was limited access, as only one BLT device was available in shared workspaces. Several participants noted that the light box was often in use by another resident, making it difficult to incorporate into their routine consistently. A few respondents also commented that although the light was beneficial, it was not a substitute for natural sunlight, and at times felt too intense. Others shared difficulties tracking their usage reliably, either due to competing responsibilities or forgetting to log sessions. Lastly, when asked “Do you have any suggestions to make this project better?”, the primary suggestion for improvement was to provide stands that would elevate the light boxes to a more ergonomic height. Discussion While previous studies have linked long hours and sleep deprivation to elevated depression rates in residency [ 2 ], this project provides initial data suggesting that structured environmental supports like BLT may help mitigate these effects in a non-intrusive way. This study examined psychiatry residents’ attitudes toward BLT in clinical workspaces and offers preliminary evidence supporting its feasibility and perceived benefits. Our results suggest that residents found BLT acceptable, expressed satisfaction with its use, and reported improvements in wellbeing and energy. These findings are consistent with prior research supporting the efficacy of BLT for seasonal affective disorder, shift workers and energy enhancement in both non-clinical and clinical populations [9,13,15]. Certain shift schedules, particularly in winter months at higher latitudes, have been associated with greater psychological distress and risk of seasonal-type depression [16]. Because some resident shift schedules may exacerbate seasonal vulnerability to depression, BLT could be especially relevant during winter rotations, night shifts, or in settings with limited natural light within residency programs. There are several limitations of the study. The sample was limited to one department at a single academic institution and may be subject to volunteer bias. In addition, PGY-2 and PGY-4 residents, as well as child and adolescent fellows, were frequently based in outpatient settings with limited access to shared workspaces, limiting their ability to participate in the project and contributing to a relatively low engagement (28.6%). When outpatient trainees were excluded, 42.3% (22/52) of inpatient residents engaged with the study. Some instances of bright light use not being logged, and some participants completed use logs but did not complete the end-of-study survey. Furthermore, the study relied on self-reported perceptions of wellbeing, which may not directly correlate directly with objective measures of depression or mood used in clinical practice. User error in the timing and distance of the bright light boxes may have also affected engagement and perceived effectiveness. Lastly, the long-term impact of BLT in this setting was not assessed. Nevertheless, the absence of negative feedback and the strong interest in continuing the intervention suggest a meaningful impact and warrant further exploration. Future directions could involve larger, multi-site or multi-program samples, incorporate validated mental health measures (e.g., PHQ9, GAD-7), and explore longitudinal outcomes. Additional considerations include evaluating resident workspaces for factors such as natural light exposure and their potential effects on mood and anxiety. Integrating BLT into training environments may offer a practical, low-cost, stigma-free approach for programs seeking to meet ACGME wellness requirements, complementing broader institutional initiatives [15]. In conclusion, this pilot study supports the integration of BLT into clinical workspaces as a promising wellness strategy for medical residents. As depression and burnout continue to affect healthcare trainees, interventions like BLT represent practical and meaningful steps toward fostering a healthier training culture. Our findings contribute to the existing literature on resident wellbeing by highlighting BLT as a simple, low-cost intervention that can be implemented across training environments without barriers commonly associated with clinical treatments, including time constraints, financial cost, or disclosure concerns. Given the persistently high prevalence of burnout among medical trainees [ 2 , 5 ], environmental interventions like BLT may offer scalable and accessible support to this critical need. Declarations Funding: Funding provided by organization **de-identified** to purchase bright lights. **de-identified** organization provided 1,600 dollars to purchase bright lights for the project. Funder had no role in the study design, analysis, or writing of this manuscript. Author Contribution D.S. - Wrote main manuscript text and participated in research implementation and design. L.M. - Supported primary writer with writing manuscript text and participated in design and participationg of research. D.L. - Participated in design, implementation, data analysis of research, and revision of manuscript. S.S. - Participated in design, implementation of research, and revision of manuscript. W.S.