Home-based light therapy for fatigue following acquired brain injury: a pilot randomized controlled trial

Abstract

Background and objectives Fatigue and sleep disturbance are debilitating problems following brain injury and there are no established treatments. Building on demonstrated efficacy of blue light delivered via a lightbox in reducing fatigue and daytime sleepiness after TBI, this study evaluated the efficacy of a novel in-home light intervention in alleviating fatigue, sleep disturbance, daytime sleepiness and depressive symptoms, and in improving psychomotor vigilance and participation in daily productive activity, following injury Methods The impact of exposure to a dynamic light intervention (Treatment) was compared to usual lighting (Control) in a randomized within-subject, crossover trial. Outcomes were fatigue (primary outcome), daytime sleepiness, sleep disturbance, insomnia symptoms, psychomotor vigilance, mood and activity levels. Participants (N = 24, M ± SDage = 44.3 ± 11.4) had mild-severe TBI or stroke > 3 months previously, and self-reported fatigue (Fatigue Severity Scale ≥ 4). Following 2-week baseline, participants completed each condition for 2 months in counter-balanced order, with 1-month follow-up. Treatment comprised daytime blue-enriched white light (CCT > 5000 K) and blue-depleted light (< 3000 K) 3 h prior to sleep. Results Random-effects mixed-model analysis showed no significantly greater change in fatigue on the Brief Fatigue Inventory during Treatment, but a medium effect size of improvement (p = .33, d = -0.42). There were significantly greater decreases in sleep disturbance (p = .004), insomnia symptoms (p = .036), reaction time (p = .004) and improvements in productive activity (p = .005) at end of Treatment relative to Control, with large effect sizes (d > 0.80). Changes in other outcomes were non-significant. Conclusions This pilot study provides preliminary support for in-home dynamic light therapy to address sleep-related symptoms in acquired brain injury. Trial registration This trial was registered with the Australian and New Zealand Clinical Trials Registry on 13 June 2017, www.anzctr.org.au, ACTRN12617000866303.

Efficacy and acceptability of blue-wavelength light therapy for post-TBI behavioral symptoms: A systematic review and meta-analysis of randomized controlled trials

“…Database searches found 233 records, which were 159 non-duplicated records. After the title and abstract screening, we reviewed 14 full-text documents and finally included six trials (N = 278) (see Fig 1 ) [ 22 , 26 , 38 – 41 ]. The data from a registered trial report were added to those of a published article [ 39 , 42 ].…”

Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression

“…Light therapy has been recognized as treatment for depression or fatigue [ 123 , 143 , 144 ], while recent studies suggest that specific LED light conditions can provide clinical benefits for people living with migraines, fibromyalgia and chronic pain ([ 145 ] and references in Table 1 and Table 2 ). Specific in-home lighting conditions were used for the treatment of fatigue in people with traumatic brain injury [ 146 , 147 ]. Effects of light exposure on sleep quality are well documented [ 148 , 149 ], while there are direct correlations between the quality of sleep and diverse health conditions [ 34 , 35 , 103 , 150 ].…”

Traumatismes crâniens et sommeil : une revue narrative

“…Ils comprennent une exposition faible à la lumière du jour, une réduction des interactions sociales et des rythmes imposés par le travail, une utilisation excessive d'écrans le soir et des horaires irréguliers. Une fois le trouble confirmé par agenda du sommeil, actimétrie et au besoin par dosages de mélatonine, le traitement combinera la mélatonine et l'exposition lumineuse le matin (luminothérapie si besoin qui a par ailleurs démontré une efficacité sur d'autres paramètres cognitifs et sur l'asthénie dans cette population [79,80]. Chez les patients pour qui la suppression de la sécrétion de mélatonine est confirmée, un traitement par mélatonine LP est indiqué avec une prise 2 heures avant le coucher.…”