Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Norway; City Department of Health and Care, City of Bergen, Norway.
Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
Sleep Med Rev. 2020 Aug;52:101310. doi: 10.1016/j.smrv.2020.101310. Epub 2020 Mar 19.
Dementia is a devastating disease with a global impact, and there is an urgent need for effective interventions to alleviate the accompanying disturbances in behavior, mood, sleep, and circadian rhythms. Bright light treatment (BLT) is a promising non-pharmacological intervention; however, studies have yielded conflicting results. This systematic review provides a comprehensive overview of the effect of BLT in dementia, with a specific focus on how study characteristics might have affected the available results. The included studies were small and comprised time-limited interventions and follow-ups. Light values, adherence to treatment, and time of year were not consistently reported. Varying designs, methods, and population characteristics such as age, gender, dementia diagnosis, circadian phase, and baseline symptoms may have moderated the outcomes and affected review results. The use of crossover designs and too high illumination as placebo lights might have nullified positive effects of BLT. Because some studies had negative outcomes after ambient BLT with high amounts of short wavelengths, more modest light levels should be further investigated. Employing rigorous designs and detailed reporting of intervention characteristics, i.e., the illumination, correlated color temperature, timing, and duration of light utilized, are of utmost importance to establish the optimal treatment approach in this population. Systematic review registration number: PROSPERO CRD42017051004.
痴呆症是一种具有全球影响的破坏性疾病，迫切需要有效的干预措施来减轻随之而来的行为、情绪、睡眠和昼夜节律紊乱。强光治疗 (BLT) 是一种很有前途的非药物干预措施；然而，研究结果却存在矛盾。本系统评价全面概述了 BLT 在痴呆症中的作用，特别关注研究特征如何影响现有结果。纳入的研究规模较小，包括限时干预和随访。光照值、治疗依从性和一年中的时间并未得到一致报告。不同的设计、方法和人群特征，如年龄、性别、痴呆症诊断、昼夜节律相位和基线症状，可能会影响结果并影响综述结果。交叉设计的使用和作为安慰剂的光照太强可能会使 BLT 的积极效果无效。由于一些研究在使用高剂量短波长的环境 BLT 后结果为阴性，因此应进一步研究更适度的光照水平。采用严格的设计和详细报告干预特征，即使用的光照、相关色温、时间和持续时间，对于确定该人群的最佳治疗方法至关重要。系统评价注册编号：PROSPERO CRD42017051004。
