Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer's disease.
Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer's disease.
复制标题
强光治疗阿尔茨海默病患者的行为和睡眠障碍。
DOI：
10.1176/ajp.149.8.1028
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Campbell,S
中科院分区：
文献类型：
--
作者：
Satlin,A;Volicer,L;Ross,V;Herz,L;Campbell,S
目的验证晚间强光脉冲可以改善阿尔茨海默病患者睡眠-觉醒模式和减少躁动的假设。阿尔茨海默病患者有严重的日落(一种在下午晚些时候或傍晚早些时候反复出现神志不清和躁动增加的综合征)和睡眠障碍。所有患者都有日落行为和睡眠障碍。在一周的基线测量后，患者在晚上7：00到晚上9：00之间每天接受2小时的强光照射，持续1周。在基线周、治疗周和治疗后一周，护士对患者的躁动、睡眠-觉醒模式、约束措施的使用和按需开出的药物的使用情况进行评分。在每周的最后两天，患者佩戴活动监测器。活动计数分析昼夜节律。结果在10名患者中，有8名患者在夜间护理班的睡眠-觉醒临床评分在光治疗后有所改善。在光照处理周，夜间发生的总日常活动的比例下降。昼夜节律运动活动节律的相对幅度在光疗周期间增加，这是衡量其稳定性的一个指标。基线日落越重，临床改善越明显。结论晚间强光脉冲可改善部分阿尔茨海默病患者的睡眠-觉醒周期紊乱。这种作用可能是通过时间生物学机制来调节的。
ObjectiveThe authors tested the hypothesis that evening bright light pulses would improve sleep-wake patterns and reduce agitation in patients with Alzheimer's disease who have severe sundowning (a syndrome of recurring confusion and increased agitation in the late afternoon or early evening) and sleep disorders.MethodTen inpatients with Alzheimer's disease on a research ward of a veterans' hospital were studied in an open clinical trial. All patients had sundowning behavior and sleep disturbances. After a week of baseline measurements, patients received 2 hours/day of exposure to bright light between 7: 00 pm and 9: 00 pm for 1 week. During the baseline week, the treatment week, and a posttreatment week, patients were rated by nurses for agitation, sleep-wake patterns, use of restraints, and use of prescribed-as-needed medication. On the last 2 days of each week, patients wore activity monitors. Activity counts were analyzed for circadian rhythmicity.ResultsClinical ratings of sleep-wakefulness on the evening nursing shift improved with light treatment in eight of the 10 patients. The proportion of total daily activity occurring during the nighttime decreased during the light-treatment week. The relative amplitude of the circadian locomotor activity rhythm, a measure of its stability, increased during the light-treatment week. More severe sundowning at baseline predicted greater clinical improvement.ConclusionsEvening bright light pulses may ameliorate sleep-wake cycle disturbances in some patients with Alzheimer's disease. This effect may be mediated through a chronobiological mechanism.