Journal
SLEEP MEDICINE REVIEWS
Volume 46, Issue -, Pages 108-123Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.smrv.2019.04.012
Keywords
Bright light treatment; Dark treatment; Dawn simulation; Circadian rhythm sleep disorders; Co-morbid insomnia; Mental illness; Dementia; Delayed sleep phase disorder; Affective disorders; Psychosis
Categories
Funding
- National Institute for Health Research (NIHR) [ICA-CDRF-2016-02-007]
- Health Education England
- MRC [MR/P001378/1] Funding Source: UKRI
- National Institutes of Health Research (NIHR) [ICA-CDRF-2016-02-007] Funding Source: National Institutes of Health Research (NIHR)
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Circadian dysregulation causes sleep disturbance and impacts quality of life and functioning. Some interventions target circadian entrainment through modifying light exposure, but existing reviews of light interventions for sleep improvement include few studies in psychiatric populations. We examined effect of light interventions on sleep quality, duration and timing, and effect moderators. We included controlled studies in intrinsic circadian rhythm disorders (such as advanced or delayed sleep) and in neuropsychiatric disorders with assumed high prevalence of circadian dysregulation (such as affective and psychotic disorders). Articles were identified through database searching: 40 studies reporting 49 relevant intervention comparisons met inclusion criteria. Meta-analysis showed improvements in sleep continuity (ES = -0.23, p = 0.000), self-reported sleep disturbance (ES = -0.32, p = 0.014), and advancement of delayed sleep timing (ES = -0.34, p = 0.010). Although the small number of studies limited meta-regression, evening light avoidance was associated with greater increase in total sleep time. Effects of light on sleep and circadian outcomes have received limited attention in studies in psychiatric disorders, but results were promising in these groups. These findings invite further refinement and testing of light interventions to improve sleep in psychiatric disorders, with improved assessment and specification of problems, and the development and implementation of light schedule interventions for delayed sleep. (C) 2019 The Authors. Published by Elsevier Ltd.
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