Block the light and sleep well: Evening blue light filtration as a part of cognitive behavioral therapy for insomnia

ABSTRACT

The objective of the present study was to assess the effect of combining CBT-I with wearing blue-light blocking glasses 90 min prior to bedtime on subjective and objective sleep parameters and daily symptoms (anxiety, depression, hyperarousal). Thirty patients (mean age 48.1 ± 16.13 years, range 21–71, 15 men/15 women) completed a CBT-I group therapy program, with groups randomly assigned to either “active” (blue-light filtering glasses) condition or “placebo” (glasses without filtering properties) condition. Patients were continually monitored by wristwatch actigraphy, kept their sleep diaries and completed a standard questionnaire battery at admission and after the end of the program. Statistical analyses showed a greater reduction of BAI score in “active” (4.33 ± 4.58) versus “placebo” (?0.92 ± 3.68) groups of patients [F = 6.389, p = .019, Cohen’s d = 1.26] and significant prolongation of subjective total sleep time in “active” (?36.88 ± 48.68 min.) versus “placebo” (7.04 ± 47.50 min.) [F = 8.56, p < .01, d = 0.91] group. When pre- and post-treatment results were compared in both groups separately, using paired-samples t-tests, significant differences were observed also in the active group for BDI-II score (t = 3.66, p = .003, Cohen’s d = 0.95) and HAS score (t = 2.90, p = .012, Cohen’s d = 0.75). No significant differences were found in the placebo group. In active group, there was also a significant reduction of subjective sleep latency (t = 2.65, p = .021, d = 0.73) and an increase of subjective total sleep time (t = ?2.73, p = .018, d = ?0.76) without change in objective sleep duration which was significantly shortened in the placebo group. We provide further evidence that blocking short-wavelength light in the evening hours may be beneficial for patients suffering from insomnia.     

Late bedtimes prevent circadian phase advances to morning bright light in adolescents

ABSTRACT

We examined phase shifts to bright morning light when sleep was restricted by delaying bedtimes. Adolescents (n = 6) had 10-h sleep/dark opportunities for 6 days. For the next 2 days, half were put to bed 4.5 h later and then allowed to sleep for 5.5 h (evening room light + sleep restriction). The others continued the 10-h sleep opportunities (sleep satiation). Then, sleep schedules were gradually shifted earlier and participants received bright light (90 min, ~6000 lux) after waking for 3 days. As expected, sleep satiation participants advanced (~2 h). Evening room light + sleep restriction participants did not shift or delayed by 2–4 h.

Abbreviations: DLMO: dim light melatonin onset.     

Antidepressant effects of light therapy and "natural" treatments for winter depression

Although bright light treatment may alleviate the symptoms of winter depression, it still remains to be clarified whether chronobiological mechanisms are involved in this antidepressant response. We studied the therapeutic action of bright light in 61 women with and 36 women without winter depression at the medical academic hospital near Novosibirsk (55 degrees North). Bright light was administered with cool-white incandescent lamp for seven days, two hours daily. The treatment started from either 8:00 (n = 29 patients and 16 controls) or 16:00 (n = 24 and 14, respectively) or 18:00 (n = 8 and 6, respectively). The subsets of bright light-treated subjects were then restudied in wintertime before and after one-week vacation in Firuza resort (south of Turkmeniya, 38 degrees North) (n = 19 and 0, respectively), in summertime (n = 42 and 18, respectively) and in the next winter before and after a week 30-min exposure in the morning hours to dim red light emitting “Light Cap” (n = 9 and 0, respectively). The results suggest that, in controls, mood slightly but statistically significantly improved after light treatment and in summer. In patients, the improvement of mood after one week of bright light was comparable with the effects of such “natural” treatments as trips south and transition from winter to summer seasons. Although next winter response to 0.5-h dim light was clinically significant, it was significantly worse compared to the previous response to 2-h bright light. Our therapeutic results indicate that, despite the different potential phase-shifting effect of bright light administered in the morning and in the second half of the day, the responses to all treatments are equally beneficial. This finding provides evidence against the view that circadian phase shifts are the key to the pathogenesis of winter depression and efficacy of light therapy. Although several different physiological effects of light therapy might be involved in the antidepressant response, none of them seems to be of more importance compared to psychological components of this response. Ours and earlier published reports on the independence of beneficial action of bright light from treatment timing support the suggestion that, in the open investigational trials, the placebo effect accounts for a large portion of the antidepressant response. We also reviewed several facts pointing to the close dependence of antidepressant effects of non-drug therapy upon patients' expectations and researchers' enthusiasm. In sum, unlike patients' chronobiology, their psychology seems to be most powerful mediator of the clinical response to bright light.     

