Adherence and acceptability of light therapies to improve sleep in intrinsic circadian rhythm sleep disorders and neuropsychiatric illness: a systematic review

Faulkner, Sophie; Dijk, Derk‐Jan; Drake, Richard; Bee, Penny

doi:10.1016/j.sleh.2020.01.014

Cited by 21 publications

(17 citation statements)

References 109 publications

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“…We therefore suggest that existing cognitive behavior therapies for insomnia (CBT-I) be adapted for this population, by emphasizing pragmatic circadian interventions that do not necessarily require technologies such as timed bright light therapy from light boxes, which are time consuming and not easily embedded into daily routines. 40 Increasing light exposure can be facilitated by simple and inexpensive behavioral interventions, such as sleep and activity schedules which encourage regular exposure to daylight and modifications that promote natural light in living spaces. Providing lux meters may also help.…”

Section: Discussionmentioning

confidence: 99%

Extracting Circadian and Sleep Parameters from Longitudinal Data in Schizophrenia for the Design of Pragmatic Light Interventions

Skeldon

Dijk

Meyer

et al. 2021

Schizophrenia Bulletin

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Sleep and circadian rhythm dysfunction is prevalent in schizophrenia, is associated with distress and poorer clinical status, yet remains an under-recognized therapeutic target. The development of new therapies requires the identification of the primary drivers of these abnormalities. Understanding of the regulation of sleep–wake timing is now sufficiently advanced for mathematical model-based analyses to identify the relative contribution of endogenous circadian processes, behavioral or environmental influences on sleep-wake disturbance and guide the development of personalized treatments. Here, we have elucidated factors underlying disturbed sleep-wake timing by applying a predictive mathematical model for the interaction of light and the circadian and homeostatic regulation of sleep to actigraphy, light, and melatonin profiles from 20 schizophrenia patients and 21 age-matched healthy unemployed controls, and designed interventions which restored sleep-circadian function. Compared to controls, those with schizophrenia slept longer, had more variable sleep timing, and received significantly fewer hours of bright light (light > 500 lux), which was associated with greater variance in sleep timing. Combining the model with the objective data revealed that non 24-h sleep could be best explained by reduced light exposure rather than differences in intrinsic circadian period. Modeling implied that late sleep offset and non 24-h sleep timing in schizophrenia can be normalized by changes in environmental light–dark profiles, without imposing major lifestyle changes. Aberrant timing and intensity of light exposure patterns are likely causal factors in sleep timing disturbances in schizophrenia. Implementing our new model-data framework in clinical practice could deliver personalized and acceptable light–dark interventions that normalize sleep-wake timing.

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Section: Discussionmentioning

confidence: 99%

Extracting Circadian and Sleep Parameters from Longitudinal Data in Schizophrenia for the Design of Pragmatic Light Interventions

Skeldon

Dijk

Meyer

et al. 2021

Schizophrenia Bulletin

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“…However, meta-analyses of light therapy have been somewhat inconsistent, and the heterogeneous effects of light treatment on dementia are not yet fully explained (Forbes et al, 2009(Forbes et al, , 2014Shikder et al, 2012;Hanford and Figueiro, 2013;van Maanen et al, 2016;Chiu et al, 2017;Mitolo et al, 2018;Missotten et al, 2019). Some of the factors influencing its effectiveness are light intensity, spectral composition, duration, timing, exposure patterns, dementia type, sleep patterns, dementia severity, and acceptance of and adherence to the regimen (Forbes et al, 2009(Forbes et al, , 2014Shikder et al, 2012;Hanford and Figueiro, 2013;van Maanen et al, 2016;Chiu et al, 2017;Figueiro, 2017;Mitolo et al, 2018;Missotten et al, 2019;Faulkner et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…In the present study, we used a lighting intervention model with horizontal illumination of at least 2,500 lux (McCurry et al, 2005(McCurry et al, , 2011Dowling et al, 2007;Sloane et al, 2007;van Maanen et al, 2016;Chiu et al, 2017;Missotten et al, 2019) within a 45 • visual field (McCurry et al, 2005(McCurry et al, , 2011 for at least 60 min/day in the morning from 9 am to 10 am (Dowling et al, 2005(Dowling et al, , 2007Zhou et al, 2012;van Maanen et al, 2016;Faulkner et al, 2020) for at least 2-4 weeks (Skjerve et al, 2004;Figueiro et al, 2014;Figueiro, 2017;Missotten et al, 2019). The treatment was administered in a group-based setting to improve adherence and acceptability for older adults with dementia (McCurry et al, 2011;van der Wardt et al, 2017;Vseteckova et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Pilot Study of the Effects of Bright Ambient Therapy on Dementia Symptoms and Cognitive Function

2021

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Light therapy potentially improves dementia symptoms. In this study, we examined the effects of bright light therapy on neuropsychiatric behaviors and cognitive function. Thirty-five participants were assigned to either the experimental or comparison group. The experimental group was exposed to bright light at 2,500 lux, and the comparison group was exposed to 114–307 lux. The instruments used were the Neuropsychiatric Inventory and the Mini-Mental State Examination. The experimental group showed a significant improvement in Neuropsychiatric Inventory scores; these scores, which were calculated using generalized estimating equations with medication (benzodiazepines) as a covariate, were reduced by 65% (P < 0.001) and 78% (P = 0.001) by the 5th and 9th weeks, respectively. At the same time, Mini-Mental State Examination scores increased by 19% (P = 0.007) and 28% (P = 0.04), respectively. However, differences in outcomes between the 5th and 9th weeks were not significant. A 4-week regimen of bright light therapy was the most effective, with higher adherence and acceptability.

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“…For example, when studying the effect of infrastructural changes in the built environment on physical activity (Stappers et al, 2018). But also on a much smaller scale, when looking at the relationship between exposure to light and sleep behavior (Faulkner et al, 2020).…”

Section: Technologymentioning

confidence: 99%

Hardwired… to self-destruct? Using technology to improve behavior change science

Crutzen¹

2020

Preprint

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Adherence and acceptability of light therapies to improve sleep in intrinsic circadian rhythm sleep disorders and neuropsychiatric illness: a systematic review

Cited by 21 publications

References 109 publications

Extracting Circadian and Sleep Parameters from Longitudinal Data in Schizophrenia for the Design of Pragmatic Light Interventions

Extracting Circadian and Sleep Parameters from Longitudinal Data in Schizophrenia for the Design of Pragmatic Light Interventions

Pilot Study of the Effects of Bright Ambient Therapy on Dementia Symptoms and Cognitive Function

Hardwired… to self-destruct? Using technology to improve behavior change science

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