DAYTIME PHOTOTHERAPY FOR
CRIGLER NAJJAR SYNDROME (CNS)

WHO WOULD BENEFIT FROM DAY PHOTOTHERAPY?

Day phototherapy has been developed to a point where it provides a valid option for most CNS people.

For small children under 5 years and for some very active children sleeping under lights may be preferable to sitting in lights awake for even one hour (or two half hours). Nevertheless day phototherapy should be considered for children over 5 years.

For people who can control blood bilirubin levels by using phenobarbital any form of phototherapy is only required if side effects of phenobarbital are unacceptable. In this case day phototherapy is a valid option. In one case a CNS lady used innovative day phototherapy during her pregnancy because of concern of phenobarbital side effects.

For people who have night phototherapy for up to 8 or 9 hours, well designed day phototherapy should be capable of controlling blood bilirubin in about two hours per day or less. The safety margin and lifestyle advantages provided over night phototherapy are substantial.

CNS people that require more than 9 hours single-sided night phototherapy reach an age where they do not sleep for 9 hours. Phototherapy must then intrude into waking hours or blood bilirubin levels will rise. For these people day phototherapy as described, is presently the only valid alternative to having a liver transplant.

For anyone who prefers phototherapy while asleep, having (say) 7 hours night phototherapy and one hour day phototherapy may be a valid option.

The vast majority of adults no longer wish to sleep alone. For these people night phototherapy is unacceptable. Well-designed day phototherapy is a valid option for these people. For adults sitting in lights in the evening for (depending on the seriousness of their CNS) 1-3 hours while reading, watching television or using a computer may not be too great a burden. It is a valid alternative to having a liver transplant.

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Copyright 2006.