- Participated in design, implementation of research, and revision of manuscript.J.C. - Primary Investigator - Substantial contributions to the design of the work, implementation of project, interpretation of data, writing, and revision of content of manuscript. Acknowledgement We would like to acknowledge the Taking Care of Our Own Program at the University of North Carolina for their organizational support, including project planning, staffing, and implementation. We also thank the Suicide Prevention Institute at the University of North Carolina for their contributions in funding and organizational support of this project References Stewart NH, Arora VM. The impact of sleep and circadian disorders on physician burnout. Chest. 2019 Nov; 156(5):1022–1030. doi:10.1016/j.chest.2019.07.00 Sun SY, Chen GH. Treatment of Circadian Rhythm Sleep–Wake Disorders. CN. 2022 June;20(6):1022–34. Baer TE, Feraco AM, Tuysuzoglu Sagalowsky S, Williams D, Litman HJ, Vinci RJ. Pediatric Resident Burnout and Attitudes Toward Patients. Pediatrics. 2017 Mar 1;139(3):e20162163. Menon NK, Shanafelt TD, Sinsky CA, Linzer M, Carlasare L, Brady KJS, et al. Association of Physician Burnout With Suicidal Ideation and Medical Errors. JAMA Netw Open. 2020 Dec 9;3(12):e2028780. Wang J, Fitzke RE, Tran DD, Grell J, Pedersen ER. Mental health treatment-seeking behaviors in medical students: A mixed-methods approach. The Journal of Medicine Access. 2023 Jan;7:27550834221147787. Joules N, Williams DM, Thompson AW. Depression in Resident Physicians: A Systematic Review. OJD. 2014;03(03):89–100. Schaefer EW, Williams MV, Zee PC. Sleep and circadian misalignment for the hospitalist: A review. Journal of Hospital Medicine. 2012 July;7(6):489–96. Wan Y, Ding J, Fan M, Huang H. Effectiveness of visible light for seasonal affective disorder: A systematic review and network meta-analysis. Medicine. 2025 July 4;104(27):e43107. Menegaz De Almeida A, Aquino De Moraes FC, Cavalcanti Souza ME, Cavalcanti Orestes Cardoso JH, Tamashiro F, Miranda C, et al. Bright Light Therapy for Nonseasonal Depressive Disorders: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2025 Jan 1;82(1):38. Comtet H, Geoffroy PA, Kobayashi Frisk M, Hubbard J, Robin-Choteau L, Calvel L, et al. Light therapy with boxes or glasses to counteract effects of acute sleep deprivation. Sci Rep. 2019 Dec 2;9(1):18073. Zhang M, Wang Q, Pu L, Tang H, Chen M, Wang X, et al. Light Therapy to Improve Sleep Quality in Older Adults Living in Residential Long-Term Care: A Systematic Review. Journal of the American Medical Directors Association. 2023 Jan;24(1):65-74.e1. Huang X, Tao Q, Ren C. A Comprehensive Overview of the Neural Mechanisms of Light Therapy. Neurosci Bull. 2024 Mar;40(3):350–62. Jeon BM, Kim SH, Shin SH. Effectiveness of sleep interventions for rotating night shift workers: a systematic review and meta-analysis. Front Public Health. 2023 June 22;11:1187382. Bjorvatn B, Waage S. Bright Light Improves Sleep and Psychological Health in Shift Working Nurses. Journal of Clinical Sleep Medicine. 2013 July 15;09(07):647–8. Accreditation Council for Graduate Medical Education. ACGME common program requirements (residency). Chicago (IL): ACGME; 2025. 46 p. Available from: https://www.acgme.org/about/policies-and-related-materials/ McLaughlin C, Bowman ML, Bradley CL, Mistlberger RE. A Prospective Study of Seasonal Variation in Shift‐Work Tolerance. Chronobiology International. 2008 Jan;25(2–3):455–70. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 02 Mar, 2026 Reviews received at journal 26 Jan, 2026 Reviews received at journal 22 Dec, 2025 Reviewers agreed at journal 18 Dec, 2025 Reviewers agreed at journal 17 Dec, 2025 Reviewers invited by journal 16 Dec, 2025 Editor assigned by journal 10 Dec, 2025 Submission checks completed at journal 10 Dec, 2025 First submitted to journal 02 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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imposes long work hours, irregular schedules, and limited exposure to natural light, all of which contribute to disruptions in circadian rhythms [1]. Circadian rhythm disruptions have been linked to mood disturbances, fatigue, burnout and diminished overall wellbeing