Effect of exposure to evening light on sleep initiation in the elderly: A longitudinal analysis for repeated measurements in home settings

Epidemiologic data have demonstrated associations of sleep-onset insomnia with a variety of diseases, including depression, dementia, diabetes and cardiovascular diseases. Sleep initiation is controlled by the suprachiasmatic nucleus of the hypothalamus and endogenous melatonin, both of which are influenced by environmental light. Exposure to evening light is hypothesized to cause circadian phase delay and melatonin suppression before bedtime, resulting in circadian misalignment and sleep-onset insomnia; however, whether exposure to evening light disturbs sleep initiation in home settings remains unclear. In this longitudinal analysis of 192 elderly individuals (mean age: 69.9 years), we measured evening light exposure and sleep-onset latency for 4 days using a wrist actigraph incorporating a light meter and an accelerometer. Mixed-effect linear regression analysis for repeated measurements was used to evaluate the effect of evening light exposure on subsequent sleep-onset latency. The median intensity of evening light exposure and the median sleep-onset latency were 27.3?lux (interquartile range, 17.9–43.4) and 17?min (interquartile range, 7–33), respectively. Univariate models showed significant associations between sleep-onset latency and age, gender, daytime physical activity, in-bed time, day length and average intensity of evening and nighttime light exposures. In a multivariate model, log-transformed average intensity of evening light exposure was significantly associated with log-transformed sleep-onset latency independent of the former potential confounding factors (regression coefficient, 0.133; 95% CI, 0.020–0.247; p?=?0.021). Day length and nighttime light exposure were also significantly associated with log-transformed sleep-onset latency (p?=?0.001 and p?<?0.001, respectively). In conclusion, exposure to evening light in home setting prolongs subsequent sleep-onset latency in the elderly.     

Polarized light therapy: Shining a light on the mechanism underlying its immunomodulatory effects

This study investigates the immunomodulatory effects of polychromatic polarized light therapy (PLT) on human monocyte cells. While there is some evidence demonstrating a clinical effect in the treatment of certain conditions, there is little research into its mechanism of action. Herein, U937 monocyte cells were cultured and exposed to PLT. The cells were then analyzed for change in expression of genes and cell surface markers relating to inflammation. It was noted that 6 hours of PLT reduced the expression of the CD14, MHC I and CD11b receptors, and increased the expression of CD86. It was also shown that PLT caused downregulation of the genes IL1B, CCL2, NLRP3 and NOD1, and upregulation of NFKBIA and TLR9. These findings imply that PLT has the capacity for immunomodulation in human immune cells, possibly exerting an anti‐inflammatory effect.     

Predictors of response to combined wake and light therapy in treatment-resistant inpatients with depression

