Mental & Emotional Health

#286 ‒Journal club with Andrew Huberman: the impact of light exposure on mental
health and an immunotherapy breakthrough for cancer treatment

“People spend 90% of their time indoors now. Their daytime environments are too dim, their nighttime environments
are too bright." —Andrew Huberman

by Peter Attia
Andrew Huberman, professor of neurobiology at Stanford University and host of the Huberman Lab podcast,
returns for another special journal club episode. Andrew introduces an observational study investigating the
infuence of light exposure on circadian clock regulation and its link to mental health, while Peter covers a
phase III clinical trial employing immune checkpoint inhibitors for the treatment of metastatic cancer. They
delve into the essential fndings of their respective papers, elucidate the reasons for their enthusiasm, and
tackle potential limitations and unanswered questions. Additionally, they provide valuable insights into their
approaches for comprehending research studies, aiding listeners in independently navigating this process.
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Show Notes
• As a brief reminder, Andrew is an associate professor of neurobiology and ophthalmology at the
Stanford University School of Medicine and the host of the very popular Huberman Lab podcast
• He’s also a former podcast guest on episodes #249 and #270
The intricate relationship between light exposure, circadian rhythms, and mental health [3:30]
• Andrew is excited about this journal club because he gets to pick papers he’s really excited about, and
he gets to hear about papers Peter is really excited about
• They get to sharpen their skills at reading and sharing data, and people listening can do that as
well
• Andrew is excited about this paper for a number of reasons
• It’s powerful in the sense that it examined light exposure behavior as well as dark exposure
behavior
• This was a study of >85,000 people as part of a cohort in the UK Biobank
There’s a longstanding interest in the relationship between light and mental health and physical health, and we can
throw up some very well agreed upon bullet points
• 1 – There is such a thing as seasonal affective disorder
• It doesn’t just impact people living at really northern locations, but basically there’s a
correlation between day length and mood and mental health such that for many people (not all)
when days are longer in the spring and summer, they feel better, and they report fewer
depressive symptoms
• Conversely, when days are shorter, signifcantly more people report feeling lower mood and
affect
• There’s a longstanding treatment for seasonal affective disorder, which is to give people
exposure to very bright light, especially in the morning
• That’s normally accomplished with SAD lamps (seasonal affective disorder lamps), and
those lamps are basically bright (more than 10,000 lux lights)
 • They place on their kitchen counter or at their table in the morning or in their offce so
they’re getting a lot of bright light
• That has proven to be fairly effective for the treatment of seasonal affective disorder
• What’s less understood is how light exposure in the middle of the night can negatively impact mood and
health
Where we are headed with this is that there seems to be (based on the conclusions of this new
study) a powerful and independent role of both daytime light exposure and nighttime dark
exposure for mental health
• 2 – The biological mechanisms for all this are really well established
• There’s a set of cells in the neural retina which lines the back of your eye
• They’re sometimes called intrinsically photosensitive
• Retinal ganglion cells are sometimes called melanopsin retinal ganglion cells
• It’s well known that those cells are the ones that respond to two different types of light input
(not one, but two different types of light input) and send information to the hypothalamus
where your master circadian clock resides
• Then your master circadian clock sends out secretory signals (so peptides, hormones, but also
neural signals) to the brain and body and say, “Hey, now it’s daytime, now it’s nighttime, be awake,
be asleep.”
• But it goes way beyond that
• These melanopsin intrinsically photosensitive retinal ganglion cells also project to areas of the
brain like the habenula, which can trigger negative affect, negative mood
• They can trigger the release of dopamine or the suppression of dopamine, the release
of serotonin, the suppression of serotonin, and so they’re not just cells for setting your
circadian clock
• They also have a direct line (literally one synapse away) into the structures of the brain
that we know powerfully control mood
• The mechanistic basis for all this is there
• There’s just a couple of other key points to understand for people to really be able to digest the data in
this paper fully
• 3 – There are basically two types of stimuli that these cells respond to
• #1 is very bright light, as we just talked about
• That’s why getting a lot of daytime sunlight is correlated with elevated mood
• That’s why looking at a 10,000 lux artifcial lamp can offset seasonal affective disorder
Peter asks, “How many lux does the sun provide on a sunny day at noon?”
• On a really bright day with minimal cloud cover, it could be 300,000 lux
• Most indoor environments [are dim], even though they might seem very bright, a department store
with the bright lights, is probably only closer to 6,000 lux maximum and probably more like 4,000 lux
Most brightly lit indoor environments are not that bright when it comes down to total photon
energy
• On a cloudy day when you’re outside, it can be as bright as an average of 100,000 lux, but it won’t
seem bright because you don’t see the sun
• Also, when there’s cloud cover, a lot of those long wavelengths of light (such as orange and red
light) aren’t coming through
• 4 – The circadian clock (the suprachiasmatic nucleus), it sums photons
• “It’s a photon summing system”
• If you’re outside in 8,000 lux, a very overcast UK winter day, and you’re walking around
(hopefully without sunglasses because sunglasses are going to flter a lot of those photons out),
your circadian clock is summing the photons
 • It’s an integration mechanism; it’s not triggered in a moment
• The experiments of recording from these cells (frst done by David Berson at Brown) were historic in
the feld of visual neuroscience
• When shown bright light on these intrinsically photosensitive cells, you could crank up the
intensity of the light and the neurons would ramp up their membrane potential and then start
spiking fring action potentials
• Long trains of action potentials that have been shown to go on for hours
• “That’s the signal that’s propagating into the whole brain and body”
The important thing to understand is this is not a quick switch, and that’s why Andrew
suggests on non-cloudy days, that people get 10 minutes or so of sunlight in their eyes in the
early part of the day, another 10 minimum in the later part of the day
• He recommends people get as much sunlight in their eyes as they safely can throughout the day
• The key time for people to get sunlight in their eyes is when the sun is low in the sky (low solar angle
sunlight), and Andrew will explain more about this later
• Since Peter is a physician, he had a guest on talking about this recently
• When the sun is low in the sky, you run very, very little risk of inducing cataract by looking in
the general direction of the sun, you should still blink as needed to protect the eyes
• It’s when the sun is overhead, there’s all those photons coming in quickly in a short period of
time that you do have to be concerned about cataract and macular degeneration if you’re
getting too much daytime sunlight
• The idea is sunglasses in the middle of the day are fne, but you really should avoid using them
in the early and later part of the day
• Unless you’re driving into the sun for safety reasons
Peter asks, “If a person is indoors, but they have large windows, they’re getting tons of sunlight into their space, and
they don’t even need ambient indoor light. How much of the photons are making it through the glass and how does that
compare to this effect?”
In general, unless the light is coming directly through the window, most of the relevant
wavelengths are fltered out
• In other words, if you can’t see the sun through the window, even if suffcient light is being provided,
that’s insuffcient to trigger this phenomenon
• However, if you have windows on your roof (skylights), that makes the situation much better
• The neurons in the eye that signal to the circadian clock and these mood centers in the brain reside
mainly in the bottom two thirds of the neural retina and are responsible for looking up
• Basically, they’re gathering light from above
• These cells are also very low resolution
• Think of them as big pixels
• They’re not interested in patterns and edges and movement
• They’re interested in how much ambient light there happens to be
• Keep in mind that this mechanism is perhaps the most well conserved mechanism in cellular organisms