among residents, particularly during winter months [2]. Furthermore, chronic sleep deprivation among resident physicians has been linked to increased rates of depression, burnout, and reduced empathy which can impair clinical performance and compromise patient outcomes [3]. Depression is significantly more prevalent among resident physicians than in the general population, with a meta-analysis estimating prevalence around 28-32% [3]. Contributing factors include chronic sleep deprivation, work-related stress, emotionally demanding rotations, limited sunlight exposure and prior history of depression [3]. \u0026nbsp;Depression among residents has been linked to increased medical errors, impaired performance, leaves of absence, and, in severe cases, suicide [4]. Despite these risks, many medical trainees avoid seeking treatment due to stigma, confidentiality concerns, and fear of professional repercussions [5].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBeyond fatigue, circadian misalignment is independently associated with increased risk of depression, anxiety, and other psychiatric symptoms, underscoring its relevance in residency training settings [6]. Shift Work Disorder, a circadian rhythm sleep\u0026ndash;wake disorder characterized by insomnia and excessive sleepiness related to work schedules, has been reported in a substantial proportion of hospitalists [7]. Given the similar schedule demands of residency, this disorder may also contribute to impaired wellbeing among trainees.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBright light therapy (BLT), an established and low-cost intervention for improving mood and alertness, has shown effectiveness in treating conditions like seasonal affective disorder (SAD) and enhancing energy in general populations [8,9,10]. The efficacy of BLT is influenced by duration and timing of exposure, length of intervention, and light intensity. Prior studies exploring the use of BLT in long-term care settings have demonstrated that short-term interventions of 30\u0026ndash;60 minutes using high-intensity light (\u0026ge;10,000 lux) yielded the most favorable outcomes [11]. These effects are thought to occur through circadian entrainment and neurobiological mechanisms, including modulation of monoamine pathways and the stress-response system [12]. BLT has been shown to improve alertness and wellbeing among shift workers, a population that experiences circadian disruption similar to resident physicians [13]. In healthcare settings, BLT has also been shown to improve sleep quality and psychological wellbeing among shift-working nurses, further supporting its potential relevance to resident physicians [13,14].\u003c/p\u003e\n\u003cp\u003eAlthough the clinical benefits of BLT are well documented, its practical application and acceptability within residency training environments remains largely unexplored. Specifically, little is known about residents\u0026rsquo; willingness to engage in BLT, their perceptions of its value, and potential logistical or cultural barriers to integrating BLT into high-stress and time-constrained training environments within clinical settings. \u0026nbsp;This gap is particularly relevant given the 2017 ACGME revisions to Common Program Requirements, which mandate that residency and fellowship programs more directly address physician wellbeing [15]. In an effort to address this important mandate, we implemented bright light boxes in psychiatry resident workspaces at a major academic medical center and surveyed residents about their experiences, including usage patterns, satisfaction, and perceived impact on mood and wellbeing. Our goal was to identify practical, scalable wellness strategies that meet the unique needs of resident physicians, especially during the winter months, with the broader aim of enhancing wellbeing and mitigating burnout in medical training.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis descriptive, mixed-methods pilot study was conducted at a major academic institution in the Department of Psychiatry from February to May 2025. The study protocol was reviewed and deemed exempt by the IRB. Eligible participants included 77 psychiatry residents across all levels of training: (PGY-1 through PGY-5), including consultation-liaison and child and adolescent psychiatry fellows. Participation was voluntary, and formal informed consent was not required by IRB. Potential participants received an email with instructions explaining the purpose, safe usage, and potential benefits and risks of both BLT and the study. Authors also attended a residency education meeting to introduce the project and answer any questions prior to the start of the intervention. No monetary incentives were offered for participation.