scholarly journals Methodological challenges in studies of bright light therapy to treat sleep disorders in nursing home residents with dementia

2014 ◽  
Vol 68 (11) ◽  
pp. 777-784 ◽  
Author(s):  
Eva S. van der Ploeg ◽  
Daniel W. O'Connor
2020 ◽  
Vol 77 (1) ◽  
pp. 113-125 ◽  
Author(s):  
Ilaria Roccaro ◽  
Daniela Smirni

Background: A system of photosensitive retinal ganglion cells provides ‘non-visual’ information on the circadian sequences of light to the suprachiasmatic nucleus (SCN), which, as the ‘master clock’, synchronizes the chronobiological mechanisms of all the biological clocks. Damage to SCN structure alters circadian behavioral and hormonal rhythms and interferes with a regular sleep-wake pattern. Several studies have shown that, in aging and in Alzheimer’s disease (AD), circadian rhythms change their synchronization with the environment and behavior loses sync with light. Objective: The current overview aims to examine research studies showing the effect of bright light therapy (BLT) on sleep disorders and sleep-wake patterns in AD. Methods: A literature search was conducted, taking into consideration the relevant studies over the last 20 years. Fifteen studies have been thorough: seven followed an environmental-architectural approach and eight followed a treatment devices approach. Results: Studies agree in considering BLT as a promising non-pharmacological intervention to compensate for circadian rhythm alterations and they support the need for standardized protocols that allow a comparison between multicenter studies. Conclusion: Interestingly, in an attempt to contain the spread of the COVID-19 pandemic, health authorities have forced the population to stay home. Therefore, AD people are not currently able to enjoy exposure to sunlight. It is predictable that they may experience an exacerbation of circadian disturbances and that the BLT can be an effective response to prevent such exacerbation.


2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sonja Rutten ◽  
Chris Vriend ◽  
Odile A. van den Heuvel ◽  
Jan H. Smit ◽  
Henk W. Berendse ◽  
...  

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.


Author(s):  
Sarah Bogen ◽  
Tanja Legenbauer ◽  
Stephanie Gest ◽  
Martin Holtmann

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.



Neurology ◽  
2019 ◽  
pp. 10.1212/WNL.0000000000007090 ◽  
Author(s):  
Sonja Rutten ◽  
Chris Vriend ◽  
Jan H. Smit ◽  
Henk W. Berendse ◽  
Eus J.W. van Someren ◽  
...  

2021 ◽  
Author(s):  
Canazei Markus ◽  
Weninger Johannes ◽  
Pohl Wilfried ◽  
Marksteiner Josef ◽  
Weiss Elisabeth

Abstract Bright light therapy is an effective treatment option for seasonal and non-seasonal affective disorders. However up to now, no study has investigated effects of dynamic bedroom lighting in hospitalized patients with major depression. A bedroom lighting system, which automatically delivered artificial dawn and dusk and blue-depleted nighttime lighting (DD-N lighting) was installed in a psychiatric ward. Patients with moderate to severe depression were randomly assigned to stay in bedrooms with the new lighting or standard lighting system. Patients wore wrist actimeters during the first two treatment weeks. Additionally, hospitalization duration and daily psychotropic medication were retrieved from patients’ medical charts. Data from thirty patients were analyzed. Patients under DD-N lighting generally woke up earlier (+20 minutes), slept longer (week 1: +11 min; week 2: +27 min) and showed higher sleep efficiency (+2.4%) and shorter periods of nighttime awakenings (-15 minutes). In the second treatment week, patients started sleep and the most active 10-hour period earlier (-33 min and -64 min, respectively). This pilot study gives first evidence that depressed patients’ sleep and circadian rest/activity system may benefit from adjunctive bedroom lighting when starting inpatient treatment.


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