Volf Carlo, Aggestrup Anne Sofie, Petersen Paul Michael, Dam-Hansen Carsten, Knorr Ulla, Erkocevic Petersen Ema, Engstrøm Janus, Skov Hansen Torben, Østergaard Madsen Helle, Hageman Ida, Martiny Klaus
New Interventions in Depression (NID-GROUP), Copenhagen Affective Disorder Research Center (CADIC), Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Denmark.
Chronobiol Int. 2025 Aug 4:1-15. doi: 10.1080/07420528.2025.2530129.
Translational research has shown a profound impact of daylight and electrical lighting on circadian rhythms, sleep, mood, and alertness. Dynamic LED-lighting can mimic daily and seasonal changes in daylight by continuous changes in intensity and spectral distribution throughout the 24-hour day. The current study assessed the clinical effect of dynamic LED-lighting in a randomized controlled setup. In an affective disorders ward, 10 single patient rooms were fitted with a dynamic LED-lighting system, replacing the existing lighting, able to switch between a dynamic or a static mode. In the dynamic mode, daytime Melanopic Daylight Equivalent Illuminance (M-EDI) peaked at 10:30h with 576 lx M-EDI vs. 66 lx in the static mode. During the evening, the dynamic mode gradually reduced intensity to 0.3 lx M-EDI, with the static mode staying at 66 lx. Patients with major depression were randomly allocated to a static or a dynamic lighting mode in their room, lasting three weeks, with weekly assessments, and after 6 months. The primary outcome was the change in scores on the HAM-D6 scale from baseline to week 3. In all, 60 patients were included in the study with a 96.7% follow-up of the primary outcome. On the 6-item Hamilton Depression Rating Scale (HAM-D) scale, a significantly greater antidepressant effect of the dynamic light was seen at week 3 for females (71%) ( = 0.02), but not for the whole group ( = 0.47). At 6 months, a significantly greater effect of dynamic light was seen for the whole group ( = 0.03). Sleep diaries showed significantly longer sleep ( = 0.02), fewer awakenings ( = 0.04), and later sleep offset ( = 0.03) with dynamic light, for the whole group. The dynamic lighting system was well functioning. Participants were most satisfied with the dynamic light. These findings should be tested in larger studies with measurement of individual light exposure.
转化研究表明，自然日光和人工照明对昼夜节律、睡眠、情绪和警觉性有着深远影响。动态LED照明可以通过在全天24小时内持续改变光强和光谱分布来模拟日光的每日和季节性变化。本研究在随机对照试验中评估了动态LED照明的临床效果。在一个情感障碍病房中，10个单人病房安装了动态LED照明系统，取代了现有的照明设备，该系统能够在动态模式和静态模式之间切换。在动态模式下，白天的黑素视等效照度（M-EDI）在10:30达到峰值，为576勒克斯M-EDI，而静态模式下为66勒克斯。在晚上，动态模式逐渐将光强降低到0.3勒克斯M-EDI，而静态模式保持在66勒克斯。重度抑郁症患者被随机分配到房间内的静态或动态照明模式，持续三周，每周进行评估，并在6个月后进行评估。主要结局是从基线到第3周汉密尔顿抑郁量表（HAM-D6）评分的变化。共有60名患者纳入研究，主要结局的随访率为96.7%。在6项汉密尔顿抑郁量表（HAM-D）上，第3周时动态光对女性的抗抑郁效果显著更强（71%）（P = 0.02），但对整个组没有显著差异（P = 0.47）。在6个月时，整个组动态光的效果显著更强（P = 0.03）。睡眠日记显示，对于整个组来说，动态光下的睡眠时间显著更长（P = 0.02）、觉醒次数更少（P = 0.04）且睡眠结束时间更晚（P = 0.03）。动态照明系统运行良好。参与者对动态光最为满意。这些发现应在更大规模的研究中进行测试，并测量个体的光照暴露情况。