\u003c/p\u003e \u003cp\u003e10,000 Lux Bright light therapy boxes (LASTAR Sunlight Lamp, Shenzhen. China, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://lastarhome.com/products/10000-lux-sunlight-lamp\u003c/span\u003e\u003cspan address=\"https://lastarhome.com/products/10000-lux-sunlight-lamp\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) were placed in shared psychiatry resident workspaces at the hospital. Printed BLT instructions, including a user log and information on safe use, risks and benefits, and research details were placed beside each BLT device. Residents voluntarily recorded each use on a sign-in sheet using a unique anonymous personal identification number (PIN) and date of use for tracking purposes over three months. At the conclusion of the three month period, all eligible participants were invited to complete an anonymous REDCap survey evaluating satisfaction, perceived impact on wellbeing, and a free-response section for feedback (e.g., \u0026ldquo;what were the most and least helpful aspects of the intervention?\u0026rdquo;).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTwenty-two psychiatry residents (28.6% of eligible individuals) reported that they participated in the study, with 20 recording that they used the light boxes at least once and 11 responding to the survey. Over 25% of surveyed participants recorded using the light boxes at least on five occasions. Twenty residents recorded BLT use on the logs. Of the 11 residents who completed the post-study survey, one reported not using the BLT, and two reported use but did not record on the use logs. Eighty-two percent (9/11) indicated that BLT helped their wellbeing \u0026ldquo;somewhat\u0026rdquo; or a \u0026ldquo;great deal\u0026rdquo;, and none reported a negative effect. Satisfaction levels were similarly high, with 82% (9/11) reporting they were mostly or very satisfied with the intervention (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant BLT Usage and Survey Responses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidents who recorded BLT use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20/77 (26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidents who completed survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11/77 (14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReported BLT helped wellbeing (overall)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9/11 (82%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e... Helped somewhat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7/11 (64%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e... Helped a great deal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2/11 (18%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReported negative effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0/11 (0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMostly or very satisfied with BLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9/11 (82%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eBLT \u0026ndash; Bright Light Therapy; N - Number\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn response to the free-text survey question, \u0026ldquo;What was helpful about utilizing the bright light?\u0026rdquo;, residents described a range of benefits including feeling more energized and alert, particularly in the early morning hours or when starting shifts after limited sleep. Several participants noted that BLT helped them transition into the workday. Participants also valued the added brightness in windowless or dimly lit workrooms, noting that BLT improved their physical environments. In addition to individual benefits, some residents highlighted incorporating the lights into a team routine, which fostered a sense of shared structure and support among colleagues.\u003c/p\u003e \u003cp\u003eWhen asked \u0026ldquo;What did you most like about the bright light project?\u0026rdquo;, residents emphasized the convenience and accessibility of BLT. Many noted how easy it was to incorporate the therapy into their routine without disrupting their workflow. The simplicity of setup and use made participation feel manageable, even amid busy clinical schedules. Several participants also expressed gratitude for any effort aimed at improving the resident work environment, particularly in response to the lack of natural light in windowless offices. Beyond convenience, some residents shared that they were surprised by the effectiveness of BLT. One resident also mentioned that after experiencing BLT firsthand, it increased their confidence in recommending it to patients. Others noted that the project felt like a tangible expression of institutional support for resident wellness, reinforcing a sense that their wellbeing was being acknowledged and prioritized.