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Bright-Light Treatment Reduces Actigraphic-Measured Daytime Sleep in Nursing Home Patients With Dementia: A Pilot Study

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Objective

The authors evaluated the effects of bright-light therapy on daytime sleep among nursing home patients with dementia.

Methods

Eleven patients with sleep/wake disturbances received 2 hours/day of morning bright-light exposure for 2 weeks. Sleep was measured with actigraphy and nursing staff diaries.

Results

Daytime sleep decreased significantly in the period from rising time to 3:00 P.M. with bright-light treatment. Treatment effects did not last into the 16-week post-treatment period.

Conclusions

Bright light exposure was effective in reducing daytime sleep in nursing home patients with dementia; this finding is possibly related to bright light's acute alerting effects.

Section snippets

Subjects

The subjects were selected from an entire nursing home population of 25 patients.7 All 18 subjects with sleep efficiency below 85% were selected to the present study. One patient rejected participation, five patients died before the study commenced, and one died in the early part of the study. The remaining 11 patients (10 women, 1 man) had the following characteristics: mean age: 86.1 years (standard deviation [SD]: 8.9); Mini-Mental State Exam (MMSE) score: 11.7 (SD: 4.2); Clinical Dementia

RESULTS

Actigraphic-measured average nap duration and total nap duration during the day period (rising time to 3:00 P.M.) were both significantly reduced with bright-light treatment (Table 1). A significant reduction of daytime sleep with treatment was also found in the nursing staff diaries, from 0.57 (pretreatment) to 0.26 (treatment; p = 0.042). No significant changes were found in sleep/wake measurements (actigraphy and nursing staff) between pretreatment and baseline recordings 8 months before the

DISCUSSION

Morning bright-light treatment increased daytime wakefulness by an average of more than 30 minutes in the period from rising time to 3:00 P.M. in nursing home residents with dementia. Actigraphic measurements were supported by nursing staff's ratings. The positive effect of bright-light treatment on daytime wakefulness was short-acting and did not last in the post-treatment registration periods. Although daytime sleep was reduced, number of naps remained unchanged.

The small sample size and lack

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This study was supported by the Norwegian College of General Practitioners.

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