The importance of low solar angle sunlight, and other types of light needed for optimal mental and physical
health [12:00]
• Types of light that one needs to see every 24 hours for optimal health
• By optimal health, he really means mental health and physical health, but we’re going to talk
about mental health mainly today in this paper
Why exposure to low solar angle sunlight (at sunrise and in the evening) is important
Evolutionary conservation of a system to recognize the wavelengths of light present early in the day and in the evening
• There’s a beautiful evolutionary story whereby single cell organisms all the way to humans, dogs,
rabbits, and everything in between have at least 2 cone opsins: one that responds to short
wavelength light (AKA blue light), and another one that responds to longer wavelength light
(orange and red)
• Your dogs have this, and we have this
• It’s a comparison mechanism in these cells of the eye
• These neurons of the eye, they compare contrast between blues and orange or sometimes
blues, and reds, and pinks (which are also all long wavelength light)
• There are two times a day when the sky is enriched with blues, oranges, pinks, and reds, and that’s low
solar angle sunlight at sunrise and in the evening
These cells are uniquely available to trigger the existence of those wavelengths of light early
in the day and in the evening, not in the middle of the day
• These cells have these two cone photopigments and they say, “How much blue light is there? How much
red light is there or orange light?”
• The subtraction between those two triggers the signal for them to fre the signal off to the circadian
clock of the brain
“That’s why I say, look at low solar angle sunlight early in the day.”‒ Andrew Huberman

