Individually tailored lighting system to improve sleep in older adults

描述（由申请人提供）：睡眠障碍是老年人的常见问题，与日间功能下降、医疗保健费用增加、福尔斯和受伤增加以及生活质量下降有关。来自我们实验室的试验数据， Rensselaer Polytechnic Institute的照明研究中心（LRC）表明，在预测的最低核心体温（CBTmin）之前通过眼睑传递的单色530 nm（绿色）光严重抑制褪黑激素并延迟昏暗光褪黑激素发作（DLMO）。基于我们最新发表的眼睑透射率数据，我们建议与位于查佩尔山的北卡罗来纳州大学的研究人员合作，测试一种设备的有效性和可接受性，该设备旨在有效地将光输送到患有慢性早醒失眠症的老年人的睡眠时间延迟，并评估该设备在家庭环境中的有效性、可接受性和安全性。光治疗设备将具有三个组件：1）个人昼夜节律光计，即Dimesimeter，用于收集昼夜节律光/暗和活动/休息模式; 2）识别应用昼夜节律光的最有效时间的算法;以及3）光罩，用于在睡眠期间递送530 nm（绿色）光。对于目标1，我们将在20名诊断为清晨醒来的老年人和20名年龄匹配的对照受试者中现场测试和研究该设备的使用。在目标2中，我们将研究在32名患有慢性早醒失眠症的老年人的家庭环境中使用该设备。由于老年人的昼夜节律睡眠障碍是护理人员选择将他们所爱的人制度化的主要原因之一，因此可以改善老年人睡眠质量并减少失眠的照明干预也可能延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 -健康独立生活研究赠款技术的框架。将这种新型器械成功引入临床环境可能会导致经济、非药物、简单的治疗方式的实施，从而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.