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

M. N. Böhmer*, A. Oppewal, M. J. Valstar, P. J.E. Bindels, E. J.W. van Someren, D. A.M. Maes-Festen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Downloads (Pure)

Abstract

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

Original languageEnglish
Pages (from-to)756-781
Number of pages26
JournalJournal of Intellectual Disability Research
Volume66
Issue number10
DOIs
Publication statusPublished - Oct 2022

Bibliographical note

Source of funding
The study was carried out with the financial and organisational support of Middin, a care organisation
for people with intellectual disabilities in Rijswijk, the Netherlands. Light Technology Netherlands did not
sponsor the current project. Middin and Light Technology had no influence on the study design, data
collection, data analysis and interpretation and writing of the report.

Publisher Copyright: © 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this