Role in determining circadian rhythm

• What that does is it “phase advances” the clock
• This can get a little technical, and we don’t want to get too technical here
• Think about pushing your kid on a swing
• The the duration of that swing is a little bit longer than 12 hours
• When you stand closer to the kid, so your kid swings back and you give it a push,
you’re shortening the period; you’re not allowing the swing to come all the way up
• That’s what happens when you look at morning sunlight: you’re advancing your
circadian clock
• Translated to English (or non-nerd speak): you’re making it such that you will want to go to
bed a little bit earlier and wake up a little bit earlier the next day
• In the evening, when you view low solar angle sunlight, the afternoon setting sun or evening setting sun,
you do the exact opposite: you’re “phase delaying” the clock
• It’s the equivalent of your kid being at the very top of the arc
• Let’s say 12 and a half hours is the duration of that swing, and you run up and you push them
from behind and give them a little more push
• That’s the equivalent of making yourself stay up a little later and wake up a little later
These two signals average so that your clock stays stable, you don’t drift, meaning you’re not
waking up earlier every single day or going to sleep later every single day; and this is why it’s
important to view low angle sunlight in the morning and again in the evening as often as
possible
• This is done by that readout of those two photopigments
Midday sun is different
• It’s bright light, but you see it as white light
• It contains all of those wavelengths that equal intensity
• The middle of the day is the so-called “circadian dead zone”
 • In the middle of the day, bright light triggers the activation of the other opsin (the melanopsin) which
increases mood, increases feelings of wellbeing, and has some other consequences
• But you can’t shift your circadian clock by viewing the sun in the middle of the day because it’s in the
circadian dead zone
• It’s the equivalent of pushing your kid on the swing when they’re at the bottom of the arc
• You can get a little bit more but not much
• In biological terms, you get nothing
This is why looking at sunlight in the middle of the day is great, but it’s not going to help
anchor your sleep wake cycle
This is incredible, right?
• Every organism from single cells to us has this mechanism to know when the sun is rising and when the
sun is setting
• It’s a color comparison mechanism which tells us that actually color vision evolved frst, not for
pattern vision, not for seeing beautiful sunsets and recognizing that’s beautiful or paintings or things of
that sort, but rather for setting the circadian clock
Peter asks, “What if you only do one of these? What if you get constant exposure to low morning light, but your job
prevents you from doing the same in the evening (or visa versa)?”
• It’s better to get the morning light, because if you have to pick between low solar angle light earlier or
later in the day…
• Keep in mind if you miss a day, no big deal
• It’s a slow integrative mechanism averaging across the previous two or three days
• But if you miss a day, you’ll want to get twice as much light in your eyes that next morning
• The reason it’s better to do in the morning as opposed to the evening (although best would
be to do both) is that most people are getting some artifcial light exposure in the evening
anyway
• Here’s the diabolical thing: your retina is very insensitive to light early in the day
• You need a lot of photons to trigger this mechanism early in the day
• As the day goes on, retinal sensitivity increases and it takes very little light to shift your
circadian clock late in the day
• There’s a beautiful study published in Science Reports two years ago showing you can partially offset the
negative effects of artifcial light exposure at night
• Think of this as your Netfix inoculation
• The amount of melatonin suppression from nighttime light exposure is halved
by viewing evening setting sun
• Keep in mind, you don’t need to see the sun cross the horizon; it can just be when it’s
low solar angle
• You’re looking for those yellow blue or blue pink, blue red contrast
• And on cloudy days, believe it or not, they’re still there, just you don’t perceive as
much of it coming through
Andrew explains 3 things that we should all strive to do:
• (1) view low solar angle sunlight early in the day,
• (2) view solar angle sunlight later in the day, and
• (3) get as much bright light in our eyes as we safely can, ideally from sunlight throughout the day
Promising new lightbulb technology that simulates low solar angle sunlight [17:45]
If you can’t do that, perhaps invest in one of these SAD lights
• They can be a bit expensive
• There are a couple of companies that are starting to design sunrise simulators and evening simulators
that are actually good, that actually work
• A company that Andrew has no relationship to called the TUO sells a lightbulb that was developed by
the biologist at the University of Washington
• The biologist who basically discovered these color opponent mechanisms
• Those lights are not particularly expensive, but they do seem to work.
• Unpublished data seems to indicate that if you look at it for more than 5-6 minutes, it can induce a mild
euphoria
• That’s how powerful this contrast is
More about the TUO lightbulb
• What they did there in that light is they fgured out that when most people look at low solar angle
sunlight in the morning, they’re getting 19 reversals of blue orange per second
• When you look at this light, it looks like a barely fashing white light, but it’s reversals of orange
and blue, orange and red and blue, and it’s happening very fast
• Andrew has used one of these, it just looks like a fickering light
• Of course, there’s always the potential of a placebo effect
Peter asks, “Is there a way to control for that by having something that looks the same to the user, but of course is not
producing the same photo effect?”
• They’ve done that with the 10,000 lux SAD lamps, which most people use to try and induce sunrise
simulation in their home
• But keep in mind that sunrise gives you this comparison of short and long wavelength light
• Just a bright 10,000 lux light triggers one of the options, but it won’t set your
circadian clock
Most of the SAD lamps that are out there are activating only one of the mechanisms in these
cells that’s relevant and not the one that’s most relevant
• Andrew is excited about what TUO is doing
• He has no relation to them except he knows the biologists who do the work that provide the
mechanistic logic for that engineering
“I still think we’re in the really early days of this stuff. What should be done is to have this stuff built into
your laptop. It should be built into your phone, and hopefully it will be.”‒ Andrew Huberman

The signifcance of both darkness and the need for direct light exposure to the eyes, specifcally [20:00]
• Andrew mentioned the color contrast thing in sunrise and sunset, and bright light throughout the day
[3 important light signals]
• There is a 4th light stimulus that turns out to be really important: dark exposure at night
(independent of light exposure during the day) is important for mental health outcomes
• Aka the absence of light at night
This paper really drives home the importance of dark exposure at night even if people are not
getting enough sunlight during the day
• This is especially true in the context of mental health
• Some people seem more resilient to these light effects than others
• Meaning some people also don’t suffer from jet lag too much
• Some people can stay up late, get a lot of bright light exposure in the middle of the night and
during the day, they’ve got their sunglasses on all day and they’re in a great mood all the time
• Other people are more susceptible to these sorts of things, and we don’t know whether or not
polymorphisms underlie that
• Andrew personally is very sensitive to sunlight in the sense that if he doesn’t get enough sunlight, he
doesn’t feel well after a couple of days
• But he’s less sensitive to light exposure at night, for instance.
It is perhaps the most fundamental environmental stimulus for levels of arousal and alertness,
which correlate with all sorts of neuromodulator and hormone outputs
• None of this should come as any surprise
One last thing
• There was a study published over 10 years ago from Chuck Czeisler’s lab at Harvard Medical School,
it’s a phenomenal lab, exploring circadian human health behavior
• There was a study that was in error where they had published in Science Magazine, that light
shone behind the knee could shift circadian rhythms, and that paper was retracted, and a lot of
people don’t know that it was retracted [discussed further in this news article]
Light exposure to the eyes is what’s relevant here
• As far as we know the color of one’s eyes, the darkness or lightness of one’s eyes bears no relevance
on their sensitivity to these types of mechanisms

