Extreme fatigue often tops the list of the most distressing symptoms for millions of people who live with multiple sclerosis (MS).
And now, a new study suggests that light therapy may help these folks get their lives back.
MS is an autoimmune disease that occurs when the body attacks the insulation around its nerves, causing fatigue, numbness, bladder problems, mood issues and mobility problems that can hamper everyday life.
When patients with MS sat in front of a light box for 30 minutes a day for two weeks, they were less tired and reported more energy to get through their day than their counterparts who sat in front of a dim red light.
Exactly how light helps with fatigue isn't fully understood, but researchers have their theories.
"Light therapy promotes alertness, concentration and wakefulness during the daytime and increases the availability of serotonin and noradrenaline in the brain; both neurotransmitters are responsible for the regulation of mood and motivation," said study author Dr. Stefan Seidel. He's a neurologist at Vienna General Hospital and associate professor at the Medical University of Vienna in Austria.
The study included 26 people with MS. Half sat in front of a daylight lamp with a brightness of 10,000 lux, the level recommended for effective light therapy. The other half sat in front of an identical lamp that emitted a dim red light.
Researchers ruled out any sleep disorders before starting the study, as those could interfere with the results.
Folks who sat by the 10,000-lux daylight lamp for a half-hour every day showed improved physical and mental performance in just two weeks. In addition, they were less sleepy by day.
In contrast, no such effect was seen among people with MS who sat by the red-light lamps, the study showed. These changes were measured by reductions in scores on a Fatigue Severity Scale.
Easing fatigue makes a big difference in quality of life for people with MS, Seidel said.
"Fatigue is highly prevalent in patients with MS affecting anywhere from 75% to 98% and ranks in the top three reasons for impairment during activities of daily living," he said.
Various medications can help alleviate fatigue in MS, but they carry a risk of side effects. This is where light therapy shines as it is essentially free of side effects, Seidel said.
"It should be worth a two- to three-week trial when experiencing fatigue in combination with depression [in MS]," he said.
Seidel noted that light sensitivity due to medication should be discussed and checked by a physician before treatment starts. Certain medications cause heightened skin sensitivity when skin is exposed to light.
The study was recently published in the Multiple Sclerosis Journal -- Experimental, Translational and Clinical.
Kathy Zackowski, associate vice president of research at the New York City-based National MS Society, reviewed the findings.
"Light therapy is an option for someone with MS who has fatigue," Zackowski said. "Light therapy has been associated with lessening of fatigue in several studies, though all studies have been small and underpowered to show a strong effect."
What is needed now is a larger study and more careful consideration of the effect of natural environmental light, she said.
Still, there really isn't a downside to giving light therapy a try if you have significant fatigue, Zackowski added.
"Light therapy is a non-technical, non-pharmaceutical intervention with very few known side effects, and the financial investment needed to pursue light therapy is minimal," she said.
The light boxes used in the study start at around $200.
"MS-related fatigue is a very common symptom of MS and is very difficult to treat," Zackowski noted.
Checking in with your health care team can also help troubleshoot MS-related fatigue, she said.
"A physician can evaluate the medications a person is on and determine the risk of side effects as well as testing for physiologic reasons for feeling fatigued," Zackowski said. "A second step would be to consult with an occupational therapist to assess sleep issues, help with simplifying tasks at work and home and learn strategies for conserving energy."
In addition, a physical therapist can help develop a regular exercise program to prevent de-conditioning, and a psychologist can offer guidance in strategies such as stress management, relaxation training or psychotherapy.
The National MS Society offers more tips on how to manage MS-related fatigue.
SOURCES: Stefan Seidel, MD, associate professor, neurology, Medical University of Vienna, and neurologist, Vienna General Hospital, Austria; Kathy Zackowski, PhD, associate vice president, research, National MS Society, New York City; Multiple Sclerosis Journal -- Experimental, Translational and Clinical, Nov. 7, 2022, online