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Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities
BACKGROUND: Evidence‐based interventions to improve the sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities (ID) are limited. Increasing light exposure has been shown to be effective in improving the sleep–wake rhythm, mood, and behaviour in other populations. The cu...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541498/ https://www.ncbi.nlm.nih.gov/pubmed/36004439 http://dx.doi.org/10.1111/jir.12969 |
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author | Böhmer, M. N. Oppewal, A. Valstar, M. J. Bindels, P. J. E. van Someren, E. J. W. Maes‐Festen, D. A. M. |
author_facet | Böhmer, M. N. Oppewal, A. Valstar, M. J. Bindels, P. J. E. van Someren, E. J. W. Maes‐Festen, D. A. M. |
author_sort | Böhmer, M. N. |
collection | PubMed |
description | BACKGROUND: Evidence‐based interventions to improve the sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities (ID) are limited. Increasing light exposure has been shown to be effective in improving the sleep–wake rhythm, mood, and behaviour in other populations. The current study investigates the effect of installing environmental dynamic lighting in common living rooms of care facilities on sleep–wake rhythm, mood, and behaviour in older adults with ID. METHODS: A non‐randomised, non‐concurrent, multiple baseline study was performed from October 2017 to May 2018. Fifty‐four participants [mean (SD) age of 63.42 (8.6) years, 65% female] in six care facilities were included. All participants had three baseline measurements (Weeks 1, 5 and 9). Dynamic lighting was installed in Week 10, after which three intervention measurements took place (Weeks 12, 17 and 24). Sleep characteristics and the sleep–wake rhythm were assessed using actigraphy (GENEActiv). Mood was measured with the Anxiety, Depression and Mood Scale (ADAMS) and behaviour with the Aberrant Behaviour Checklist (ABC). RESULTS: Mixed‐effect regression analysis showed a worsening of the primary outcome interdaily stability (P = 0.001). This could be attributed to one care facility, whereas interdaily stability did not change in the other care facilities (P = 0.74). Dynamic lighting led to earlier mid‐sleep (P = 0.003) and sleep onset (P < .0001) and improved mood as indicated by lower scores on the ADAMS depression (−0.64 SD, P < 0.001) and social avoidance (−0.47 SD, P = 0.004) subscales. The prevalence of screening above cut‐off for depression decreased from 23 to 9.8% (OR = .16, P = 0.003). For behaviour, a decrease was seen in hyperactivity (−0.43 SD, P < 0.001), lethargy (−0.35 SD, P = 0.008) and irritability (−0.33 SD, P < .001) as measured with the ABC. No adverse effects were reported. CONCLUSION: Installing dynamic lighting in common living areas for older adults with ID improved the mood and behaviour of the residents up to 14 weeks after placement. Integrated dynamic lighting is a promising, undemanding and potentially effective addition to improve mood and behaviour in care organisations for people with ID, but does not seem to do so by improving sleep or sleep–wake rhythms. |
format | Online Article Text |
id | pubmed-9541498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95414982022-10-14 Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities Böhmer, M. N. Oppewal, A. Valstar, M. J. Bindels, P. J. E. van Someren, E. J. W. Maes‐Festen, D. A. M. J Intellect Disabil Res Original Articles BACKGROUND: Evidence‐based interventions to improve the sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities (ID) are limited. Increasing light exposure has been shown to be effective in improving the sleep–wake rhythm, mood, and behaviour in other populations. The current study investigates the effect of installing environmental dynamic lighting in common living rooms of care facilities on sleep–wake rhythm, mood, and behaviour in older adults with ID. METHODS: A non‐randomised, non‐concurrent, multiple baseline study was performed from October 2017 to May 2018. Fifty‐four participants [mean (SD) age of 63.42 (8.6) years, 65% female] in six care facilities were included. All participants had three baseline measurements (Weeks 1, 5 and 9). Dynamic lighting was installed in Week 10, after which three intervention measurements took place (Weeks 12, 17 and 24). Sleep characteristics and the sleep–wake rhythm were assessed using actigraphy (GENEActiv). Mood was measured with the Anxiety, Depression and Mood Scale (ADAMS) and behaviour with the Aberrant Behaviour Checklist (ABC). RESULTS: Mixed‐effect regression analysis showed a worsening of the primary outcome interdaily stability (P = 0.001). This could be attributed to one care facility, whereas interdaily stability did not change in the other care facilities (P = 0.74). Dynamic lighting led to earlier mid‐sleep (P = 0.003) and sleep onset (P < .0001) and improved mood as indicated by lower scores on the ADAMS depression (−0.64 SD, P < 0.001) and social avoidance (−0.47 SD, P = 0.004) subscales. The prevalence of screening above cut‐off for depression decreased from 23 to 9.8% (OR = .16, P = 0.003). For behaviour, a decrease was seen in hyperactivity (−0.43 SD, P < 0.001), lethargy (−0.35 SD, P = 0.008) and irritability (−0.33 SD, P < .001) as measured with the ABC. No adverse effects were reported. CONCLUSION: Installing dynamic lighting in common living areas for older adults with ID improved the mood and behaviour of the residents up to 14 weeks after placement. Integrated dynamic lighting is a promising, undemanding and potentially effective addition to improve mood and behaviour in care organisations for people with ID, but does not seem to do so by improving sleep or sleep–wake rhythms. John Wiley and Sons Inc. 2022-08-25 2022-10 /pmc/articles/PMC9541498/ /pubmed/36004439 http://dx.doi.org/10.1111/jir.12969 Text en © 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Böhmer, M. N. Oppewal, A. Valstar, M. J. Bindels, P. J. E. van Someren, E. J. W. Maes‐Festen, D. A. M. Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
title | Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
title_full | Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
title_fullStr | Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
title_full_unstemmed | Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
title_short | Light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
title_sort | light up: an intervention study of the effect of environmental dynamic lighting on sleep–wake rhythm, mood and behaviour in older adults with intellectual disabilities |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541498/ https://www.ncbi.nlm.nih.gov/pubmed/36004439 http://dx.doi.org/10.1111/jir.12969 |
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