ABSTRACT

There is growing evidence for combined chronotherapeutic interventions as adjunctive treatments for major depression. However, as the treatments can be demanding, we need to identify predictors of response. This study aimed to describe predictors of response, remission and deterioration in the short-term phase, as well as predictors of long-term response. The predictors investigated were gender, type of depression, severity of depression, treatment resistance, quetiapine use, general self-efficacy, educational level and positive diurnal variation. Follow-up data from 27 inpatients with moderate-to-severe depression participating in a chronotherapeutic intervention were analysed. As a supplement to standard treatment, they completed 3 wake therapy sessions in the first week, 30 min daily light treatment and sleep-time stabilisation in the entire 9-week study period. Patients had a significant decrease of depressive symptoms during the first 6 days measured by HAM-D6. At Day 6, 41% of the patients responded to the treatment and 19% fulfilled the criteria of remission. Deterioration by the end of wake therapy sessions was however not uncommon. In the short-term phase, mild degree of treatment resistance was associated with remission and low educational level associated with deterioration. Positive diurnal variation (mood best in the evening) was a predictor of both short-term and long-term response to combined wake and light therapy. Furthermore, patients with evening chronotypes (measured with morningness-eveningness score) were more responsive. Our results suggest that targeting the combined chronotherapeutic intervention at patients with positive diurnal variation and evening types is a viable option.     

Effect of bright light therapy on delayed sleep/wake cycle and reaction time of athletes participating in the Rio 2016 Olympic Games

This study investigated the effect of using an artificial bright light on the entrainment of the sleep/wake cycle as well as the reaction times of athletes before the Rio 2016 Olympic Games. A total of 22 athletes from the Brazilian Olympic Swimming Team were evaluated, with the aim of preparing them to compete at a time when they would normally be about to go to bed for the night. During the 8-day acclimatization period, their sleep/wake cycles were assessed by actigraphy, with all the athletes being treated with artificial light therapy for between 30 and 45 min (starting at day 3). In addition, other recommendations to improve sleep hygiene were made to the athletes. In order to assess reaction times, the Psychomotor Vigilance Test was performed before (day 1) and after (day 8) the bright light therapy. As a result of the intervention, the athletes slept later on the third (p = 0.01), seventh (p = 0.01) and eighth (p = 0.01) days after starting bright light therapy. Regarding reaction times, when tested in the morning the athletes showed improved average (p = 0.01) and minimum reaction time (p = 0.03) when comparing day 8 to day 1. When tested in the evening, they showed improved average (p = 0.04), minimum (p = 0.03) and maximum reaction time (p = 0.02) when comparing day 8 to day 1. Light therapy treatment delayed the sleep/wake cycles and improved reaction times of members of the swimming team. The use of bright light therapy was shown to be effective in modulating the sleep/wake cycles of athletes who had to perform in competitions that took place late at night.     

Effect of dim and bright light exposure on some immunological parameters measured under thermal neutral conditions

This study assesses the effects of ambient light conditions, under a thermoneutral environment, on selected immunological parameters of 7 healthy young women (aged 19 to 22 yrs). Subjects entered the bioclimatic chamber at 11:00 h, controlled at 26°C and 60% relative humidity, a “neutral climate”. They lead a well-regulated life in the climatic chamber (pre-condition) while exposed to dim (200 lux) or, on the next day, bright (5000 lux) light between 06:00 to 12:00 h. Just before the end of each period of light exposure, a blood sample was taken for later immunological assay of white blood cell count (WBC), phagocytosis, interferon-γ (IFN-γ), interleukin-4 (IL-4), CD69 T cells (CD69), CD4⁺CD25⁺ T cells (CD4⁺CD25⁺), and transforming growth factor-β 1 (TGF-β1). The results, when compared with the pre-condition, were as follows: 1) CD69 and IFN-γ increased during normal conditions without thermal stress under dim light; 2) WBC increased and IL-4 decreased under bright light; 3) as shown by the highly significant decrease of TGF-β1, the immune system was activated under bright light; 4) phagocytosis tended to increase under bright light exposure; 5) CD69 and IFN-γ were significantly higher, and CD4⁺CD25⁺ tended to decrease under bright light; 6) phagocytosis tended to be lower and TGF-β1 significantly higher under dim light, indicating a decline of immune system function. Taken together, this preliminary single time-point sampling study infers that some parameters are activated (CD69) while others are attenuated (phagocytosis, TGF-β1) according to the environmental light intensity, dim vs. bright, in women adhering to a standardized routine in the absence of thermal stress. These findings are discussed in terms of inhibition of the sympathetic and excitation of the parasympathetic nervous system under the influence of life-style regularity and daytime bright light exposure.     

