scholarly journals The Impact of Environmental Risk Factors on Delirium and Benefits of Noise and Light Modifications: A Scoping Review

2020 ◽  
Author(s):  
Haleh Hashemighouchani ◽  
Julie Cupka ◽  
Jessica Lipori ◽  
Matthew M Ruppert ◽  
Elizabeth Ingersent ◽  
...  
Keyword(s):  
Risk Factors ◽  
Circadian Rhythm ◽  
Noise Exposure ◽  
Light Exposure ◽  
Bright Light ◽  
Light Therapy ◽  
Quiet Time ◽  
Bright Light Therapy ◽  
Or Management ◽  
The Impact

ABSTRACTPurposeTo explore existing literature on the association between environmental risk factors with delirium and to investigate the effectiveness of environmental modifications on prevention or management of delirium.Materials and MethodsThis is a scoping review of peer-reviewed studies in Pubmed and the reference lists of reviewed articles. Observational studies reporting the effect of noise, light, and circadian rhythm on delirium and interventional studies assessing delirium in modified environments were reviewed.ResultsThirty eight studies were included, of which, 21 evaluated impact of environment on delirium, and 16 studied the interventions. Interventions targeted reducing noise exposure, improving light exposure to follow circadian rhythm, and promoting sleep. Mixed findings of the reviewed studies yielded to inconclusive results; however quiet-time protocols, earplugs, and bright light therapy might benefit prevention, or management of delirium.ResultsThirty seven studies were included, 21 of which evaluated the impact of environment on delirium and 16 studied possible solutions to mitigate those impacts. Mixed findings of the reviewed studies yielded inconclusive results; a clearly delineated association between high noise levels, abnormal amounts of light exposure, and sleep disruption with delirium could not be established. Interventions targeted reducing noise exposure, improving day-time and mitigating night-time light exposure to follow circadian rhythm, and promoting sleep. The overall evidence supporting effectiveness of environmental interventions was also of a low confidence; however, quiet-time protocols, earplugs, and bright light therapy showed a benefit for prevention or management of delirium.ConclusionEnvironmental modifications are non-invasive, risk-free, and low-cost strategies that may be beneficial in preventing and managing delirium, especially when used as part of a multi-component plan. However, given the limited evidence-based conclusions, further high-quality and larger studies focusing on environmental modifications and delirium outcomes are strongly recommended.

scholarly journals The impact of environmental risk factors on delirium and benefits of noise and light modifications: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1183
Author(s):  
Haleh Hashemighouchani ◽  
Julie Cupka ◽  
Jessica Lipori ◽  
Matthew M. Ruppert ◽  
Elizabeth Ingersent ◽  
...  
Keyword(s):  
Risk Factors ◽  
Circadian Rhythm ◽  
Environmental Risk ◽  
Scoping Review ◽  
Light Exposure ◽  
Environmental Risk Factors ◽  
Quiet Time ◽  
Environmental Interventions ◽  
Or Management ◽  
The Impact

Background: To explore existing literature on the association between environmental risk factors and delirium, and to investigate the effectiveness of environmental modifications on prevention or management of delirium. Methods: This is a scoping review of peer-reviewed studies in PubMed and the reference lists of reviewed articles. Observational studies reporting the effect of noise, light, and circadian rhythm on delirium and interventional studies assessing delirium in modified environments were reviewed. Results: 37 studies were included, 21 of which evaluated the impact of environment on delirium and 16 studied possible solutions to mitigate those impacts. Mixed findings of the reviewed studies yielded inconclusive results; a clearly delineated association between high noise levels, abnormal amounts of light exposure, and sleep disruption with delirium could not be established. The environmental interventions targeted reducing noise exposure, improving daytime and mitigating night-time light exposure to follow circadian rhythm, and promoting sleep. The overall evidence supporting effectiveness of environmental interventions was also of a low confidence; however, quiet-time protocols, earplugs, and bright light therapy showed a benefit for prevention or management of delirium. Conclusions: Environmental modifications are non-invasive, risk-free, and low-cost strategies that may be beneficial in preventing and managing delirium, especially when used as part of a multi-component plan. However, given the limited evidence-based conclusions, further high-quality and larger studies focusing on environmental modifications and delirium outcomes are strongly recommended.

