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早晨日光干预对老年患者昼夜节律和睡眠的影响:一项随机交叉试验。

Effects of a daylight intervention in the morning on circadian rhythms and sleep in geriatric patients: a randomized crossover trial.

作者信息

Schubert Anna, Laurentius Thea, Lange Svenja, Bertram Jens, Bollheimer Leo Cornelius, Schweiker Marcel, Christoforou Rania

机构信息

Healthy Living Spaces Lab, Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.

Department of Geriatric Medicine, RWTH Aachen University Hospital, 52074, Aachen, Germany.

出版信息

Eur Geriatr Med. 2025 Feb;16(1):281-292. doi: 10.1007/s41999-024-01100-z. Epub 2024 Dec 3.

Abstract

PURPOSE

During hospitalization, circadian rhythms and sleep are often disrupted, which has negative effects on health outcomes. Therefore, we aimed to investigate whether a daylight intervention in the morning could improve the circadian rhythms of cortisol and melatonin and enhance objective and subjective sleep quality in geriatric patients.

METHODS

The present study is a randomized, two-period crossover trial conducted in a geriatric ward in 15 non-demented geriatric trauma patients with a mean age of 83.1 ± 5.4 years. All patients underwent a daylight intervention period, during which they were exposed to a daylight lamp from 8:00 to 13:00 h, and a control period of 6 days each. Cortisol and melatonin levels were measured on day 5 of each period. Objective and subjective sleep quality were assessed using actigraphy and questionnaires, respectively. Within-participant differences between periods were investigated for all parameters.

RESULTS

A trend towards improvement in cortisol and melatonin rhythmicity was found. An increase in mean melatonin levels from 0.3 ± 0.1 to 0.9 ± 0.8 ng/L was observed during the intervention period (p = .063). There was also a trend towards increased sleep efficiency, whereas subjective sleep quality tended to decrease. None of the results were significant.

CONCLUSION

A daylight intervention in the morning led to a positive trend in cortisol and melatonin rhythmicity, whereas no improvement in subjective sleep quality was found.

TRIAL REGISTRATION

DRKS00028626 at German Clinical Trials Register, 13.06.2022.

摘要

目的

住院期间,昼夜节律和睡眠常常被打乱,这对健康结局有负面影响。因此,我们旨在研究早晨的日光干预是否能改善老年患者皮质醇和褪黑素的昼夜节律,并提高客观和主观睡眠质量。

方法

本研究是一项随机、两阶段交叉试验,在一个老年病房对15名平均年龄为83.1±5.4岁的非痴呆老年创伤患者进行。所有患者均经历一个日光干预期,在此期间他们于8:00至13:00暴露于日光灯下,以及各为期6天的对照期。在每个阶段的第5天测量皮质醇和褪黑素水平。分别使用活动记录仪和问卷评估客观和主观睡眠质量。对所有参数研究各阶段内参与者之间的差异。

结果

发现皮质醇和褪黑素节律性有改善趋势。在干预期间观察到平均褪黑素水平从0.3±0.1增加至0.9±0.8 ng/L(p = 0.063)。睡眠效率也有增加趋势,而主观睡眠质量有下降趋势。所有结果均无统计学意义。

结论

早晨的日光干预使皮质醇和褪黑素节律性呈积极趋势,而主观睡眠质量未得到改善。

试验注册

德国临床试验注册中心DRKS00028626,2022年6月13日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ed8/11850413/770bc07ee24f/41999_2024_1100_Fig1_HTML.jpg

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