Light Intervention Effects on Circadian Activity Rhythm Parameters and Nighttime Sleep in Dementia Assessed by Wrist Actigraphy: A Systematic Review and Meta-Analysis
| Autor: | Ilona Papousek, Markus Canazei, Elisabeth M. Weiss |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Light therapy
Sleep Wake Disorders medicine.medical_specialty medicine.medical_treatment law.invention Physical medicine and rehabilitation Randomized controlled trial law Alzheimer Disease Medicine Dementia Humans Circadian rhythm business.industry Actigraphy General Medicine Wrist medicine.disease Circadian Rhythm Sleep onset latency Geriatrics and Gerontology Sleep onset business Sleep Gerontology Dawn simulation |
| Zdroj: | The Gerontologist. 62(10) |
| ISSN: | 1758-5341 |
| Popis: | Background and Objectives Persons with dementia often show circadian rhythm disturbances and sleep problems. Timed light exposure seems to be a promising nonpharmacological treatment option. In this review, meta-analyses were run on light effects on circadian activity rhythm parameters in persons with dementia measured with wrist actimetry. Furthermore, we update a Cochrane review, published in 2014, on actigraphically measured light effects in nighttime sleep parameters in persons with dementia. Research Design and Methods Four electronic databases were searched for randomized controlled trials. Effects in meta-analyses were summarized by using mean differences and 95% confidence intervals. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to assess the risk of bias and registered the review protocol (PROSPERO: CRD42020149001). Results Thirteen trials met inclusion criteria, and either utilized light therapy devices, ambient room lighting systems, or dawn–dusk interventions. Eleven of these studies were subjected to meta-analyses. They did not reveal significant light effects on circadian activity parameters: amplitude (p = .62; n = 313), acrophase (p = .34; n = 313), intradaily variability (p = .51; n = 354), and interdaily stability (p = .38; n = 354). Furthermore, no light effects were found on sleep parameters: total sleep duration (p = .53; n = 594), sleep efficiency (p = .63; n = 333), wake after sleep onset (p = .95; n = 212), and sleep onset latency (p = .26; n = 156). Subgroup analyses, pooling data from 3 studies including persons with Alzheimer’s dementia, also did not show light effects on circadian activity and sleep parameters. The overall risk of bias of included studies was high. Discussion and Implications There is insufficient evidence for actigraphically measured circadian light effects in persons with dementia. More high-quality research is needed to recommend the application of adjunctive light. |
| Databáze: | OpenAIRE |
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