Individually tailored lighting system to improve sleep in older adults

描述(申请人提供)：睡眠受损是老年人的常见问题，与日间功能下降、医疗费用增加、跌倒和受伤增加以及生活质量下降有关。我们实验室的试点数据 伦斯勒理工学院照明研究中心(LRC)的研究表明，在预测最低核心体温(CBTmin)之前通过眼睑的单色530 nm(绿色)光可显著抑制褪黑素和延迟昏暗的褪黑素开始(DLMO)。基于我们最新发表的眼皮透过率数据，我们建议与北卡罗来纳大学教堂山分校的研究人员合作，测试一种设备的有效性和接受性，该设备旨在有效地将光传输到相位延迟患有慢性早醒失眠的老年人的睡眠时间，并评估该设备在家庭环境中的有效性、接受性和安全性。光治疗设备将包括三个组件：1)个人昼夜节律测光仪，即Dimesieter，用于收集昼夜光/暗和活动/休息模式；2)算法，以确定应用昼夜节律光的最有效时间；以及3)光面具，在睡眠期间提供530 nm(绿色)光。对于目标1，我们将在20名被诊断为清晨醒来的老年人和20名年龄匹配的对照组受试者中现场测试和研究该设备的使用。在目标2中，我们将研究这种设备在32名患有慢性早醒失眠的老年人的家庭环境中的使用情况。由于老年人的昼夜睡眠障碍是照顾者选择将亲人送进精神病院的主要原因之一，因此可以改善老年人睡眠质量、减少失眠的照明干预也可能推迟老年人向受控生活环境的过渡。因此，该项目非常适合PA-11-020-健康独立生活技术研究资助的框架。将这种新型设备成功地引入临床环境可能会导致实施一种经济的、非药物的、简单的治疗方式，以减轻与早醒失眠相关的不良后果。

DESCRIPTION (provided by applicant): Impaired sleep is a common problem among older persons, and is associated with reduced daytime function, increased health care costs, increases in falls and injuries, and reduced quality of life. Pilot data from our laboratory at the Lighting Research Center (LRC) at Rensselaer Polytechnic Institute showed that monochromatic 530-nm (green) light delivered through the eyelids before predicted minimum core body temperature (CBTmin) acutely suppressed melatonin and delayed dim light melatonin onset (DLMO). Based on our newly published data on eyelid transmittance, we propose to, in conjunction with investigators at the University of North Carolina at Chapel Hill, test the efficac and acceptance of a device developed to effectively deliver light to phase delay the timing of sleep in older persons with chronic early awakening insomnia, and to assess the effectiveness, acceptance, and safety of this device in the home environment. The light treatment device will have three components: 1) a personal circadian light meter, the Dimesimeter, to collect circadian light/dark and activity/rest patterns; 2) an algorithm to identify the most effective timng to apply circadian light; and 3) a light mask, to deliver 530-nm (green) light during sleep. For Aim 1, we will field test and study the use of this device in 20 older adults with diagnoses of early morning awakenings, and 20 age-matched control subjects. In Aim 2, we will study the use of this device in the home environments of 32 older adults with chronic early awakening insomnia. Because circadian sleep disorders in older adults are one of the primary reasons why caregivers choose to institutionalize their loved ones, a lighting intervention that could improve sleep quality and reduce insomnia in older adults could also potentially delay the transition of older adults to a controlled living environment. Therefore, this project is well-suited for the framework of the PA-11-020 - Technology for Healthy Independent Living Research Grants. Successful introduction of this novel device into clinical settings could lead to the implementation of an economical, non-pharmacological, simple treatment modality that alleviates the adverse consequences associated with early awakening insomnia.