Effect of bright light therapy on sleep in critically ill surgical patients

Abstract

Background : Most critically ill surgical patients suffer with sleep disturbance, anxiety, unfamiliar environment and noises from medical equipment in the ICU which cause sleep disturbance. Therefore, bright light therapy (BLT) may be an alternative treatment to improve the quality of sleep of these patients. In Thailand, so far there has not been any study on the effect of bright light therapy on sleep in critically ill surgical patients.

Objective : To study the effect of bright light therapy on sleep in critically ill surgical patients.

Methods : Sixty-one patients from surgical ICU were randomized and recruited from September 2016 to February 2017. The instruments consisted of a questionnaire about general information, APACHE II score, the Confusion
Assessment Method-Intensive Care Unit (CAM-ICU) and the Insomnia Severity Index (ISI). The intervention group was treated with BLT of 5,000 lux for 2 hours from 09.00 - 11.00 a.m. for 3 consecutive days which started within 24 hours after SICU admission. The control group was treated with standard care and was exposed to a light source of 500 lux (office light source). The data were analyzed with SPSS software version 22 for descriptive statistics, ANOVA, Chi-square test and Generalized Estimating Equation (GEE) was performed to evaluate the effect of BLT on sleep.

Results : The results showed a significant association between BLT and Insomnia Severity Index. BLT can significantly decreased ISI score of the treatment group, compared to the control (P-value = 0.03, OR = 0.8; 95%CI = 0.6 – 1.0). And we found that the duration (day) of BLT significantly decreased the ISI score (P-value = 0.02, OR = 0.8; 95%CI = 0.7 – 1.0).

Conclusion : Bright light therapy could significantly decrease insomnia scores of the patients in surgical ICU and may be an alternative intervention to improve quality of sleep, facilitate early ambulation and prevent postoperative complications of the patients.