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Further, participants should be blind to their treatment condition in order to address performance, expectation and detection bias. In order to address these concerns, groups could be added to the research design that include non-therapeutic light exposure (basic lamp). Once efficacy of BLT for NES has been established, dosing should be considered to determine duration, frequency and intensity of light needed (lux) for maximum symptom reduction. Studies testing longer durations of light therapy administration would be appropriate, as this was only a 14-day trial and there may be additional benefit to completing a longer course of treatment. In addition, long-term studies that examine the duration of symptom relief should be included. It would be beneficial to perform dismantling studies that help determine the active ingredient of treatment (e.g., attention vs. light or food records vs. light). Future studies might also include salivary or blood sample testing of hormonal shifts that occur during and after BLT in individuals with NES. Biological samples to be assessed might include 24-hour melatonin, leptin, blood glucose, insulin and/or cortisol. Finally, future studies could examine the possible benefit of adding a melatonin supplement to a trial of BLT for NES to determine if the combined treatment would provide benefit above and beyond light therapy alone. Future studies that include daily assessment of constructs that may be influencing night eating behavior are necessary to determine if change in one symptom is leading to change in another or if they are changing concurrently/independently. As noted, with the current design, it is not possible to determine if mood, anxiety, and/or sleep changes led to changes in eating behavior, vice versa, or if the changes were independent of one another. This will be important to determine the pattern of behavior change. In order to assess this pattern, reliable methods of assessing NI and EH should be included in the research design. An example of this might be verbal 24-hour dietary recalls that use a multiple-pass structure. 56PDF Image | BRIGHT LIGHT THERAPY FOR late NIGHT EATING SYNDRome
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