School of Nursing, National Yang Ming Chiao Tung University, (School of Nursing, National Yang-Ming University), Psychiatric Nurse of City Hospital, Songde Branch, Taiwan.
Institute of Community Health Care, School of Nursing, National Yang Ming Chiao Tung University (School of Nursing, National Yang-Ming University), President of Lambda Beta-at-Large Chapter, The Honor Society of Nursing, Sigma Theta Tau International, Taiwan.
Sleep Med. 2022 Jan;89:1-9. doi: 10.1016/j.sleep.2021.10.011. Epub 2021 Oct 21.
Ambient light therapies are potentially effective in improving sleep disturbances and circadian rhythms. This study created a new lighting intervention model for elderly patients with dementia. It is hypothesized that exposure to bright ambient light in the morning is more effective than general lighting in improving sleep disturbances and circadian rhythms.
A single-blind longitudinal-group experimental design was employed. The dementia participants came from the community and nursing homes. Those in the experimental group were exposed to ambient light at 2500 lux, and those in the comparison group were exposed to 114-307 lux. The corresponding sleep disturbances and circadian rhythms were determined using an accelerometer (XA-5). A longitudinal experimental design was adopted to observe the time to an effective response.
The covariates of benzodiazepine use and total activity during the day were analyzed using generalized estimating equations. The experimental group showed significant sleep efficiency improvement, with mean increases of 41.9% (P < 0.001) and 31.7% (P = 0.002), sleep time increases of 141 min (P = 0.001) and 135 min (P = 0.008), awakening time decreases of 116 min (P = 0.001) and 108 min (P = 0.002), and sleep onset advancements of 60-84 min/sleep offset delays of 57-79 min upon the fifth and ninth week, respectively. A 4-week bright ambient light intervention was the most effective.
This study found that bright ambient light in the morning is beneficial for improving sleep disturbances and was driven by stabilizing circadian rhythms.
环境光照疗法在改善睡眠障碍和昼夜节律方面可能具有效果。本研究为痴呆老年患者创建了一种新的光照干预模型。假设在早晨暴露于明亮的环境光比一般照明更能改善睡眠障碍和昼夜节律。
采用单盲纵向组实验设计。痴呆参与者来自社区和疗养院。实验组暴露于 2500 勒克斯的环境光下，对照组暴露于 114-307 勒克斯的环境光下。使用加速度计（XA-5）确定相应的睡眠障碍和昼夜节律。采用纵向实验设计来观察有效反应的时间。
使用广义估计方程分析苯二氮䓬类药物使用和白天总活动的协变量。实验组的睡眠效率显著提高，平均增加 41.9%（P<0.001）和 31.7%（P=0.002），睡眠时间分别增加 141 分钟（P=0.001）和 135 分钟（P=0.008），觉醒时间分别减少 116 分钟（P=0.001）和 108 分钟（P=0.002），入睡时间提前 60-84 分钟/睡眠延迟时间分别推迟 57-79 分钟，在第五和第九周时。4 周的明亮环境光干预最为有效。
本研究发现，早晨的明亮环境光有利于改善睡眠障碍，并通过稳定昼夜节律来驱动。