\u003c/p\u003e \u003cp\u003eIn response to \u0026ldquo;What did you least like about this bright light project?\u0026rdquo;, the most frequently reported concern was limited access, as only one BLT device was available in shared workspaces. Several participants noted that the light box was often in use by another resident, making it difficult to incorporate into their routine consistently. A few respondents also commented that although the light was beneficial, it was not a substitute for natural sunlight, and at times felt too intense.\u003c/p\u003e \u003cp\u003eOthers shared difficulties tracking their usage reliably, either due to competing responsibilities or forgetting to log sessions. Lastly, when asked \u0026ldquo;Do you have any suggestions to make this project better?\u0026rdquo;, the primary suggestion for improvement was to provide stands that would elevate the light boxes to a more ergonomic height.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWhile previous studies have linked long hours and sleep deprivation to elevated depression rates in residency [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], this project provides initial data suggesting that structured environmental supports like BLT may help mitigate these effects in a non-intrusive way. This study examined psychiatry residents\u0026rsquo; attitudes toward BLT in clinical workspaces and offers preliminary evidence supporting its feasibility and perceived benefits. Our results suggest that residents found BLT acceptable, expressed satisfaction with its use, and reported improvements in wellbeing and energy. These findings are consistent with prior research supporting the efficacy of BLT for seasonal affective disorder, shift workers and energy enhancement in both non-clinical and clinical populations [9,13,15]. Certain shift schedules, particularly in winter months at higher latitudes, have been associated with greater psychological distress and risk of seasonal-type depression [16]. Because some resident shift schedules may exacerbate seasonal vulnerability to depression, BLT could be especially relevant during winter rotations, night shifts, or in settings with limited natural light within residency programs.\u003c/p\u003e \u003cp\u003eThere are several limitations of the study. The sample was limited to one department at a single academic institution and may be subject to volunteer bias. In addition, PGY-2 and PGY-4 residents, as well as child and adolescent fellows, were frequently based in outpatient settings with limited access to shared workspaces, limiting their ability to participate in the project and contributing to a relatively low engagement (28.6%). When outpatient trainees were excluded, 42.3% (22/52) of inpatient residents engaged with the study. Some instances of bright light use not being logged, and some participants completed use logs but did not complete the end-of-study survey. Furthermore, the study relied on self-reported perceptions of wellbeing, which may not directly correlate directly with objective measures of depression or mood used in clinical practice. User error in the timing and distance of the bright light boxes may have also affected engagement and perceived effectiveness. Lastly, the long-term impact of BLT in this setting was not assessed.\u003c/p\u003e \u003cp\u003eNevertheless, the absence of negative feedback and the strong interest in continuing the intervention suggest a meaningful impact and warrant further exploration. Future directions could involve larger, multi-site or multi-program samples, incorporate validated mental health measures (e.g., PHQ9, GAD-7), and explore longitudinal outcomes. Additional considerations include evaluating resident workspaces for factors such as natural light exposure and their potential effects on mood and anxiety. Integrating BLT into training environments may offer a practical, low-cost, stigma-free approach for programs seeking to meet ACGME wellness requirements, complementing broader institutional initiatives [15].\u003c/p\u003e \u003cp\u003eIn conclusion, this pilot study supports the integration of BLT into clinical workspaces as a promising wellness strategy for medical residents. As depression and burnout continue to affect healthcare trainees, interventions like BLT represent practical and meaningful steps toward fostering a healthier training culture. Our findings contribute to the existing literature on resident wellbeing by highlighting BLT as a simple, low-cost intervention that can be implemented across training environments without barriers commonly associated with clinical treatments, including time constraints, financial cost, or disclosure concerns. Given the persistently high prevalence of burnout among medical trainees [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], environmental interventions like BLT may offer scalable and accessible support to this critical need.