Effect of exposure to evening light on sleep initiation in the elderly: A longitudinal analysis for repeated measurements in home settings
Effect of exposure to evening light on sleep initiation in the elderly: A longitudinal analysis for repeated measurements in home settings
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DOI：
10.3109/07420528.2013.840647
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发表时间：
2014-01-01
影响因子：
2.8
通讯作者：
Kurumatani, Norio
中科院分区：
文献类型：
--
作者：
Obayashi, Kenji;Saeki, Keigo;Kurumatani, Norio
流行病学数据表明，睡眠失眠与多种疾病有关，包括抑郁症、痴呆症、糖尿病和心血管疾病。睡眠的启动由下丘脑视交叉上核和内源性褪黑素控制，两者都受到环境光的影响。据推测，晚光暴露会导致睡前的昼夜节律延迟和褪黑素抑制，从而导致昼夜节律失调和睡眠失眠；然而，是否暴露在傍晚的灯光下干扰了家庭环境中的睡眠启动仍不清楚。在这项对192名老年人(平均年龄：69.9岁)的纵向分析中，我们使用手腕活动仪测量了4天的晚光暴露和入睡潜伏期，其中包括测光仪和加速计。重复测量的混合效应线性回归分析被用来评估晚光暴露对随后的入睡潜伏期的影响。夜间光照强度和入睡潜伏期的中位数分别为27.3勒克斯(四分位数范围17.9-43.4)和17分钟(四分位数范围7-33)。单变量模型显示，入睡潜伏期与年龄、性别、白天体力活动、卧床时间、白天长度以及傍晚和夜间光线暴露的平均强度之间存在显著关联。在多变量模型中，夜间光线暴露的对数转换平均强度与对数转换后的入睡潜伏期显著相关，与先前的潜在混杂因素无关(回归系数，0.133；95%可信区间，0.020-0.247；p=0.021)。白昼长度和夜间光线暴露也与对数转换睡眠开始潜伏期显著相关(p=0.001和p
Epidemiologic data have demonstrated associations of sleep-onset insomnia with a variety of diseases, including depression, dementia, diabetes and cardiovascular diseases. Sleep initiation is controlled by the suprachiasmatic nucleus of the hypothalamus and endogenous melatonin, both of which are influenced by environmental light. Exposure to evening light is hypothesized to cause circadian phase delay and melatonin suppression before bedtime, resulting in circadian misalignment and sleep-onset insomnia; however, whether exposure to evening light disturbs sleep initiation in home settings remains unclear. In this longitudinal analysis of 192 elderly individuals (mean age: 69.9 years), we measured evening light exposure and sleep-onset latency for 4 days using a wrist actigraph incorporating a light meter and an accelerometer. Mixed-effect linear regression analysis for repeated measurements was used to evaluate the effect of evening light exposure on subsequent sleep-onset latency. The median intensity of evening light exposure and the median sleep-onset latency were 27.3 lux (interquartile range, 17.9-43.4) and 17 min (interquartile range, 7-33), respectively. Univariate models showed significant associations between sleep-onset latency and age, gender, daytime physical activity, in- bed time, day length and average intensity of evening and nighttime light exposures. In a multivariate model, log-transformed average intensity of evening light exposure was significantly associated with log-transformed sleep-onset latency independent of the former potential confounding factors (regression coefficient, 0.133; 95% CI, 0.020-0.247; p =0.021). Day length and nighttime light exposure were also significantly associated with log-transformed sleep-onset latency (p =0.001 and p