Each year, thousands of athletes experience repetitive head acceleration events. These events increase concussion risk and are associated with sleep and emotional disturbances, including poor stress response and increased anxiety and depression symptoms. Transcranial photobiomodulation (tPBM), also known as low-level light or laser therapy, is an emerging treatment that may improve sleep, emotional functioning, and cognitive functioning, potentially promoting brain health. As part of a larger study, we tested the impact of tPBM on sleep and emotional functioning in Division I NCAA football athletes over the course of a football season.

This was a randomized, pilot, proof-of-concept study using a pre-/post- assessment design, comparing tPBM treatment against a sham control. Initially, 40 healthy, non-inured, NCAA Division I male American football athletes enrolled; one was excluded due to non-football injury, one was excluded due to dismissal from the team, and three discontinued prior to the commencement of the first session, leaving 35 athletes (18 randomized to the tPBM treatment [mean age: 21.6 +/- 1.5 years] and 17 randomized to the sham control group [mean age: 21.9 +/- 2.0 years]. Before the football season, participants underwent assessments using the STOP-BANG sleep apnea screener, Pittsburgh Sleep Quality Index (PSQI), Depression, Anxiety and Stress Scale – 21 (DASS-21), and the C3-Logix system’s Standard Assessment of Concussion (SAC) and graded concussion symptom checklist. All assessments were repeated post-season. Athletes completed tPBM treatments three times weekly for 18 weeks during the season using the Vielight Neuro Gamma system (810 nM light pulsing at 40-Hz using five transcranial LED diodes and one intranasal diode).

There were no significant differences in the number of treatments completed between groups. The treatment group averaged 38.8 +/- 7.6 treatments, and the sham control group averaged 34.9 +/- 12.2 treatments. The average tPBM exposure for participants in the treatment group was 9,306.7 +/- 1,819 J/cm2. Using latent difference score models parameterized as the difference between scores at time two and time one, we tested group differences in change scores. To address missing data, we used factored sequential regression. No significant between-group differences were observed in change scores across all outcome variables. Given the pilot nature of the study, we also examined outcomes to see if overall outcomes favored tPBM or sham. Concussion symptoms, emotional functioning, and sleep quality favored tPBM treatment compared to sham. Specifically, outcomes favored tPBM relative to sham for: 1) improved SAC score, 2) decreased symptoms of anxiety, depression, and stress, and 3) improved sleep quality. There were no observable differences between tPBM and sham in the concussion symptom score and sleep apnea symptoms.

Although there were no statistically significant change scores over time, the general trend of outcomes, particularly concerning emotional functioning and sleep, favored tPBM treatment over sham in a healthy non-injured group of athletes. These findings underscore the potential of tPBM as a viable treatment, suggesting the need for more extensive future trials.