References on Sleep and Aging

Alleviation of Sleep Maintenance Insomnia with Timed Exposure to Bright Light. Journal of the American Geriatric Society. 1993; 41(8): 829-36
S.S. Campbell, D. Dawson, M.W. Anderson.

"Half of the population over 65 suffers from chronic sleep disturbance. As a consequence, almost 40% of hypnotic medications are prescribed to people over age 60. Yet, hypnotics are often of little benefit in this population. As such, an effective non-drug alternative could prove important in the management of age-related sleep maintenance insomnia. The current study sought to evaluate the efficacy of bright light exposure in the treatment of sleep maintenance insomnia."
"Conclusions: The findings demonstrate the effectiveness of timed exposure to bright light in the treatment of age-related sleep maintenance insomnia. With further refinement of treatment regimens, this non-drug intervention may prove useful in a large proportion of sleep disturbed elderly." Full Abstract

Editorial; Sensory Stimulation in Dementia. British Medical Journal 2002;325:1312-1313 Burns A, Byrne J, Ballard C, Holmes C.

"Three controlled trials have been published in the past three years that investigate the effect of bright light on sleep disturbance and behavioural disorders in dementia (table).9-11 Some benefits were reported for restlessness, but a particular beneficial effect has been found for sleep disturbances. These results are promising." Full Article

Bright Light Therapy for Sleep Problems in Adults Aged 60+. Cochrane Database Syst Rev 2002;(2):CD003403
P. Montgomery, J. Dennis.

"REVIEWER'S CONCLUSIONS: When the possible side-effects of standard treatment (hypnotics) are considered, there is a reasonable argument to be made for clinical use of non-pharmacological treatments. In view of the promising results of bright light therapy in other populations with problems of sleep timing, further research into their effectiveness with older adults would seem justifiable." Full Abstract

Bright Light Therapy and Melatonin in Motor Restless Behaviour in Dementia: A Placebo-Controlled Study. International Journal of Geriatric Psychiatry 2001;16(1):106-10
PM Haffmans, RC Sival, SA Lucius, Q Cats, L. van Gelder.

"Conclusions: Bright light therapy has a positive effect on motor restless behaviour. Light therapy in combination with melatonin has no positive effects. The results might be explained by a possible overshoot of chronobiological synchronisation or the timing of the melatonin intake.." Full Abstract

Diminished Melatonin Secretion in the Elderly Caused by Insufficient Environmental Illumination. Journal of Clinical Endocrinology and Metabolism 2001;86(1):129-34
K Mishima, M Okawa, T Shimizu, Y Hishikawa.

"The elderly persons, especially the elderly insomniacs, were exposed to significantly less environmental light and simultaneously suffered from significantly diminished nocturnal melatonin secretion. Supplementary exposure to 4 h (1000 to 1200 h, 1400 to 1600 h) of midday bright light in the Elderly Insomniac group significantly increased melatonin secretion to levels similar to those in the young control group without circadian phase-shifting. There was a tendency for the magnitude of the increase in nocturnal melatonin secretion stimulated by bright light to parallel amelioration of sleep disturbances in these subjects. The present findings suggest that we need to pay attention to elderly individuals who suffer under conditions of poor environmental light resulting in disorganized circadian rhythms, including the sleep-wake cycle."
"We need to recognize the physiological significance of environmental midday light. Sufficient and well-timed morning and evening exposure to light according to the human phase-response curve is essential for maintaining proper mutual phase position." Full Abstract

A Randomized, Controlled Trial of Bright Light Therapy for Agitated Behaviors in Dementia Patients Residing in Long-term Care. Journal of Geriatric Psychiatry 1999;14(7):520-5.
CG Lyketsos, VL Lindell, A Baker, C Steele

"Patients randomized to the BLT condition exhibited a statistically significant improvement in nocturnal sleep from a mean of 6.4 hours/night to 8.1 hours/night 4 weeks later (p<0.05). The sleep of patients in the control condition did not improve significantly."
"Conclusion: Patients with dementia in chronic care who exhibit agitated behaviors sleep more hours at night when administered morning BLT. However, BLT does not lead to improvements in agitated behaviors in institutionalized patients with dementia with non-disturbed sleep-wake cycles." Full Abstract

Effects of Bright Light at Lunchtime on Sleep in Patients in a Geriatric Hospital II Psychiatry and Clinical Neurosciences 2001; 55( 3):291
Noriko Fukuda, Riko Kobayashi, Masako Kohsaka, Hiroshi Honma, Yoichi Sasamoto, Satoshi Sakakibara, Emi Koyama, Fumihiro Nakamura, and Tsukasa Koyama.

"These results suggest that exposure to bright light is effective in improving the disturbed sleep of patients." Full Abstract

Sleep Improvement by Light in a Demented Aged Individual. Psychiatry and Clinical Neurosciences 1998; 52(2):194-6
Okumoto Y, Koyama E, Matsubara H, Nakano T, Nakamura R.

"These results suggest that morning bright light exposure provides a better environment for aged persons to maintain a regular sleep-wake pattern.." Full Abstract

Morning Bright Light Therapy for Sleep and Behavior Disorders in Elderly Patients with Dementia. Acta Psychiatry Scandia. 1994; 89(1):1-7K.
Mishima, M. Okawa, Y. Hishikawa, S. Hozumi, H. Hori, K. Takahashi.

"Morning light therapy significantly increased total and nocturnal sleep time and significantly decreased daytime sleep time. These results indicate that morning bright light is a powerful synchronizer that can normalize disturbed sleep and substantially reduce the frequency of behavior disorders in elderly people with dementia." Full Abstract