Antidepressant effects of mono- and combined non-drug treatments for seasonal and non-seasonal depression

The involvement of chronobiological mechanisms in the antidepressant response to such non-drug treatments as bright light, physical exercise and sleep deprivation still remain to be clarified. We compare the efficacy of several treatment strategies for seasonal and non-seasonal depression and discuss possible the contribution of chronobiological and psychological mechanisms in antidepressant response. The therapeutic effects were tested at the medical academic hospital near Novosibirsk (55 degrees North) in 138 subjects, either with winter depression or with non-seasonal depression or without depression (n = 41, 64 and 33, respectively). One-week monotreatments were either 2-hour 2500 lux cool-white incandescent light from 14:00 (n = 9, 9, 9, respectively) or 1-hour physical exercise from 13:00 (n = 9, 9, 9, respectively). One-week combined treatments included a night of total sleep deprivation followed by either 2-hour bright light from 14:00 (n = 8, 12, 0, respectively) or 1-hour physical exercise either under ordinary room light from 13:00 (n = 0, 12, 0, respectively) or under bright light from 12:00 (n = 5, 11, 0, respectively). The results indicate that, in subjects left without antidepressant treatment for a week (n = 10, 11, and 15, respectively), the 21-item Hamilton Depression Rating Scale score did not change significantly. The beneficial effects of total sleep deprivation were similar in seasonal and non-seasonal depression. The seasonals exhibited better response to bright light compared to non-seasonals. After sleep deprivation the substantial further improvements were produced by either lighting or exercising. Compared to the patients exercising under ordinary room light, the patients exercising under bright light did not gain an additional benefit. In general, winter depression was well-treated with either exercise or light, while the most promising treatment for non-seasonal depression was physical exercise combined with sleep deprivation. Bright light or physical exercise administered in the middle of the day were not less favorable compared to the treatments in the morning hours, although it is unlikely that they considerably challenged patient's chronobiology. It was concluded that the placebo effect would account for a large portion of clinical response to open non-pharmacological treatments. Therapeutic hops and visibility of such treatments would explain their high antidepressant efficacy in comparison with pharmacological trials applying a double blind cross-over design. In particular, the excellent response of patients with winter depression to light therapy might be related to their tendency to attribute a high symbolic value to bright light and associate their bad mood with a dark season.     

Association between light exposure at night and insomnia in the general elderly population: The HEIJO-KYO cohort

Chronic circadian misalignment between the internal and environmental rhythms, which is typically related to night-shift work and clock-gene variants, is associated with disruption of suprachiasmatic nucleus function and increased risk of insomnia. Under controlled laboratory conditions, light at night (LAN) suppresses melatonin secretion, delays the internal biological rhythm, and reduces sleepiness. Therefore, LAN exposure may cause circadian misalignment and insomnia, though it remains unclear in real-life situations whether LAN exposure is associated with insomnia. To evaluate an association between LAN exposure and sleep quality in home settings, we conducted a cross-sectional community-based study in 857 elderly individuals (mean age, 72.2 years). We evaluated bedroom light intensity using a light meter and subjectively and objectively measured sleep quality using the Pittsburgh Sleep Quality Index and an actigraph, respectively, along with urinary 6-sulfatoxymelatonin excretion. Compared with the lowest quartile group of LAN intensity, the highest quartile group revealed a significantly higher odds ratio (OR) for subjective insomnia in a multivariate model adjusted for age, gender, body mass index, daytime physical activity, urinary 6-sulfatoxymelatonin excretion, bedtime, rising time, and day length (adjusted OR, 1.61, 95% confidence interval, 1.05–2.45, p?=?0.029). In addition, higher OR for subjective insomnia was significantly associated with the increase in quartiles of LAN intensity (p_trend?=?0.043). Consistently, we observed significant association trends between the increase in quartiles of LAN intensity and poorer actigraphic sleep quality, including decreased sleep efficiency, prolonged sleep-onset latency, increased wake-after-sleep onset, shortened total sleep time, and delayed sleep-mid time in multivariate models adjusted for the covariates mentioned above (all p_trend?<?0.001). In conclusion, we demonstrated that LAN exposure in home settings is significantly associated with both subjectively and objectively measured sleep quality in a community-based elderly population.     