Use of bright light therapy for older adults with dementia

2020 ◽  
Vol 26 (4) ◽  
pp. 221-228
Author(s):  
Lisa L. Onega ◽  
Thomas W. Pierce
Keyword(s):  
Older Adults ◽  
Light Exposure ◽  
Bright Light ◽  
Light Therapy ◽  
Adjunctive Treatment ◽  
Evidence Based ◽  
Bright Light Therapy ◽  
The Past ◽  
Bright Light Exposure ◽  
Circadian Rhythm Disorders

SUMMARYBright light therapy is an accepted and commonly used treatment for seasonal affective and circadian rhythm disorders. In the past 20 years, researchers have examined the effectiveness of bright light therapy in improving depression and agitation in older adults with dementia. This article provides clinicians with a summary of the neurophysiology of bright light therapy, bright light research considerations, an evidence-based bright light protocol, problems related to bright light therapy, and clinical implications for bright light therapy in older adults with dementia. Bright light exposure is a safe, non-pharmacological treatment that is currently underutilised in this population. Clinicians may find bright light therapy beneficial as a primary or adjunctive treatment in reducing depression and agitation in older adults with dementia.

scholarly journals Shining the Light on the MotionWatch8 Light Sensor for Sleep and Aging Research: What Can We Measure and What Are We Missing?

2021 ◽  
Vol 5 (1) ◽  
pp. 55-63
Author(s):  
Ryan S. Falck ◽  
Rachel A. Crockett ◽  
Jennifer C. Davis ◽  
Karim M. Khan ◽  
Teresa Liu-Ambrose
Keyword(s):  
Light Exposure ◽  
Bright Light ◽  
Light Therapy ◽  
Poor Sleep ◽  
Bright Light Therapy ◽  
Field Methods ◽  
Aging Research ◽  
Cut Points ◽  
Light Sensor ◽  
Receiver Operator Characteristics

Background: Poor sleep is common among older adults at risk for dementia and may be due to circadian dysregulation. Light is the most important external stimulus to the circadian clock and bright light therapy (BLT) has been used for >20 years to help realign circadian rhythms. However, the ability of field methods (e.g., actigraphy) to accurately determine the type and intensity of light is unknown. Objective: We examined the ability of the MotionWatch8 (MW8) light sensor to determine: 1) light versus dark, 2) electrical light versus daylight, and 3) device-based BLT versus light which was not BLT. Methods: We tested the MW8 under 17 daily light scenarios. Light exposure data was collected for 5 minutes during each scenario. Concurrently, we measured light exposure using the LT40 Light Meter, a sensitive measure of light intensity. We then developed individual cut-points using receiver operator characteristics analyses to determine optimal MW8 cut-points for 1) light versus dark; 2) electrical light versus daylight; and 3) light from a BLT box versus light which was not BLT. Bland-Altman plots tested the precision of the MW8 compared to the LT40. Results: The MW8 accurately discriminated light versus dark (>32 lux), and electrical light versus daylight (<323 lux). However, the MW8 had poor accuracy for 1) discriminating BLT from light which was not BLT; and 2) low precision compared to the LT40. Conclusion: The MW8 appears to be able to discern light versus dark and electrical light versus daylight; however, there remains a need for accurate field methods capable of measuring light exposure.

Bright Light Therapy Protects Women from Circadian Rhythm Desynchronization During Chemotherapy for Breast Cancer

2012 ◽  
Vol 10 (3) ◽  
pp. 202-216 ◽  
Author(s):  
Ariel B. Neikrug ◽  
Michelle Rissling ◽  
Vera Trofimenko ◽  
Lianqi Liu ◽  
Loki Natarajan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Circadian Rhythm ◽  
Bright Light ◽  
Light Therapy ◽  
Bright Light Therapy

scholarly journals Bright Light Therapy in Parkinson's Disease: An Overview of the Background and Evidence

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sonja Rutten ◽  
Chris Vriend ◽  
Odile A. van den Heuvel ◽  
Jan H. Smit ◽  
Henk W. Berendse ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Treatment Options ◽  
Bright Light ◽  
Light Therapy ◽  
Current Treatment ◽  
Bright Light Therapy ◽  
Positive Effect

Sleep disorders are common in Parkinson's disease (PD) and seem to be strongly associated with depression. It has been suggested that sleep disorders as well as depression are caused by a disturbed circadian rhythm. Indeed, PD patients are prone to misalignment of their circadian rhythm due to various factors, and many patients with PD display a phase advance of their circadian rhythm. Current treatment options for sleep disorders and depression in patients with PD are limited and can have serious side effects; alternative treatments are therefore badly needed. Bright light therapy (BLT) restores circadian rhythmicity effectively in mood- and sleep-disturbed patients without PD. The few studies that focused on the efficacy of BLT in patients with PD demonstrated a positive effect of BLT not only on sleep and mood but also on motor function. More research on the neurobiology and efficacy of BLT in PD is warranted.