Some tips and advice regarding optimizing light exposure, dark exposure, blue blockers, and the effect on the
circadian rhythm [22:15]
Going back to the morning/ evening light
• Peter spends a lot of time looking at those types of skies just because of the nature of his hobbies
• He’s always doing archery in the morning and rucking in the afternoon
• So it’s not uncommon that he’s seeing both of those
Peter asks, “How relevant is it that the sun be above the horizon?”
• For example, it begins to get light about 30 minutes before sunrise
• If sunrise is at 7:30, frst light is 7:00, and then 7:15 to 7:30 is actually quite bright
• You can see anything and everything, and the same is true at sunset
Peter asks, “Does that 30 minutes when the sun is beneath the horizon constitute part of that 10 minutes?”
• It does
• In an ideal circumstance, you’d get outside and see the sunrise every day and you’d see the sunset
every day, even on cloudy days
• Some people (like Andrew) wake up before the sun comes up
In the absence of powers to make the sunrise faster, Andrew thinks the best thing to do is
simply to turn on as many bright lights as you can indoors to trigger that melanopsin
mechanism if you want to be awake
• If you want to stay asleep or sleepy, then keep them dim
• Then get outside once the sun is starting to come out
• Some people wake up after the sun has risen, in which case get what you can
• Some people wake up 10:00 AM or noon, in which case you can still get the bright light exposure, but
you won’t shift your circadian clock
Andrew’s advice
• In the evening, especially in the winter months, it’s important to look west and try and get some
sunlight in your eyes in the evening
• If you’ve ever gone into the clinic, for instance, at two o’clock in the afternoon after lunch in the winter
and then come out and it’s dark when you’re walking to your car, it’s an eerie feeling
• That eerie feeling may correlate with the fact that you missed a signal
• Your brain is trying to orient your brain and body in time, and that’s what all of this is
• Again, some people are more susceptible to that than others
• Some people might like that feeling of, “Oh, I went in when it was bright and I came out when it’s
dark.”
• But the vast majority of people feel better when they’re getting this morning and evening
sunlight exposure
• This is especially important in kids
One of the things that this paper points out (and there are good data): people are spending
approximately 90% of their time indoors nowadays, daytime time indoors, and those indoor
environments are simply not bright enough
Andrew’s thoughts about blue light and light at night
• You may think indoor lights are bright, and some people are putting blue blockers on in the middle of
the day
• This is the worst thing you could possibly do if you’re going to wear blue blockers
• Andrew doesn’t think they’re necessary, but if you’re going to wear them, you’d want to wear
them at night
• In the evening, you don’t need to wear blue blockers
• You just simply should dim the lights and ideally have lights that are set a little bit lower in your
environment, which the Scandinavians have been doing for a long time
• Kill the overhead lights and don’t obsess about bright light exposure in the middle of the night
• For a long time people were saying (Andrew included), “Oh, even just a brief fash of light in the middle of
the night can quash your melatonin.”
• That’s true
• But the other time in which you’re in this “Circadian dead zone,” is in the middle of the night
• You can’t shift your circadian clock in the middle of the night
• All of this gets down to interweaving rhythms of light sensitivity, temperature, hormone output,
cortisol ‒ there’s a whole landscape of circadian biology
Andrew presents a paper which suggests avoiding light at night and seeking light during the day is associated
with better mental health [25:45]
• This paper, which was published in a new journal Andrew is really excited about called Nature Mental
Health, this journal was just launched recently, is entitled “Day and Night Light Exposure Are
Associated with Psychiatric Disorders in Objective Light Study in More Than 85,000 People”
• Andrew thinks the title of this paper is terrible
• It sounds like day and night light exposure is associated with psychiatric disorders, but that’s
not the conclusion
• The conclusion is that getting a lot of sunlight exposure during the day and getting a lot of dark
exposure at night is immensely benefcial for psychiatric health in a number of ways
Previous to this study
• This paper built off a previous study entitled “Time Spent in Outdoor Light is Associated with Mood,
Sleep and Circadian Rhythm Related Outcomes”
• That was a cross-sectional longitudinal study in 400,000 Biobank participants
• This UK Biobank is an incredibly valuable resource
There are now multiple studies establishing that one’s pattern of light exposure is extremely
important
• The previous study of 400,000 participants basically nailed home the idea that the more time you spend
outdoors, the better is your mood, the better is your sleep, the better is the rhythmicity of your sleep
wake cycles and on and on
• This is something that Andrew thinks even though people will say, “We’ve known that for thousands of
years,” needed scientifc substantiation
Contributions of this new study
• This new study essentially looked at the relative contributions of daytime light exposure and nighttime
dark exposure
• They did that on a background looking in particular at people who had major depressive disorder,
generalized anxiety, PTSD, bipolar disorder
The basic takeaway
• Andrew quotes them here, “Avoiding night at light and seeking light during the day. May be a simple and
effective non-pharmacologic means for broadly improving mental health.”
• That’s a pretty bold statement, and Andrew loves that they say seeking because it implies that people
aren’t refexively getting the light exposure that they need
• That this needs to be a practice, much like zone 2 cardio or resistance training
Takeaway‒ more nighttime light exposure is worse for you, and there’s a dose response of the
effect
For people with bipolar disorder, it seems that light exposure at night is especially
problematic independent of how much sunlight they’re getting during the day
• The person with bipolar disorder who’s struggling with either a manic or a depressive episode, who’s
making a point to get sunlight during the day, who’s also getting light exposure at night is making
their symptoms worse
• Keep in mind they couldn’t completely control this, but this is largely independent of things like
sleep duration
• So that doesn’t necessarily mean that the person’s sleeping less, although in a manic
episode, presumably they are
• It’s independent of exercise, it’s independent of a bunch of other things because any logical
person will hear this and say, okay, well, they gain more light at night because they’re doing a
bunch of other things, but it’s largely independent of those other things
Figure 4. Effects of light exposure for PTSD (fgure 2d) Image credit: Nature Mental Health 2023
• Likewise, the symptomatology of PTSD gets far worse with increasing light exposure at night
• Self-harm really takes a leap from being fairly medium at the 2nd and 3rd quartiles of artifcial light
exposure at night
• Then for people who get quite a lot of nighttime light exposure, self-harm goes up, the probability of
psychotic symptoms
The positive effects of daytime light exposure [40:15]
What’s nice about the data is that the exact inverse is basically true for daytime light exposure [as compared to
nighttime light exposure], although not across the board
• We can generally say that for major depressive disorder, generalized anxiety, and bipolar symptoms it’s
a little more scattered
• With PTSD and self-harm, the more daytime light exposure (ideally from sunlight because that’s
actually what’s being measured in most cases) is going to approximately linearly drop the probability or
the severity of these symptoms
• Peter adds that the odds ratio now seems to be going down and explains, “An odds ratio of 0.7 now
refers to a 30% reduction in the variable of interest here.”
Panel f focuses on psychosis and is worth mentioning in a bit more detail

