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

Aug 25, 2022Journal of intellectual disability research : JIDR

Dynamic lighting’s effects on sleep patterns, mood, and behavior in older adults with intellectual disabilities

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Abstract

Dynamic lighting installation in care facilities led to improved mood and behaviour in older adults with intellectual disabilities for up to 14 weeks.

Participants showed earlier mid-sleep and sleep onset after dynamic lighting was installed.
Mood improvement was indicated by lower scores on depression and social avoidance measures.
The prevalence of depression decreased significantly from 23% to 9.8%.
Behavioural improvements included reductions in hyperactivity, lethargy, and irritability.
No adverse effects were reported during the study.

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BACKGROUND: Evidence-based interventions to improve the sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities () 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 () 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.

Key numbers

3.42 points

Decrease in Depressive Symptoms

depression scale scores before and after dynamic lighting installation

9.8%

Prevalence of Depression

Percentage of participants above cut-off for depressive symptoms before and after intervention

15 minutes

Earlier Sleep Onset

Change in sleep onset time after dynamic lighting installation

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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

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