This questionnaire has 19 questions, each with a number of points. First, add up the points you circled
and enter your total morningness-eveningness score here:
Scores can range from 16-86. Scores of 41 and below indicate “evening types.” Scores of 59 and above indicate
“morning types.” Scores between 42-58 indicate “intermediate types.”
16-30 Definite Evening
31-41 Moderate Evening
42-58 Intermediate
59-69 Moderate Morning
70-86 Definite Morning
Occasionally a person has trouble with the questionnaire. For example, some of the questions are difficult to answer if you have been on a shift work schedule, if you don’t work, or if your bedtime is unusually late. Your answers may be influenced by an illness or medications you may be taking. If you are not confident about your answers, you should also not be confident about the advice that follows.
One way to check this is to ask whether your morningness-eveningness score approximately matches the sleep onset and wake-up times listed below:
Score: Sleep onset
16-30 2:00-3:00AM
31-41 12:45-2:00AM
42-58 10:45PM-12:45AM
59-69 9:30-10:45PM
70-86 9:00-9:30PM
Score: Wake onset
16-30 10:00-11:30AM
31-41 8:30-10:00AM
42-58 6:30-8:30AM
59-69 5:00-6:30AM
70-86 4:00-5:00AM
If your usual sleep onset is earlier than 9:00 PM (21:00 h) or later than 3:00 AM {03:00 h), or your wake- up is earlier than 4:00 AM (04:00 h) or later than 11:30 AM (11:30 h), you should seek the advice of a light therapy clinician in order to proceed effectively with treatment.
We use the morningness-eveningness score to improve the antidepressant effect of light therapy. Although most people experience good antidepressant response to light therapy when they take a regular morning session using a 10,000 lux white light device (see www.cet.org for recommendations) for 30 minutes, often this will not give the best possible response. If your internal clock is shifted relative to external time (as indirectly measured by your morningness-eveningness score), the timing of light therapy needs to be adjusted.
The table at the top of the next page shows the recommended start time for light therapy for a wide range of morningness-eveningness scores. If your score falls beyond this range (either very low or very high), you should seek the advice of a light therapy clinician in order to proceed effectively with treatment.
Morningness-Eveningness Score – Start time for light therapy
23-26 – 8:15AM
27-30 – 8:00AM
31-34 – 7:45AM
35-38 – 7:30AM
39-41 – 7:15 AM
42-45 – 7:00AM
46-49 – 6:45AM
50-53 – 6:30AM
54-57 – 6:15AM
58-61 – 6:00AM
62-65 – 5:45AM
66-68 – 5:30AM
69-72 – 5:15 AM
73-76 – 5:00AM
If you usually sleep longer than 7 hours per night, you will need to wake up somewhat earlier than normal to achieve the effect – but you should feel better for doing that. Some people compensate by going to bed earlier, white others feel fine with shorter sleep. If you usually sleep less than 7 hours per night you will be able to maintain your current wake-up time. If you find yourself automatically waking up more than 30 minutes before your session start time, you should try moving the session later. Avoid taking sessions earlier than recommended, but if you happen to oversleep your alarm clock, it is better to take the session late than to skip it.
Our recommended tight schedule for evening types – say, 8:00 AM (08:00 h) for a morningness- eveningness score of 30 – may make it difficult to get to work on time, yet taking the light earlier may not be helpful. Once you have noted improvement at the recommended hour, however, you can begin inching the light therapy session earlier by 15 minutes per day, enabling your internal clock to synchronize with your desired sleepwake cycle and work schedule.
The personalized advice we give you here is based on a large clinical trial of patients with seasonal affective disorder (SAD) at Columbia University Medical Center in New York. Patients who took the light too late in the morning experienced only half the improvement of those who took it approximately at the times indicated. These guidelines are not only for SAD, but are also helpful in treatment of nonseasonal depression, for reducing insomnia at bedtime, and for reducing the urge to oversleep in the morning.
Our advice serves only as a general guideline for new users of light therapy. There are many individual factors that might call for a different schedule or dose (intensity, duration) of light. Any person with clinical depression should proceed with light therapy only under clinical guidance.
Reference: Terman M, Terman JS. Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects. CNS Spectrums, 2005;10:647-663. (Downloadable at www.cet.org) Copyright © 2008, Center for Environmental Therapeutics, www.cet.org. All rights reserved. This material may be copied without permission only for personal use. Use or distribution by commercial parties is prohibited.