Intervention Review

Bright light therapy for sleep problems in adults aged 60+

  1. Paul Montgomery1,*,
  2. Jane A Dennis2

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 22 APR 2002

Assessed as up-to-date: 14 FEB 2002

DOI: 10.1002/14651858.CD003403


How to Cite

Montgomery P, Dennis JA. Bright light therapy for sleep problems in adults aged 60+. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD003403. DOI: 10.1002/14651858.CD003403.

Author Information

  1. 1

    University of Oxford, The Centre for Evidence-Based Intervention, Oxford, UK

  2. 2

    University of Bristol, School for Policy Studies, Bristol, UK

*Paul Montgomery, The Centre for Evidence-Based Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. paul.montgomery@socres.ox.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 22 APR 2002

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The prevalence of sleep problems in adulthood increases with age. While not all sleep changes are pathological in later life, severe disturbances may lead to depression, cognitive impairments, deterioration of quality of life, significant stresses for carers and increased healthcare costs. The most common treatment for sleep disorders (particularly insomnia) is pharmacological. The efficacy of non-drug interventions has been suggested to be slower than pharmacological methods, but with no risk of drug-related tolerance or dependency.
Bright light treatment involves participants sitting in front of a "light box" which emits very high (typically 10,000 lux) fluorescent light for periods of around two hours daily. The timing of this light treatment will depend on the irregular timing of the participant's sleep pattern.

Objectives

To assess the efficacy of bright light therapy in improving sleep quality (sleep timing in particular) amongst adults aged 60 and above.

Search methods

The following databases were searched: The Cochrane Library (Issue 1, 2002); MEDLINE (1966 - January 2002); EMBASE (1980 - January 2002); CINAHL ( 1982 - January 2002); PsycINFO (1887 to January 2002); National Research Register (NRR) (Issue1, 2002). Bibliographies of existing reviews in the area, as well as of all trial reports obtained, were searched. Experts in the field were consulted.

Selection criteria

Randomised controlled trials of bright light therapy for primary sleep problems where 80% or more of participants were over 60. Participants must have been screened to exclude those with dementia and/or depression.

Data collection and analysis

Abstracts of studies identified in searches of electronic databases were read and assessed to determine whether they might meet the inclusion criteria.

Main results

Reviewers found no trials on which to base conclusions for the effectiveness of this treatment.

Authors' conclusions

When the possible side-effects of standard treatment (hypnotics) are considered, there is a reasonable argument to be made for clinical use of non-pharmacological treatments. In view of the promising results of bright light therapy in other populations with problems of sleep timing, further research into their effectiveness with older adults would seem justifiable.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Bright light therapy for sleep problems in adults aged 60+

Sleep problems become more common with age, affect quality of life for individuals and their families, and can increase healthcare costs. Older people are often prescribed a range of drugs for their health problems (including with sleep) many of which have side effects. This review considered the effectiveness of bright light treatment (also known as phototherapy). This aims to improve sleep by restoring the disturbed cycle of circadian rhythms found in some people with sleep problems by the administration of very high doses of fluorescent light for periods of around two hours a day. Reviewers found no trials on which to base conclusions for the effectiveness of this treatment.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

光亮治療用於六十歲以上成年人的睡眠問題

成年人的睡眠問題之盛行率隨著年齡增大而增加。並不是晚年的睡眠變化都是病態的,然而嚴重的失調可能會導致憂鬱、認知損害、生活品質下降、照顧者明顯的壓力,以及增加照護系統的花費。對於睡眠疾患 (特別是失眠) 最常使用的治療是藥物治療。非藥物的介入方式比起藥物治療的療效來說是較緩慢的,但是沒有和藥物有關的耐受性或依賴的風險。光亮治療指的示參加者坐在一個「光盒」的前面,而光盒會發出每天大約是二個小時長的很亮的螢光燈 (一般是10000lux) 。光亮治療的時間會根據參加者的睡眠模式的不規則時間而定。

目標

評估在大於60歲以上的成年人,使用光亮治療用於增進睡眠品質 (特別是睡眠時間) 的效果

搜尋策略

搜尋了以下的資料庫:MEDLINE (1966  January 2001); EMBASE (1980  January 2001), CINAHL (1982  January 2001; PsychINFO 1970 to 2001; The Cochrane Library (Issue 1, 2001); National Research Register (NRR [2001]。也包括了現有回顧文獻的參考書目以及所有試驗的報告。同時也諮詢了在這個領域的專家。

選擇標準

光亮治療用於原發睡眠問題上是採用隨機控制式驗,而80% 以上的參與者是大於60歲的。參與試驗者必須排除有失智症及 (或) 憂鬱症。

資料收集與分析

研究用電子資料庫中,是以研究的摘要為主,用以評估是否符合收案條件。

主要結論

回顧者發現沒有試驗對於這個方式的有效性有基本的結論。

作者結論

當一般的治療 (安眠藥) 可能出現有副作用時,在臨床上考慮使用非藥物的治療是合理的。鑑於在有睡眠問題的其他族群使用光亮治療有很不錯的效果,對於老年人身上使用的有效性,需要有更多的研究來証實。

翻譯人

本摘要由成功大學附設醫院謝佩君翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

隨著年紀增加睡眠問題也變多,影響到個人的生活品質、家庭,也會增加健康照顧的花費。老年人通常會因為他們的健康問題(包括睡眠)而服用一些藥物,而其中許多都會有副作用。這個回顧考慮的是光亮治療(或稱光療法)的有效性。這個目的是在那些有睡眠問題的人身上,給予大約兩個小時左右,很高劑量的螢光線,要藉著重新啟動混亂的生理週期來改善他們的睡眠。文獻回顧者發現,沒有任何試驗在對於這種治療方式的有效性有基本的結論。