Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Isabelle A. Van der Linden; Esther M. Hazelhoff; Eline R. De Groot; Daniel C. Vijlbrief; Luc J.M. Schlangen; Yvonne A.W. De Kort; Marijn J. Vermeulen; Demy Van Gilst; Jeroen Dudink; Laura Kervezee

doi:10.3389/fphys.2023.1217660

Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Isabelle A. Van der Linden, Esther M. Hazelhoff, Eline R. De Groot, Daniel C. Vijlbrief, Luc J.M. Schlangen, Yvonne A.W. De Kort, Marijn J. Vermeulen, Demy Van Gilst, Jeroen Dudink^*, Laura Kervezee^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

2 Citations (Scopus)

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Abstract

Objectives:

To characterize bedside 24-h patterns in light exposure in the Neonatal Intensive Care Unit (NICU) and to explore the environmental and individual patient characteristics that influence these patterns in this clinical setting.

Methods:

We conducted a retrospective cohort study that included 79 very preterm infants who stayed in an incubator with a built-in light sensor. Bedside light exposure was measured continuously (one value per minute). Based on these data, various metrics (including relative amplitude, intradaily variability, and interdaily stability) were calculated to characterize the 24-h patterns of light exposure. Next, we determined the association between these metrics and various environmental and individual patient characteristics.

Results:

A 24-h light-dark cycle was apparent in the NICU with significant differences in light exposure between the three nurse shifts (p < 0.001), with the highest values in the morning and the lowest values at night. Light exposure was generally low, with illuminances rarely surpassing 75 lux, and highly variable between patients and across days within a single patient. Furthermore, the season of birth and phototherapy had a significant effect on 24-h light-dark cycles, whereas no effect of bed location and illness severity were observed.

Conclusion:

Even without an official lighting regime set, a 24-h light-dark cycle was observed in the NICU. Various rhythmicity metrics can be used to characterize 24-h light-dark cycles in a clinical setting and to study the relationship between light patterns and health outcomes.

Original language	English
Article number	1217660
Journal	Frontiers in Physiology
Volume	14
DOIs	https://doi.org/10.3389/fphys.2023.1217660
Publication status	Published - 16 Aug 2023

Bibliographical note

Funding Information:
This work was supported by a grant from the Velux Stiftung (project 1793 to JD and LK). During parts of this work, LK was supported by a VENI fellowship from the Netherlands Organisation for Health Research and Development ZonMw (grant number 2020–09150161910128).

Publisher Copyright:
Copyright © 2023 Van der Linden, Hazelhoff, De Groot, Vijlbrief, Schlangen, De Kort, Vermeulen, Van Gilst, Dudink and Kervezee.

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10.3389/fphys.2023.1217660Licence: CC BY

Characterizing light-dark cycles in the Neonatal Intensive Care UnitFinal published version, 1.76 MBLicence: CC BY

Cite this

Van der Linden, I. A., Hazelhoff, E. M., De Groot, E. R., Vijlbrief, D. C., Schlangen, L. J. M., De Kort, Y. A. W., Vermeulen, M. J., Van Gilst, D., Dudink, J., & Kervezee, L. (2023). Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study. Frontiers in Physiology, 14, Article 1217660. https://doi.org/10.3389/fphys.2023.1217660

@article{e2312329eb14485ea240e516ea15edff,

title = "Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study",

abstract = "Objectives: To characterize bedside 24-h patterns in light exposure in the Neonatal Intensive Care Unit (NICU) and to explore the environmental and individual patient characteristics that influence these patterns in this clinical setting. Methods: We conducted a retrospective cohort study that included 79 very preterm infants who stayed in an incubator with a built-in light sensor. Bedside light exposure was measured continuously (one value per minute). Based on these data, various metrics (including relative amplitude, intradaily variability, and interdaily stability) were calculated to characterize the 24-h patterns of light exposure. Next, we determined the association between these metrics and various environmental and individual patient characteristics. Results: A 24-h light-dark cycle was apparent in the NICU with significant differences in light exposure between the three nurse shifts (p < 0.001), with the highest values in the morning and the lowest values at night. Light exposure was generally low, with illuminances rarely surpassing 75 lux, and highly variable between patients and across days within a single patient. Furthermore, the season of birth and phototherapy had a significant effect on 24-h light-dark cycles, whereas no effect of bed location and illness severity were observed. Conclusion: Even without an official lighting regime set, a 24-h light-dark cycle was observed in the NICU. Various rhythmicity metrics can be used to characterize 24-h light-dark cycles in a clinical setting and to study the relationship between light patterns and health outcomes.",

author = "{Van der Linden}, {Isabelle A.} and Hazelhoff, {Esther M.} and {De Groot}, {Eline R.} and Vijlbrief, {Daniel C.} and Schlangen, {Luc J.M.} and {De Kort}, {Yvonne A.W.} and Vermeulen, {Marijn J.} and {Van Gilst}, Demy and Jeroen Dudink and Laura Kervezee",