Figure 5. Psychosis odds ratio according to light exposure (fgure 2f). Image credit: Nature
Mental Health 2023
• There’s a fairly dramatic reduction in psychotic symptoms as one gets more daytime light exposure
independent of nighttime light exposure
There’s a well-known phenomenon called ICU psychosis
• Which is that people come into the hospital for a broken leg or a car accident
• They’re housed in the hospital, and the lighting environment in the hospital is absolutely dreadful for
health (it’s absolutely counter to health)
• Peter adds, “Especially in the intensive care unit. I think the intensive care unit at Hopkins, the main
one, the main SICU didn’t have windows.”
• Andrew advises for people who go into the hospital with a brain injury or with a stroke or something
that they get near a window and start controlling their sleep-wake cycle
• Oftentimes, there’s nurses coming in and taking blood tests and measuring pulses in the middle
of the night, and that’s disruptive
• There’s bright light, not just blue light, and it’s noisy
ICU psychosis is when anti-psychotic individuals start having psychotic episodes in the
hospital because of nighttime light exposure, and in some cases, lack of daytime sunlight
• We can say that with some degree of confdence because when those people go home, even though
sometimes their symptoms for what brought them to the hospital in the frst place get worse, their
psychosis goes away and it’s independent of medication
Andrew explains
• There is a possibility that we are all socially jet-lagged, that we are all disrupting these mood regulation
systems by not getting enough daytime light and by getting too much nighttime light
Figure 7. Anxiety and bipolar disorder according to light exposure (fgure 2c & 2e). Image
credit: Nature Mental Health 2023
• Andrew agrees, there’s a bit more scatter on generalized anxiety and the degree of signifcant change is
not as robust
• In other words, getting a lot of daytime light, ideally from sunlight, is not necessarily going to
reduce your levels of anxiety
• Getting a lot of nighttime light exposure is not increasing nighttime anxiety that much, although
20% is not nothing for nighttime light exposure
• The [results for] psychosis, major depression, and self-harm, they leap out

Takeaways from the study of daytime and nighttime light exposure [49:45]
One thing Andrew hopes people are taking away from this study
• Imagine you’re somebody who has a very sensitive circadian mood system
• That would mean you need less daytime light exposure to feel good or less bad
• But it also means that you might need very little light at night in order to negatively impact your mood
systems
• They make this argument in the discussion as an interesting point
• What Andrew likes about this study is that they’ve separated day and nighttime light exposure
Drugs used to treat bipolar disorder
• It turns out that many of the drugs that are used to treat bipolar disorder are effective, perhaps in part
because they reduce the sensitivity of the light sensing circadian apparati
If you think about this, these are drugs that can ameliorate some of the symptoms of bipolar,
perhaps in part by reducing the extent to which nighttime light exposure can exacerbate
bipolar symptoms
• Conversely, there’s evidence that people who take certain antidepressants may suppress the ability for
daytime light to positively impact the mood systems of the brain
• Of course, we don’t want people halting their medication on the basis of that statement alone (please
don’t)
• Talk to your psychiatrist
• We know one thing for sure, it’s that if you want a signifcant outcome and a paper as a scientist, give a
drug, any drug, and look at the amount of rapid eye movement, sleep, or the circadian cycle
• Pretty much any drug alters the circadian rhythm, for better or worse
• We start to think about which medications might adjust our overall sensitivity to light
• Sometimes this could be a good thing; think less sensitivity to light
For people who have bipolar disorder, the amount of daytime light exposure isn’t that
important for their overall mood regulation, but the amount of nighttime light exposure
really is
• In other words, darkness for 8 hours every night should be viewed (in Andrew’s opinion) as a
treatment for bipolar disorder, not the only treatment
It’s also clear that we should all be avoiding extensive really bright nighttime light exposure
“If anything, my takeaway from this study is that darkness at night is the fourth key light stimulus.”‒
Andrew Huberman

