College of Design, School of Architecture, Georgia Institute of Technology, Atlanta, GA, USA.
HDR Architecture, Omaha, NE, USA.
HERD. 2019 Oct;12(4):116-141. doi: 10.1177/1937586719827946. Epub 2019 Feb 20.
Lighting is one of the environmental factors which can improve patient sleep in healthcare environments. Due to the high degree of variation in study designs and results on this topic, the implications have been difficult to interpret. This review consolidates studies on the impact of bright light exposure on sleep to identify lighting conditions that can be applied and researched in future healthcare environments.
We searched for peer-reviewed articles on the impact of light on sleep or sleep-related outcomes in healthcare settings. We provided detailed analysis of the direct links between light and sleep, and a more cursory analysis of links between light and sleep-related factors, from 34 articles which met our inclusion criteria.
The current state of the literature includes evidence on how various durations and intensities of morning, midday, and evening bright light exposure, as well as whole-day light exposure interventions can improve specific aspects of sleep. Lighting interventions differed in all attributes (illuminance levels, exposure time, exposure duration, and spectral qualities) but showed promising results in improving patients' sleep.
Short-term bright light exposure in the morning, up to 2 hr of moderate (3,000-10,000 lux) morning exposures, up to 4 hr of moderate evening exposure, and whole-day exposures to lower illuminance levels (<3,000 lux) can improve patient sleep outcomes. Based on new findings on the mechanism through which light impacts sleep, future studies should be more specific about the spectral qualities of light sources.
照明是改善医疗环境中患者睡眠的环境因素之一。由于该主题的研究设计和结果存在高度差异，因此难以解释其影响。本综述汇总了关于强光照射对睡眠影响的研究，以确定可以在未来的医疗保健环境中应用和研究的照明条件。
我们搜索了关于光照对医疗环境中睡眠或与睡眠相关结果影响的同行评审文章。我们详细分析了光照与睡眠之间的直接联系，并从符合纳入标准的 34 篇文章中对光照与与睡眠相关因素之间的联系进行了粗略分析。
目前的文献证据包括各种时长和强度的晨间、午间和晚间强光照射，以及全日光照干预如何改善特定睡眠方面的证据。光照干预在所有属性（照度水平、暴露时间、暴露持续时间和光谱质量）上均存在差异，但在改善患者睡眠方面显示出有前景的结果。
晨间短期强光暴露，长达 2 小时的中等强度（3000-10000 勒克斯）晨间暴露，长达 4 小时的中等强度晚间暴露，以及全日低照度水平（<3000 勒克斯）的暴露可以改善患者的睡眠结果。基于光照影响睡眠机制的新发现，未来的研究应该更具体地说明光源的光谱质量。