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eFunding:\u003c/p\u003e\n\u003cp\u003eFunding provided by organization **de-identified** to purchase bright lights. **de-identified** organization provided 1,600 dollars to purchase bright lights for the project. Funder had no role in the study design, analysis, or writing of this manuscript.\u0026nbsp;\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eD.S. - Wrote main manuscript text and participated in research implementation and design. L.M. - Supported primary writer with writing manuscript text and participated in design and participationg of research. D.L. - Participated in design, implementation, data analysis of research, and revision of manuscript. S.S. - Participated in design, implementation of research, and revision of manuscript. W.S.- Participated in design, implementation of research, and revision of manuscript.J.C. - Primary Investigator - Substantial contributions to the design of the work, implementation of project, interpretation of data, writing, and revision of content of manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe would like to acknowledge the Taking Care of Our Own Program at the University of North Carolina for their organizational support, including project planning, staffing, and implementation. We also thank the Suicide Prevention Institute at the University of North Carolina for their contributions in funding and organizational support of this project\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eStewart NH, Arora VM. The impact of sleep and circadian disorders on physician burnout. Chest. 2019 Nov; 156(5):1022–1030. doi:10.1016/j.chest.2019.07.00 \u003c/li\u003e\n \u003cli\u003eSun SY, Chen GH. Treatment of Circadian Rhythm Sleep–Wake Disorders. CN. 2022 June;20(6):1022–34. \u003c/li\u003e\n \u003cli\u003eBaer TE, Feraco AM, Tuysuzoglu Sagalowsky S, Williams D, Litman HJ, Vinci RJ. Pediatric Resident Burnout and Attitudes Toward Patients. Pediatrics. 2017 Mar 1;139(3):e20162163. \u003c/li\u003e\n \u003cli\u003eMenon NK, Shanafelt TD, Sinsky CA, Linzer M, Carlasare L, Brady KJS, et al. Association of Physician Burnout With Suicidal Ideation and Medical Errors. JAMA Netw Open. 2020 Dec 9;3(12):e2028780. \u003c/li\u003e\n \u003cli\u003eWang J, Fitzke RE, Tran DD, Grell J, Pedersen ER. Mental health treatment-seeking behaviors in medical students: A mixed-methods approach. The Journal of Medicine Access. 2023 Jan;7:27550834221147787. \u003c/li\u003e\n \u003cli\u003eJoules N, Williams DM, Thompson AW. Depression in Resident Physicians: A Systematic Review. OJD. 2014;03(03):89–100. \u003c/li\u003e\n \u003cli\u003eSchaefer EW, Williams MV, Zee PC. Sleep and circadian misalignment for the hospitalist: A review. Journal of Hospital Medicine. 2012 July;7(6):489–96. \u003c/li\u003e\n \u003cli\u003eWan Y, Ding J, Fan M, Huang H. Effectiveness of visible light for seasonal affective disorder: A systematic review and network meta-analysis. Medicine. 2025 July 4;104(27):e43107. \u003c/li\u003e\n \u003cli\u003eMenegaz De Almeida A, Aquino De Moraes FC, Cavalcanti Souza ME, Cavalcanti Orestes Cardoso JH, Tamashiro F, Miranda C, et al. Bright Light Therapy for Nonseasonal Depressive Disorders: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2025 Jan 1;82(1):38. \u003c/li\u003e\n \u003cli\u003eComtet H, Geoffroy PA, Kobayashi Frisk M, Hubbard J, Robin-Choteau L, Calvel L, et al. Light therapy with boxes or glasses to counteract effects of acute sleep deprivation. Sci Rep. 2019 Dec 2;9(1):18073. \u003c/li\u003e\n \u003cli\u003eZhang M, Wang Q, Pu L, Tang H, Chen M, Wang X, et al. Light Therapy to Improve Sleep Quality in Older Adults Living in Residential Long-Term Care: A Systematic Review. Journal of the American Medical Directors Association. 2023 Jan;24(1):65-74.e1. \u003c/li\u003e\n \u003cli\u003eHuang X, Tao Q, Ren C. A Comprehensive Overview of the Neural Mechanisms of Light Therapy. Neurosci Bull. 2024 Mar;40(3):350–62. \u003c/li\u003e\n \u003cli\u003eJeon BM, Kim SH, Shin SH. Effectiveness of sleep interventions for rotating night shift workers: a systematic review and meta-analysis. Front Public Health. 2023 June 22;11:1187382. \u003c/li\u003e\n \u003cli\u003eBjorvatn B, Waage S. Bright Light Improves Sleep and Psychological Health in Shift Working Nurses. Journal of Clinical Sleep Medicine. 