To put this in perspective

• Very bright moonlight, very bright candlelight is probably only 3-50 lux
• You can download a free app called Light Meter (Andrew has no relationship to it)
• It gives you a pretty good read of what the lux are in that environment
• Hold down the button and it tells you how many lux
• It’s kind of fun; go out on a really bright moonlit night
• You’re not going to get above 100 lux
• Peter had an interesting experience a couple of months ago on an elk hunt where it was a full moon
• It was the frst time he’s ever noticed his shadow in relation to the moon (that’s how bright it
seemed the light was)
• It’s super interesting to think a full moon could be that dim
• Campfres are extremely bright, but they’re not that bright compared to a very densely overcast day
Peter asks “What is [the lux of] your phone if you don’t use any sort of light mitigating tech on it?”
• Distance matters
• With all the wavelengths cranked up, there is a nice feature intrinsic to the phone where you can
eliminate the blues at night or this kind of thing, but if you crank it up to maximum light intensity,
probably something like 500 to 1,000 lux
• Now keep in mind though, it’s additive, so it’s over time
• Lux is a measure of, Andrew thinks it relates back to candelas as the amount of light shown, and it’s
like one meter away and there’s a squaring and a falling off of distance [1 lux = 1 lumen/meter2]
Keep in mind that if you’re looking at your phone or tablet at 800 lux or 500 lux in the
evening and you do that for two hours where you’re summing quite a lot of photons
• Andrew explains, “We’ve hammered on people about not shifting their circadian rhythm with light at night,
but we know that the middle of the day and the middle of the night are circadian dead zones.”
• You can’t shift your circadian rhythm that well in the middle of the day and the middle of the
night, but you can provide a wake-up signal for your body and brain
Sunrise and sunset are critical for circadian rhythm
• This is why Andrew said there are 4 things:
• 1 – See sunrise (you don’t need to see it cross the horizon)
• 2 – Bright light during the day
• 3 – Minimize light exposure at tonight (you don’t need pitch black)
• Pitch black probably increases the frequency of injury as most people get up in the middle of
the night to use the bathroom
• Use dim lights
• Some people use red lights
• 4 – [see the sun set (light exposure in the early evening), mentioned earlier]
The practicalities of minimizing light exposure and screen time at night, the use of sleep trackers, and overall
challenge of modern, indoor lifestyles [55:15]
A funny story about Rick Rubin (a mutual friend) and red lights
• Rick was a guest at Peter’s house last summer
• He came down after the frst night and was like, unacceptable accommodations
• He removed all the lighting that existed in that room and replaced it with red light bulbs, which
Andrew later used when he stayed at Peter’s, and then later stole when I left
• Andrew loves them
• At Rick’s place, he has mostly either no lighting or red lighting
• During the day, he just goes by ambient light and then red light in the evening or candlelight, and it’s
great
• People hear red lights and they think they have to buy these expensive red light units, but that’s not
what we’re talking about
• You can literally buy red party lights or just a red bulb
• Andrew dims the lights in his home at night
• When he travels, sometimes he will bring one of the stolen red lights from Rick Rubin
An instance where Peter has softened his tune
• He used to be a hard-liner, no blue light in the evening guy
• Everything was red light at night as far as his phone, using fux on the computer, whatever it was
• He suspects that that matters somewhat, but he thinks what matters more is the stimulation that may
come from those things
What Peter has come to realize at least for him (which means it probably is true in at least
some others) is that what he’s doing on his phone matters more than how bright the phone is
• In other words, if he’s got the best blue light flter in the world on his phone, but he’s doom scrolling
social media and getting lit up on email, that’s way worse for him than if he’s got his phone on
maximum light and watching YouTube videos of F1 cars and driving around having fun
• It’s a totally different experience
• So the context matters, and for that reason, he would want people to be mindful of the whole
picture
• Going to bed under a period of intense duress brought on by something, that’s an
equally dangerous component to all of this that’s distinct from what we’re talking about
[light exposure]
Andrew’s advice
• If you’re going to stay up past your normal bedtime, if you’re going to get a lot of light in your eyes, he
would hope that it will be for fun reasons and for reasons you enjoy
• You should defnitely spend some nights out
• You should defnitely do some all-nighters studying if it’s going to help you get the grade that’s
permanent
• He certainly has done all-nighters studying and grant writing for years
• There are going to be the inevitable all-nighters due to trip to the hospital or you heard
something on the news that really amped you up or you just simply can’t sleep
The goal should be to minimize light exposure at night
• And what Peter just said is especially true
• For instance, people talk about the negative impact of social media
• Is it the fact that people are looking at this little box for so many hours per day?
• Is it all the things they’re not doing?
• Is it what they’re looking at per se?
• All of those things interact and are really important
• We know based on studies from the Stanford Sleep Lab that if you wake up in the middle of the night,
looking at what time it is can be very disruptive to your ability to fall back asleep
• And to your sense the next day, it’s a placebo effect, but it’s a powerful one, of how tired you
are the next day
• They’ve done this where they wake people up in the middle of the night and then they say it’s
4:00 AM versus 2:00 AM versus 6:00 AM and people’s perceived levels of energy during the day
in some ways correlate with how much sleep they think they got
• Likewise, and this is one of the concerns, potential concerns with sleep trackers, Alia Crum talked
about this when she came on the Huberman Lab podcast
