LIGHT AND HEALTH
Be Creative! Three Approaches to a Tailored Lighting Intervention for Improving Sleep-Wake Cycles in Dementia Patients By MARIANA G. FIGUEIRO AND DAVID PEDLER
Light and Health Research Center at Mount Sinai
In previous Light and Health Research Center (LHRC) contributions to designing lighting (dl), we described studies employing tailored lighting interventions using circadian stimulus (CS) to improve sleep using single devices among nursing home residents living with ADRD and home-dwelling patients living with a related neurodegenerative disorder, Parkinson’s disease (PD). Those studies showed that, despite the difficulties commonly encountered when delivering therapeutic lighting interventions in the field, the simple principle of promoting brighter days (i.e., high CS), dimmer evenings (i.e., low CS), and darker nights can significantly improve objectively and subjectively assessed sleep outcomes. Because patient compliance can pose formidable challenges to the efficacious application of nonpharmacological light therapies in controlled settings, the key to success in field studies lies in being able to deliver the treatment as participants go about their daily activities.
This study followed the same general approach described in our previous two articles but differed in its use of three separate lighting systems/devices among 14 cognitively impaired participants with sleep disturbances residing in three separate assisted living and memory care facilities in Westborough (5 participants), Northborough (4 participants), and Medway (5 participants), Massachusetts.
Study Method Following specifications proven in previous studies,1, 2 we delivered a tailored lighting intervention (TLI) designed and specified to provide a robust light–dark pattern to maximally stimulate the human circadian system based on the mathematical model of CS developed by Rea and colleagues.3, 4 Our research has shown that providing a criterion CS value of 0.3 improves sleep, mood, and behavior in ADRD and PD patients.5, 6 The TLI employed
Figure 1. The TLI modes used in the study: light table (left), light tray (middle), and retrofitted ambient room lighting (right).
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designing lighting