The Effectiveness of Light/Dark Exposure to Treat Insomnia in Female Nurses Undertaking Shift Work during the Evening/Night Shift
The Effectiveness of Light/Dark Exposure to Treat Insomnia in Female Nurses Undertaking Shift Work during the Evening/Night Shift
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DOI：
10.5664/jcsm.2824
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发表时间：
2013-01-01
影响因子：
4.3
通讯作者：
Hsu, Shih-Chieh
中科院分区：
文献类型：
--
作者：
Huang, Li-Bi;Tsai, Mei-Chu;Hsu, Shih-Chieh
研究目的：本研究调查了晚班/夜班前半段的强光照射与早晨的光衰减是否能有效改善患有临床失眠症的轮班护士的睡眠问题。方法：这是一项前瞻性、随机对照研究。失眠严重程度指数（ISI）和医院焦虑抑郁量表（HADS）分别用于评估失眠和焦虑/抑郁严重程度。招募了在晚间或夜班轮班且 ISI 评分 > 14 的女性医院护士。治疗组中的受试者 (n = 46) 暴露在 7,000-10,000 勒克斯的强光下 >= 30 分钟。两周内持续暴露至少 10 天，受试者下班后戴墨镜避免白天户外阳光照射。对照组（n = 46）的受试者没有暴露在强光下，但在工作后也戴上了太阳镜。进行统计分析以检查组间差异和治疗间差异。结果：治疗后，与治疗前相比，治疗组的 ISI 评分以及 HADS 总分和子量表评分均显着改善。与对照组相比，治疗组的 ISI、HADS 和 HADS 分量表评分均得到显着改善。结论：本研究的设计易于在现实世界中付诸实践。这是第一项研究，证明患有临床失眠症的女护士在轮班/夜班的前半段接受更高强度和更短时间的强光照射，并在白天进行黑暗程序，可以改善她们的失眠、焦虑和抑郁严重程度。
Study Objectives: The present study investigated whether bright light exposure during the first half of the evening/night shift combined with light attenuation in the morning is effective in improving sleep problems in nurses undertaking rotating shift work who suffer from clinical insomnia.Methods: This was a prospective, randomized control study. The Insomnia Severity Index (ISI) and the Hospital Anxiety Depression Scale (HADS) were used to evaluate insomnia and anxiety/depression severity, respectively. Female hospital nurses on rotating shifts during the evening or night shift with an ISI score > 14 were enrolled. Subjects in the treatment group (n = 46) were exposed to bright light at 7,000-10,000 lux for >= 30 minutes. Exposure was continued for at least 10 days during 2 weeks, and the subjects avoided daytime outdoor sun exposure after work by wearing dark sunglasses. Subjects in the control group (n = 46) were not exposed to bright light, but also wore sunglasses after work. Statistical analyses were performed to examine group differences and differences across treatments.Results: After treatment, the treatment group showed significant improvements in the ISI score and the HADS total and subscale scores as compared with pre-treatment. The ISI, HADS, and subscales of the HADS scores were significantly improved across treatments in the treatment group as compared with the control group.Conclusions: The design of this study is easy to put into practice in the real world. This is the first study to document that a higher intensity and briefer duration of bright light exposure during the first half of the evening/night shift with a daytime darkness procedure performed in rotating shift work female nurses suffering from clinical insomnia could improve their insomnia, anxiety, and depression severity.