Scheduled Bright Light for Treatment of Insomnia in Older Adults
Scheduled Bright Light for Treatment of Insomnia in Older Adults
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DOI：
10.1111/j.1532-5415.2008.02164.x
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发表时间：
2009-03-01
影响因子：
6.3
通讯作者：
Yesavage, Jerome A.
中科院分区：
文献类型：
--
作者：
Friedman, Leah;Zeitzer, Jamie M.;Yesavage, Jerome A.
为了确定明亮的光线是否能改善老年失眠症患者的睡眠。单盲，安慰剂对照，12周，平行组随机设计，比较四个治疗组，代表两种光照条件和两次光照的因子组合。居家光疗；8个办公室治疗疗程。从社区招募符合原发性失眠标准的36名女性和15名男性（年龄63.6 +/- 7.1）。一项为期12周的睡眠卫生计划，每天早晚暴露在明亮（4,000勒克斯左右）或昏暗（65勒克斯左右）的光线下45分钟。在早晨或晚上强光照射后，观察组内主观（睡眠记录、问卷调查）和客观（活动记录仪、多导睡眠记录仪）睡眠测量的变化。在组内，早晨或晚上接受强光照射后主观睡眠测量的变化与接受预定的弱光照射后观察到的变化没有显著差异。目的：光照组与暗光照组治疗后睡眠变化（活动图、多导睡眠图）无显著差异。定时光照能够可预测地改变昼夜节律阶段，但与客观或主观睡眠测量的变化无关。CLOCK基因的多态性预示着早起，但并不能调节光线对睡眠的影响。昼夜节律系统（褪黑素中点）和睡眠（黑暗）之间的相位角预测了由强光引起的相位延迟的大小，而不是相位提前的大小。除了一项主观测量外，计划的早晚强光效应与计划的弱光效应并无差异。因此，没有发现支持强光治疗原发性失眠症的老年人。
To determine whether bright light can improve sleep in older individuals with insomnia.Single-blind, placebo-controlled, 12-week, parallel-group randomized design comparing four treatment groups representing a factorial combination of two lighting conditions and two times of light administration.At-home light treatment; eight office therapy sessions.Thirty-six women and fifteen men (aged 63.6 +/- 7.1) meeting primary insomnia criteria recruited from the community.A 12-week program of sleep hygiene and exposure to bright (similar to 4,000 lux) or dim light (similar to 65 lux) scheduled daily in the morning or evening for 45 minutes.Within-group changes were observed for subjective (sleep logs, questionnaires) and objective (actigraphy, polysomnography) sleep measures after morning or evening bright light.Within-group changes for subjective sleep measures after morning or evening bright light were not significantly different from those observed after exposure to scheduled dim light. Objective sleep changes (actigraphy, polysomnography) after treatment were not significantly different between the bright and dim light groups. Scheduled light exposure was able to shift the circadian phase predictably but was unrelated to changes in objective or subjective sleep measures. A polymorphism in CLOCK predicted morningness but did not moderate the effects of light on sleep. The phase angle between the circadian system (melatonin midpoint) and sleep (darkness) predicted the magnitude of phase delays, but not phase advances, engendered by bright light.Except for one subjective measure, scheduled morning or evening bright light effects were not different from those of scheduled dim light. Thus, support was not found for bright light treatment of older individuals with primary insomnia.