2013 July 15;09(07):647–8. \u003c/li\u003e\n \u003cli\u003eAccreditation Council for Graduate Medical Education. ACGME common program requirements (residency). Chicago (IL): ACGME; 2025. 46 p. Available from: https://www.acgme.org/about/policies-and-related-materials/ \u003c/li\u003e\n \u003cli\u003eMcLaughlin C, Bowman ML, Bradley CL, Mistlberger RE. A Prospective Study of Seasonal Variation in Shift‐Work Tolerance. Chronobiology International. 2008 Jan;25(2–3):455–70. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":false,"email":"","identity":"academic-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"","title":"Academic Psychiatry","twitterHandle":"","acdcEnabled":false,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"VoR Journals","inReviewEnabled":false,"inReviewRevisionsEnabled":false},"keywords":"Bright light therapy, resident wellness, medical education, circadian rhythms","lastPublishedDoi":"10.21203/rs.3.rs-8256506/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8256506/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective:\u003c/h2\u003e \u003cp\u003eResident physicians often experience circadian rhythm disruptions due to long work hours and limited sunlight exposure, contributing to mood changes, fatigue, and reduced wellbeing, particularly during winter months. The objective of this study was to examine psychiatry residents\u0026rsquo; attitudes toward bright light therapy (BLT) in clinical workspaces and evaluate perceived impact on wellbeing.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eFrom February to May 2025, 10,000 lux BLT boxes were placed in psychiatry resident workspaces at a major academic institution. Seventy-seven residents (Post Graduate Year (PGY)1\u0026ndash;5, consult liaison fellows, and child and adolescent psychiatry fellows) were eligible. Residents received instructions on BLT use, benefits, and risks, and were asked to log daily use anonymously. At the end of study, usage logs and anonymous survey responses were collected to assess satisfaction, wellbeing impact, and suggestions.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eTwenty-two residents participated, with 11 completing the post-study survey. Among those surveyed, 82% reported improved wellbeing and 82% were \u0026ldquo;mostly\u0026rdquo; or \u0026ldquo;very satisfied\u0026rdquo; with the intervention. Residents cited improved morning alertness, enhanced mood in dim environments, and ease of use as benefits. Common concerns included limited access and the light not fully replacing natural sunlight. Several expressed interest in continued use.\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e \u003cp\u003eBLT was well received and perceived as beneficial. This pilot study suggests that BLT is a feasible, low-barrier intervention that may support resident wellness. Future directions include broader implementation, extended use periods, and integration with mental health screening tools.\u003c/p\u003e","manuscriptTitle":"Bright Light Therapy for Psychiatry Residents: A Pilot Study of Feasibility and Perceived Impact on Wellbeing","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-19 17:49:58","doi":"10.21203/rs.3.rs-8256506/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-02T17:18:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-26T17:17:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-22T16:12:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"65113239077036161216205461722406203684","date":"2025-12-18T18:24:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"57677920448830101954804422186515378933","date":"2025-12-17T11:58:55+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-16T21:58:34+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-10T22:16:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-10T13:26:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"Academic Psychiatry","date":"2025-12-02T06:05:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":false,"email":"","identity":"academic-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"","title":"Academic Psychiatry","twitterHandle":"","acdcEnabled":false,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"VoR Journals","inReviewEnabled":false,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"72c17c85-a3d8-49eb-bd9f-3243c0e30c7c","owner":[],"postedDate":"December 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-15T20:23:03+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-19 17:49:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8256506","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8256506","identity":"rs-8256506","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}