• If people see a poor sleep score, they often feel worse than if they see a good sleep score
• Now, of course, physiology matters
• You can’t lie to yourself and say you got a great night’s sleep simply by virtue of a sleep
score, but Andrew worries more about the false, if it’s false negative
• We don’t want to put valence on this, seeing a bad sleep score and then deciding that
you’re going to have a terrible day
• A bad sleep score is an indication that you might need to dial some things in a bit better
• Getting a great sleep score is an indication that you might be doing a number of things right and
start looking at these things as averages
• Peter agrees about sleep scores and doesn’t think it’s much different from CGM
• CGM is an amazing tool to provide insight after a relatively short period of time
• In 30-90 days you know all you need to know about how the inputs affect the outputs
• Thereafter, if you choose to use it, it’s a behavioral tool (you’re using this to build in a
Hawthorne effect)
• He thinks the same is true of sleep trackers
• Most people have this profound sense of learning when they frst encounter one of these
things
• Again, you’ve heard it all 100 times, “Oh my God, I can’t believe what alcohol does to my
sleep.”
• Andrew relates this to caloric trackers: Layne Norton’s app Carbon has taught him that he consumes a
lot of calories in the form of certain things at certain times of day
• There’s a lot of good learning in that
• He has no fnancial relationship to this app
It’s the act of tracking that helps you manage it, and similarly, it’s the act of knowing you’re
going to be looking at that score that gamifes it, that helps people do the right things
• That said, Peter thinks that recovery scores and things like that are just notoriously poor at
predicting performance
• There’s a reason that serious athletes would never use things like that
• They would tend to rely on the more tried and true methods of predicting behaviors
such as heart rate, maybe heart rate variability, but morning resting heart rate probably
more predictive than anything else, and then in workout, things such as heart rate,
heart rate recovery, lactate threshold, things like that
• Andrew does some tracking (not as much as Peter), and he loves things that seem to work the frst
time and every time in terms of our natural biology based on a couple of criteria
• Where there’s an established mechanism, and it’s been explored in the context of pathology
• Like mental health disorders as well as pro-health in healthy individuals
• That it makes really good sense at the level of wellness and let’s just say ancient health
Andrew’s explains how living indoors affects our light exposure
• When you’re talking about getting a lot of sunlight during the day, a lot of people will say, well, of
course, get outside and play
• About not getting too much light at night, people say, “Of course, this is just ‘good old-fashioned’ advice.”
• People spend 90% of their time indoors now
• Their daytime environments are too dim, their nighttime environments are too bright, and this
misleading aspect of artifcial light that when you see a bright bulb, you think “I’m getting a lot of
photons,” is part of the problem and the fact that when you’re out on an overcast day and you
think the sun “isn’t out,” it’s hidden by cloud cover
• Just think about how well you can navigate that environment without a fashlight versus
at night where you would require a fashlight
• We evolved under this dramatic difference in day-night availability of photons independent of whether
or not you can see the sun, and it’s just very clear that all the mechanisms in our brain and body that
regulate mood are just powerfully regulated by this stuff
Andrew has made it a point to really reduce the amount of nighttime light that he’s
getting
• But he is less concerned about fipping on the light switch to use the bathroom as he used to be
• He used to think, “I’m quashing all my melatonin. This is terrible.”
• He knows he can’t shift his circadian clock
• He knows that, that light while it’s bright, if it’s brief, he’s not going to worry about it too much
• Would it be better to have a dim light on as opposed to a bright light [at night]?
• Sure, but he’s not going to stress in a hotel bathroom or walk around shielding his eyes
• People will sometimes ask him, “Is it different to look at the phone directly versus if you tilt the phone
away?”
• Well, it absolutely is
• Think about a fashlight shown on the ground in front of you, very few photons are getting in
your eyes versus shown directly into your eyes
• Think about ambient light from the sun going everywhere versus looking in the general
direction of the sun
• So east in the morning, west in the afternoon
• The directionality of the light matters
A funny story about avoiding direct light at night
• Andrew is not saying that you need to peek at your phone as if you’re looking over the edge of a bowl
or something into it
• Andrew’s friend, Samer Hattar is head of the chronobiology unit at the National Institute of Mental
Health, and they used to room together at meetings
• They stopped because he’s a terrible snorer
• There were a few times when Andrew considered suffocating him in the middle of the
night since he was already suffocating himself
• Andrew caught him looking at his phone in the middle of the night and he would tilt it away like
he’s holding a platter, and looking over at the screen there
• This is ridiculous
• Samar said, “I’m trying not to get so much light in my eyes.”
• That’s a little extreme, but it illustrates the point, which is how much direct light
exposure you get at night matters
• How much direct sunlight exposure you get, especially early morning, late afternoon, and throughout
the day, it really matters
Peter asks, “What is the wavelength of sunlight?” [1:05:15]
• Sunlight is going to include all visible spectrums
• This RISS sensor [used in this study] detected 470 nanometer to 650 nanometer light, so that’s going
to be blue and ultraviolet [see the table below]
• They’re measuring blue to orange
• Red light is going to be around 680, and far red is going to be 720 and up
• Blue light is going to fall somewhere in the low 400s
• Ultraviolet is getting down into the high 300s and lower