Evaluation of a consumer fitness-tracking device to assess sleep in adults

Wearable fitness-tracker devices are becoming increasingly available. We evaluated the agreement between Jawbone UP and polysomnography (PSG) in assessing sleep in a sample of 28 midlife women. As shown previously, for standard actigraphy, Jawbone UP had high sensitivity in detecting sleep (0.97) and low specificity in detecting wake (0.37). However, it showed good overall agreement with PSG with a maximum of two women falling outside Bland–Altman plot agreement limits. Jawbone UP overestimated PSG total sleep time (26.6?±?35.3?min) and sleep onset latency (5.2?±?9.6?min), and underestimated wake after sleep onset (31.2?±?32.3?min) (p’s?<?0.05), with greater discrepancies in nights with more disrupted sleep. The low-cost and wide-availability of these fitness-tracker devices may make them an attractive alternative to standard actigraphy in monitoring daily sleep–wake rhythms over several days.     

光疗及光照剂量对抑郁症的作用研究进展

抑郁症是一种患病率高、易复发、自杀率高的精神障碍疾病,容易导致认知功能损伤等问题.光疗以无创、副作用小、疗效快等优势受到广泛的关注,为调节抑郁症生物节律和睡眠障碍等症状提供了新的可能性.光信号通过视网膜神经节细胞投射到抑郁脑区参与非视觉成像功能,激活神经细胞活动,分泌神经递质使神经通路产生生理性改变,对生物机体的昼夜节...     

Effects of an adjunctive,chronotype-based light therapy in hospitalized patients with severe burnout symptoms - a pilot study

Light therapy is a well-established treatment option for seasonal affective disorders and is effective in reducing sleep problems and daytime fatigue. Symptoms of severe burnout include feelings of exhaustion and impaired sleep and mood. Thus, light therapy seems promising for burnout treatment. So far, light therapy effects in burnout were investigated in outpatient settings only, with inconclusive results. The present study targeted light therapy effects in an inpatient setting. Participants with severe burnout were recruited in two psychosomatic clinics and randomly assigned to a control group with multimodal psychiatric treatment or an add-on light treatment group. Participants in the latter group were additionally exposed to morning bright light (illuminance: 4246 lux, irradiance: 1802.81 µW.cm^?2) for 3 weeks, 30 minutes a day, timed to their chronotypes. Light effects on burnout symptoms, depression, well-being, daytime sleepiness, sleep quality, and attentional performance were measured twice (pre-/postintervention design). Adjunctive chronotype-based bright light therapy was well tolerated and improved burnout symptoms and well-being without additional effect on severity of depression. Furthermore, reduced daytime sleepiness, improved nighttime sleep quality, a sleep phase advance of 25 minutes, shortened sleep latency, less sleep disturbances and increased sleep duration were observed in the light treatment group. No group differences were found in attentional performance. Chronotype-based bright light therapy seems to be effective in improving burnout symptoms and sleep problems in patients with severe burnout symptoms. Further studies with larger sample sizes and objective measures of sleep are necessary to confirm these preliminary results before practical recommendations can be made.     

Sex-related effects of sleep deprivation on depressive- and anxiety-like behaviors in mice