note = "Funding Information: This work was supported by a grant from the Velux Stiftung (project 1793 to JD and LK). During parts of this work, LK was supported by a VENI fellowship from the Netherlands Organisation for Health Research and Development ZonMw (grant number 2020–09150161910128). Publisher Copyright: Copyright {\textcopyright} 2023 Van der Linden, Hazelhoff, De Groot, Vijlbrief, Schlangen, De Kort, Vermeulen, Van Gilst, Dudink and Kervezee.",

year = "2023",

month = aug,

day = "16",

doi = "10.3389/fphys.2023.1217660",

language = "English",

volume = "14",

journal = "Frontiers in Physiology",

issn = "1664-042X",

publisher = "Frontiers Media SA",

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TY - JOUR

T1 - Characterizing light-dark cycles in the Neonatal Intensive Care Unit

T2 - a retrospective observational study

AU - Van der Linden, Isabelle A.

AU - Hazelhoff, Esther M.

AU - De Groot, Eline R.

AU - Vijlbrief, Daniel C.

AU - Schlangen, Luc J.M.

AU - De Kort, Yvonne A.W.

AU - Vermeulen, Marijn J.

AU - Van Gilst, Demy

AU - Dudink, Jeroen

AU - Kervezee, Laura

N1 - Funding Information: This work was supported by a grant from the Velux Stiftung (project 1793 to JD and LK). During parts of this work, LK was supported by a VENI fellowship from the Netherlands Organisation for Health Research and Development ZonMw (grant number 2020–09150161910128). Publisher Copyright: Copyright © 2023 Van der Linden, Hazelhoff, De Groot, Vijlbrief, Schlangen, De Kort, Vermeulen, Van Gilst, Dudink and Kervezee.

PY - 2023/8/16

Y1 - 2023/8/16

N2 - Objectives: To characterize bedside 24-h patterns in light exposure in the Neonatal Intensive Care Unit (NICU) and to explore the environmental and individual patient characteristics that influence these patterns in this clinical setting. Methods: We conducted a retrospective cohort study that included 79 very preterm infants who stayed in an incubator with a built-in light sensor. Bedside light exposure was measured continuously (one value per minute). Based on these data, various metrics (including relative amplitude, intradaily variability, and interdaily stability) were calculated to characterize the 24-h patterns of light exposure. Next, we determined the association between these metrics and various environmental and individual patient characteristics. Results: A 24-h light-dark cycle was apparent in the NICU with significant differences in light exposure between the three nurse shifts (p < 0.001), with the highest values in the morning and the lowest values at night. Light exposure was generally low, with illuminances rarely surpassing 75 lux, and highly variable between patients and across days within a single patient. Furthermore, the season of birth and phototherapy had a significant effect on 24-h light-dark cycles, whereas no effect of bed location and illness severity were observed. Conclusion: Even without an official lighting regime set, a 24-h light-dark cycle was observed in the NICU. Various rhythmicity metrics can be used to characterize 24-h light-dark cycles in a clinical setting and to study the relationship between light patterns and health outcomes.

AB - Objectives: To characterize bedside 24-h patterns in light exposure in the Neonatal Intensive Care Unit (NICU) and to explore the environmental and individual patient characteristics that influence these patterns in this clinical setting. Methods: We conducted a retrospective cohort study that included 79 very preterm infants who stayed in an incubator with a built-in light sensor. Bedside light exposure was measured continuously (one value per minute). Based on these data, various metrics (including relative amplitude, intradaily variability, and interdaily stability) were calculated to characterize the 24-h patterns of light exposure. Next, we determined the association between these metrics and various environmental and individual patient characteristics. Results: A 24-h light-dark cycle was apparent in the NICU with significant differences in light exposure between the three nurse shifts (p < 0.001), with the highest values in the morning and the lowest values at night. Light exposure was generally low, with illuminances rarely surpassing 75 lux, and highly variable between patients and across days within a single patient. Furthermore, the season of birth and phototherapy had a significant effect on 24-h light-dark cycles, whereas no effect of bed location and illness severity were observed. Conclusion: Even without an official lighting regime set, a 24-h light-dark cycle was observed in the NICU. Various rhythmicity metrics can be used to characterize 24-h light-dark cycles in a clinical setting and to study the relationship between light patterns and health outcomes.

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U2 - 10.3389/fphys.2023.1217660

DO - 10.3389/fphys.2023.1217660

M3 - Article

C2 - 37664437

AN - SCOPUS:85169565937

SN - 1664-042X

VL - 14

JO - Frontiers in Physiology

JF - Frontiers in Physiology

M1 - 1217660

ER -

Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Abstract

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