Figure 10. Visible spectrum of light. Image credit: Wikipedia

• In midday light, you’re getting what looks like white light
• You’ll see the sky is blue and the sun is bright white light
 • It’s not even yellow to your eye, and of course, don’t stare at it, especially in the middle of the
day
• You’re getting all visible spectra, so you’re getting everything from UV all the way out to red
light
• It’s just coming in at equal intensities

Potential limitations of the light exposure study, reverse causality, and the complex interplay of variables in
epidemiological studies [1:06:00]
Peter asks, “Is that a potential limitation of this study in that it didn’t have a sensor that
could pick up the full spectrum of light?”
• Potentially
• We don’t think of humans as UV capable (being able to perceive UV light)
• A ground squirrel, for instance, has UV sensors in its eyes
• Turns out, when the ground squirrels sit up on their haunches, they’re actually signaling one
another: they rub urine on their belly and it refects UV
• The New York Times for some reason has been running a series of articles about naturally occurring
fuorescence at night in all sorts of species, scorpions and monotremes like the platypus
• No one really knows the reason for these odd wavelength of light emissions for all these animals, but
we view things in the blue, violet, and up to red, and we’re not pit vipers
• We can’t see far red, but we can see lower than 470 nanometers and we can see higher than 650
Peter asks, “Is there a technology reason why they had such a narrow band in these sensors? Is it not possible that they
could have used a RISS sensor that was wider?”
• This study was initiated in 2013
• The tech was probably far worse than it is now
• Andrew would love for somebody to design an eyeglass where it’s measuring how many photons
you’re getting across the day
• He’s not a big fan of having everything be app-ifed, so he would love it if the frame would just
shift color across the morning
• For instance, if you go outside on a cloudy day and wear these glasses…
Andrew points out about sunlight viewing
• It’s fne to wear eyeglasses or contacts for sunlight viewing, for setting your circadian rhythm
• People ask, “Well, why is that okay, and a window is not?”
• Corrective lenses are actually focusing the light onto your retina
• Windows and windshields are scattering the light and fltering
Peter asks, “How much are sunglasses fltering this out?”
• Too much
• They’re probably causing a tenfold decrement in the total lux count that’s landing on your retina
• But of course, sunglasses are important [to wear when] driving into sun, and some people have very
sensitive eyes
• Andrew can’t sit at a cafe with a brightly refective table in the afternoon; he squints like crazy
• Andrew’s dad, who’s darker eyed, and he is South American descent, he can just sit there just
fne
• People differ in their light sensitivity
Andrew and Peter’s take on the causality vs. correlation of light exposure to mental health, the damage of
circadian disruption, and the interpretation of observational data [1:17:30]
To fnish up this frst paper
Peter asks, “If you had to just lay on your judgment, if it were a hundred to zero, you would say the light is 100%
causal in the effects we’re seeing. If it were zero to a hundred, you’d say, nope, the behavior is 100% causal of the
exposure to light. Again, you can’t know it, but what does your intuition tell you?”
• Andrew begins with, “There’s my intuition, and then there’s my recognition of my own bias.”
• Andrew started working on these circadian pathways originating in the eye back in ‘98, as a graduate
student at Berkeley
• The cells, these melanops and intrinsically sensitive retinal ganglion cells were discovered in the
early 2000’s by a guy named Iggy Provencio, David Berson, Samer Hattar, Satchidananda Panda,
and others
• It was one of the most important discoveries in all of biology, clearly
• So Andrew has been very excited about these systems
• Setting that bias disclosure aside
Andrew thinks 65-75% of the effects are likely due to light directly
• It’s impossible to tease those apart
To play devil’s advocate and consider the level of light exposure of person with
depression
• You could imagine that the depressed individual is laying around indoors with the curtains drawn
• They didn’t sleep well the night before, which gives you a photosensitivity that isn’t pleasant
• It sucks to have bright light in your eyes frst thing in the morning, especially if you didn’t sleep
well
• And then they’re making their coffee in a dimly lit, what they think is brightly lit, environment
• Then they’re looking at their phone, and the state of the world sucks, and their state of their internal
landscape is rough, and maybe they’re dealing with a pain or injury or something, and their likelihood of
getting outside is low, and when they do get outside, they’re going to shuffe and not
So Andrew could see how the behaviors could really limit the amount of light exposure
• Then evening rolls around, they’ve been tired all day, and a common symptom of depression, they fall
asleep, and then two or three in the morning they’re wide awake
• What are you going to do at two or three when you’re wide awake, sit in the dark?
• No, you’re going to get online; you’re going to listen to things
• Andrew is not recommending this, but they may have an alcoholic drink in order to try
and fall asleep
• This is the pattern
Shaking up that pattern is really so much of Andrew’s public health work these days is about,
and trying to get people onto a more natural daylight, night dark rhythm
• But yeah, it’s impossible to tease apart
Andrew explains more about circadian rhythm
“We do know this, and this is really serious. We know that in almost every instance, almost every
psychopathology report of suicide, in the weeks, but especially in the days, preceding suicide, that person’s
circadian rhythms looked almost inverted from their normal patterns. And that’s true of non-bipolar
individuals as well.”‒ Andrew Huberman

• Circadian disruption and disruption in psychiatric health are inextricable

• Conversely, positive mood and affect and circadian behavior seem very correlated
• If you want to become an early riser, get light in your eyes and get activity in your body early in
the day
• You entrain to those rhythms so that you start to anticipate that morning workout, you start
to anticipate the morning sunlight
• Just one more scientifc point, we know that when you view bright sunlight in the
morning (or just sunlight that’s illuminating your environment, you don’t even have to see the
sun itself), that there’s a 50% increase in the amplitude of the morning cortisol spike
• Which is a good thing because the amplitude of the morning cortisol spike is inversely
related to the amplitude of the evening cortisol spike
• And high evening cortisol is associated with middle of the night waking, and on and on
• Andrew is very bullish on these mechanisms
• He loves that they’re so deeply woven into our evolutionary history that we share with single cell
organisms
• But of course there’s going to be a bi-directionality there, and it’s impossible to see where one thing
starts and the other one stops

At the end of the day, what’s the purpose of the discussion?

• The purpose of the discussion is, if you are under the infuence of any of these psychiatric conditions, in
addition to the treatments you’re doing now, what else can you do?
The takeaway is follow these light behaviors
• That’s a relatively low lift, when you consider some of the other things
• For example, Peter is asking people to do zone 2 for 3 hours a week, and VO2 max workouts,
and all this other stuff
• He thinks all those things matter for mental health as much as physical health
• But this strikes him as on the spectrum of ‘low asks’
• If it’s only even 30% causality, 70% reverse causality, he would still instate that
How to implement this
• Andrew explains, “It’s taking your coffee on the balcony”
• People ask, “Well, how do you do this with kids?”
• The kids should be doing it, too
• It means popping your sunglasses off, it means getting out for just a few minutes in
• And the fact that it’s additive, that these photon counting mechanisms, they sum
• This paper also says, “If you missed your daytime light ration, get your nighttime dark ration. They are
independent and additive.”
• Ideally, you get both
• Andrew appreciates Peter’s expertise in parsing epidemiology
• Andrew looks at fewer studies of that sort, but he learned from Peter, and that’s one of the
reasons he loves doing these journal clubs (to learn)