Anxiety and depressive symptoms are generated after paradoxical sleep deprivation (PSD).However, it is not clear whether PSD produces differential effects between females andmales. The aim of this study was to assess the effect of PSD on anxiety- anddepressive-like behaviors between sexes. Male and female BALB/c mice were divided in threegroups: the control group, the 48-h PSD group and the 96-h PSD group. Immediately afterPSD protocols, the forced swimming and open field test were applied. Sucrose consumptiontest was used to evaluate the middle-term effect of PSD. We found that corticosteroneserum levels showed significant differences in the 96-h PSD females as compared to 96-hPSD males. In the open-field test, the 48-h and 96-h PSD females spent more time at theperiphery of the field, and showed high locomotion as compared to males. In the elevatedplus maze, the 48-h PSD females spent more time in closed arms than males, which iscompatible with anxiety-like behavior. The forced swim test indicated that the 96-h PSDmales spent more time swimming as compared to the 96-h PSD females. Remarkably, the 96-hPSD males had lower sucrose intake than the 96-h PSD females, which suggest that male micehave proclivity to develop a persistent depressive-like behavior late after PSD. Inconclusion, male mice showed a significant trend to depressive-like behaviors late aftersleep deprivation. Conversely, female have a strong tendency to display anxiety- anddepressive-like behaviors immediately after sleep deprivation.     

Effects of different light intensities during the forenoon on the afternoon thermal sensation in mild cold

1. 1. The study aimed at knowing whether thermal sensation during afternoon cool exposure could be influenced by bright light (4000 lx) or dim light (200 lx) in the forenoon.

2. 2. The subjects felt cooler after exposure to dim light than to bright light.

3. 3. Melatonin in the urine was significantly higher in bright light than in dim light at 10:30 h and at noon.

     

Working multiple jobs over a day or a week: Short-term effects on sleep duration

ABSTRACT

Approximately 10% of the employed population in the United States works in multiple jobs. They are more likely to work long hours and in nonstandard work schedules, factors known to impact sleep duration and quality, and increase the risk of injury. In this study we used multivariate regression models to compare the duration of sleep in a 24-hour period between workers working in multiple jobs (MJHs) with single job holders (SJHs) controlling for other work schedule and demographic factors. We used data from the Bureau of Labor Statistics US American Time Use Survey (ATUS) pooled over a 9-year period (2003–2011). We found that MJHs had significantly reduced sleep duration compared with SJHs due to a number of independent factors, such as working longer hours and more often late at night. Male MJHs, working in their primary job or more than one job on the diary day, also had significantly shorter sleep durations (up to 40 minutes less on a weekend day) than male SJHs, even after controlling for all other factors. Therefore, duration of work hours, time of day working and duration of travel for work may not be the only factors to consider when understanding if male MJHs are able to fit in enough recuperative rest from their busy schedule. Work at night had the greatest impact on sleep duration for females, reducing sleep time by almost an hour compared with females who did not work at night. We also hypothesize that the high frequency or fragmentation of non-leisure activities (e.g. work and travel for work) throughout the day and between jobs may have an additional impact on the duration and quality of sleep for MJHs.     

Effects of a chronic reduction of short-wavelength light input on melatonin and sleep patterns in humans: Evidence for adaptation

Light is an important environmental stimulus for the entrainment of the circadian clock and for increasing alertness. The intrinsically photosensitive ganglion cells in the retina play an important role in transferring this light information to the circadian system and they are elicited in particular by short-wavelength light. Exposure to short wavelengths is reduced, for instance, in elderly people due to yellowing of the ocular lenses. This reduction may be involved in the disrupted circadian rhythms observed in aged subjects. Here, we tested the effects of reduced blue light exposure in young healthy subjects (n?=?15) by using soft orange contact lenses (SOCL). We showed (as expected) that a reduction in the melatonin suppressing effect of light is observed when subjects wear the SOCL. However, after chronic exposure to reduced (short wavelength) light for two consecutive weeks we observed an increase in sensitivity of the melatonin suppression response. The response normalized as if it took place under a polychromatic light pulse. No differences were found in the dim light melatonin onset or in the amplitude of the melatonin rhythms after chronic reduced blue light exposure. The effects on sleep parameters were limited. Our results demonstrate that the non-visual light system of healthy young subjects is capable of adapting to changes in the spectral composition of environmental light exposure. The present results emphasize the importance of considering not only the short-term effects of changes in environmental light characteristics.     

