Effects of dim-evening lighting optimised for geographical orientation versus standard lighting on mental health: protocol paper for a quasiexperimental study in a psychiatric hospital

Oct 10, 2024BMJ open

Effects of low evening light designed for location awareness versus normal lighting on mental health in a psychiatric hospital

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Abstract

The study investigates a dynamic LED lighting scenario at a psychiatric hospital over 24 months.

The intervention includes variable color temperature and light intensity aimed at enhancing circadian rhythms.
Outcomes are evaluated through patient medication use, length of stay, sleep quality, and quality of life.
A comparison is made between two groups of patients admitted during different lighting conditions.
Data on patient demographics and mental health will be collected retrospectively from medical records and surveys.
The study seeks to understand the potential impact of tailored lighting on patient health and well-being.

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INTRODUCTION: Research has provided novel insights into how light stimulates circadian rhythms through specialised retinal ganglion cells to the suprachiasmatic nucleus. In addition, there has been a revolution in light-emitting diode (LED) technology, leading to tunable LED light sources and lighting systems, enabling 24-hour dynamic light scenarios with bright blue-enriched short wavelength light during the day and dim evening light, stimulating the circadian system. These dynamic LED lighting systems are now being implemented at hospitals without adequate understanding of how it may affect the health and well-being of patients and staff.

METHODS AND ANALYSIS: An optimised dynamic LED lighting scenario is investigated at a newly built psychiatric hospital in Copenhagen. In the 12 months baseline period, a standard lighting scenario with dynamic colour temperature and fixed light intensity is investigated. In the following 12-month intervention period, a new DEL scenario is investigated, having dynamic colour temperature as well as dynamic light intensity with a higher daytime and lower evening-time melanopic daylight equivalent illuminance. This setting is furthermore adjusted for geographical orientation to compensate for differences in sunlight access in wintertime. The study uses a quasiexperimental design comparing patients admitted in the two study periods. Prior to each of the study periods, daylight and the contribution from the LED-lighting scenarios was measured. Patient sociodemographic and mental health data will be retrieved retrospectively from electronic medical records and by questionnaires administered in the two periods, evaluating lighting, noise, sleep quality and quality of life. Primary outcome is the proportion of patients receiving pro re nata medications. Secondary outcomes are the length of stay, sleep onset latency, sleep quality and quality of life.

ETHICS AND DISSEMINATION: No ethical issues are expected. The results will be disseminated through peer-reviewed international journal, lectures, posters and interviews.

TRIAL REGISTRATION NUMBER: NCT05868291.

Key numbers

1500

Patient Cohort Size

Total number of patients expected to be included across both study periods.

294

Required Patients for Primary Outcome

Total number of patients needed for statistical analysis of pro re nata medication use.

3–30 days

Length of Stay Range

Expected range of patient stay duration in the psychiatric hospital.

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Effects of dim-evening lighting optimised for geographical orientation versus standard lighting on mental health: protocol paper for a quasiexperimental study in a psychiatric hospital

Abstract

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