Is Seasonal Affective Disorder a Disorder of Circadian Rhythms?

CNS Spectrums ◽  
2001 ◽  
Vol 6 (6) ◽  
pp. 487-501 ◽  
Author(s):  
Paul H. Desan ◽  
Dan A. Oren
Keyword(s):  
Circadian Rhythms ◽  
Phase Shift ◽  
Affective Disorder ◽  
Clinical Improvement ◽  
Seasonal Affective Disorder ◽  
Light Exposure ◽  
Bright Light ◽  
Light Therapy ◽  
Bright Light Therapy ◽  
The Relationship

AbstractSeasonal affective disorder (SAD) is a form of depression that starts in the fall and ends in the spring. This article reviews existing theories about the relationship between circadian rhythms and the disorder. Recent research indicates that as with pharmacologic antidepressants, at least 2–4 weeks are needed to demonstrate the effectiveness of bright-light therapy compared to placebo. The response to such treatment is strongest with precisely timed light exposure: treatment is optimal during the morning hours when the circadian systemt is susceptible to phase advance. Such clinical improvement is correlated with the magnitude of the phase shift induced. These observations suggest a model of circadian function in SAD and provide important guidelines for its treatment.

scholarly journals Circadian Rhythm Dysregulation and Restoration: The Role of Melatonin

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3480
Author(s):  
Clayton Vasey ◽  
Jennifer McBride ◽  
Kayla Penta
Keyword(s):  
Circadian Rhythm ◽  
Driving Force ◽  
Bright Light ◽  
Light Therapy ◽  
Bright Light Therapy ◽  
The Past ◽  
Search Terms ◽  
Circadian Rhythm Disorder ◽  
Rhythm Disorder

Sleep is an essential component of overall human health but is so tightly regulated that when disrupted can cause or worsen certain ailments. An important part of this process is the presence of the well-known hormone, melatonin. This compound assists in the governing of sleep and circadian rhythms. Previous studies have postulated that dysregulation of melatonin rhythms is the driving force behind sleep and circadian disorders. A computer-aided search spanning the years of 2015–2020 using the search terms melatonin, circadian rhythm, disorder yielded 52 full text articles that were analyzed. We explored the mechanisms behind melatonin dysregulation and how it affects various disorders. Additionally, we examined associated therapeutic treatments including bright light therapy (BLT) and exogenous forms of melatonin. We found that over the past 5 years, melatonin has not been widely investigated in clinical studies thus there remains large gaps in its potential utilization as a therapy.

Morning bright light therapy: a helpful tool for reducing comorbid symptoms of affective and behavioral dysregulation in juvenile depressed inpatients? A pilot trial

2017 ◽  
Vol 45 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Sarah Bogen ◽  
Tanja Legenbauer ◽  
Stephanie Gest ◽  
Martin Holtmann
Keyword(s):  
Pilot Trial ◽  
Secondary Analysis ◽  
Bright Light ◽  
Light Therapy ◽  
Bright Light Therapy ◽  
Circadian Phase ◽  
Behavioral Dysregulation ◽  
Sleep Parameters ◽  
Circadian Effect ◽  
Dysregulation Profile

Abstract. Objective: In recent years, bright light therapy (BLT) has been used to treat depression and to stabilize circadian rhythms. In this study we evaluated whether it is also helpful for comorbid symptoms of affective and behavioral dysregulation in depressive inpatients. Method: This article reports a secondary analysis comparing two subgroups of depressive participants with comorbid affective and behavioral dysregulation, captured with the dysregulation-profile of the Strengths and Difficulties Questionnaire (SDQ-DP; n = 16 vs. n = 11). Participants were randomly allocated to active BLT (10,000 lux) or control BLT (approx. 100 lux), and received 45 minutes of BLT for 2 weeks. SDQ-DP scores, sleep parameters, and circadian preference were assessed at baseline, after the intervention, and 3 weeks later. Results: No direct effects on SDQ-DP scores were observed. Sleep improved in both conditions. Only in the active BLT condition was a circadian phase advance found. Correlation and regression analyses indicated an indirect, circadian effect for improved SDQ-DP scores. Conclusions: The data of this pilot trial should be considered preliminary and merely descriptive. Further research is warranted.


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