Efficacy of light therapy for perinatal depression: a review

ABSTRACT: Perinatal depression is an important public health problem affecting 10-20% of childbearing women. Perinatal depression is associated with significant morbidity, and has enormous consequences for the well-being of the mother and child. Treatment of depression during the perinatal period poses a complex problem for both mother and clinician, as antidepressant treatment strategies must consider the welfare of both mother and child during pregnancy and lactation. Bright light therapy may be an attractive treatment for perinatal depression because it is low cost, home-based, and has a much lower side effect profile than pharmacotherapy. The antidepressant effects of bright light are well established, and there are several rationales for expecting that bright light might also be efficacious for perinatal depression. This review describes these rationales, summarizes the available evidence on the efficacy of bright light therapy for perinatal depression, and discusses future directions for investigation of bright light therapy as a treatment for perinatal depression.     

Exposure to dim artificial light at night increases REM sleep and awakenings in humans

Exposure to artificial light at night (ALAN) has become increasing common, especially in developed countries. We investigated the effect of dALAN exposure during sleep in healthy young male subjects. A total of 30 healthy young male volunteers from 21 to 29 years old were recruited for the study. They were randomly divided into two groups depending on light intensity (Group A: 5 lux and Group B: 10 lux). After a quality control process, 23 healthy subjects were included in the study (Group A: 11 subjects, Group B: 12 subjects). Subjects underwent an NPSG session with no light (Night 1) followed by an NPSG session randomly assigned to two different dim light conditions (5 or 10 lux, dom λ: 501.4 nm) for a whole night (Night 2). We found significant sleep structural differences between Nights 1 and 2, but no difference between Groups A and B. Exposure to dALAN during sleep was significantly associated with increased wake time after sleep onset (WASO; F = 7.273, p = 0.014), increased Stage N1 (F = 4.524, p = 0.045), decreased Stage N2 (F = 9.49, p = 0.006), increased Stage R (F = 6.698, p = 0.017) and non-significantly decreased REM density (F = 4.102, p = 0.056). We found that dALAN during sleep affects sleep structure. Exposure to dALAN during sleep increases the frequency of arousals, amount of shallow sleep and amount of REM sleep. This suggests adverse effects of dALAN during sleep on sleep quality and suggests the need to avoid exposure to dALAN during sleep.     

Outdoor artificial light at night,obesity, and sleep health: Cross-sectional analysis in the KoGES study

Obesity is a common disorder with many complications. Although chronodisruption plays a role in obesity, few epidemiological studies have investigated the association between artificial light at night (ALAN) and obesity. Since sleep health is related to both obesity and ALAN, we investigated the association between outdoor ALAN and obesity after adjusting for sleep health. We also investigated the association between outdoor ALAN and sleep health. This cross-sectional survey included 8526 adults, 39–70 years of age, who participated in the Korean Genome and Epidemiology Study. Outdoor ALAN data were obtained from satellite images provided by the US Defense Meteorological Satellite Program. We obtained individual data regarding outdoor ALAN; body mass index; depression; and sleep health including sleep duration, mid-sleep time, and insomnia; and other demographic data including age, sex, educational level, type of residential building, monthly household income, alcohol consumption, smoking status and consumption of caffeine or alcohol before sleep. A logistic regression model was used to investigate the association between outdoor ALAN and obesity. The prevalence of obesity differed significantly according to sex (women 47% versus men 39%, p < 0.001) and outdoor ALAN (high 55% versus low 40%, p < 0.001). Univariate logistic regression analysis revealed a significant association between high outdoor ALAN and obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.14–1.35, p < 0.001). Furthermore, multivariate logistic regression analyses showed that high outdoor ALAN was significantly associated with obesity after adjusting for age and sex (OR 1.25, 95% CI 1.14–1.37, p < 0.001) and even after controlling for various other confounding factors including age, sex, educational level, type of residential building, monthly household income, alcohol consumption, smoking, consumption of caffeine or alcohol before sleep, delayed sleep pattern, short sleep duration and habitual snoring (OR 1.20, 95% CI 1.06–1.36, p = 0.003). The findings of our study provide epidemiological evidence that outdoor ALAN is significantly related to obesity.