ENHANCING EFFECTIVENESS OF LIGHT THERAPY FOR INSOMNIA

在美国，每年因失眠造成的直接经济损失超过150亿美元。65岁以上人口中有高达50%的人患有慢性失眠。其结果既损害了健康，又降低了生活质量。大约40%的催眠药是给60岁以上的人开的，而且使用的比例随着年龄的增加而增加，这一事实突显了这个问题的严重性。 构成与年龄相关的睡眠障碍的特征表明，这与昼夜节律有关，越来越多的证据表明，定时暴露在强光下可能是治疗这种障碍的有效方法。然而，以前的工作清楚地表明，如果更多地关注干预限制疗效的特定生理和行为因素，强光治疗可能会更有利。目前的申请试图利用最近的发现，这些发现表明，一种低维护的治疗策略，明智地控制个人在24小时内暴露在光线下，可能是使这一有前途的非药物方法更有效的关键。 使用基于实验室的评估和家庭治疗方法，我们将检查家庭环境光操作系统(光环)对一组患有睡眠维持性失眠的老年受试者睡眠质量和觉醒功能的影响。开发和实施这一安全、负担得起和易于使用的有效治疗年龄相关睡眠障碍的方法，将对患有这种疾病的个人的生活质量产生重大的积极影响，同时降低与治疗年龄相关失眠及其后果相关的医疗保健系统的重大经济成本。

The direct economic costs of insomnia in the United States exceeds $15 billion per year. Up to 50% of the population over 65 years suffers from chronic insomnia. The result is both compromised health and a reduction in the quality of life. The magnitude of the problem is underscored by the fact that approximately 40% of hypnotic medications are prescribed to individuals over 60 years of age, and the proportion of use increases with age. The features that make up age-related sleep disturbance are suggestive of a circadian rhythms involvement, and growing evidence suggests that timed exposure to bright light can be an effective treatment for this disorder. Yet, previous work makes it clear that bright light treatments could be more beneficially applied if greater attention is given to specific physiological and behavioral factors that intervene to limit efficacy. The current application seeks to take advantage of recent findings which suggest that a low-maintenance treatment strategy that controls judiciously an individual's exposure to light throughout the 24-hour day may be critical to making this promising non-drug approach more effective. Using a lab-based assessment and in-home treatment approach, we will examine the effects a home ambient light operating system (HALOS) on the sleep quality and waking function of a group of older subjects with sleep maintenance insomnia. Development and implementation of this safe, affordable and easy-to-use approach for the effective treatment of age-related sleep disturbance will make a significant positive impact on the quality of life of individuals suffering from the disorder, while reducing the substantial economic cost to our health care system associated with the treatment and consequences of age-related insomnia.