The challenge being addressed
Since 2013, a Danish research project by the Apoplexy Unit, Department of Neurorehabilitation, including stakeholders such as patients, Neuro Doctors and Nurses, has studied the effect of Circadian Lighting on apoplexy patients hospitalized for rehabilitation.
It can be a great challenge for hospitalized patients to maintain a natural circadian rhythm. Patients hospitalized for rehabilitation after a blood clot or a brain haemorrhage are often immobile and can therefore not go outside and get the light that the brain needs to obtain a steady circadian rhythm, explains Doctor Anders West, Rigshospitalet Glostrup.
Challenges that arose in the collaboration
The research group and the operations department at Rigshospitalet Glostrup have in collaboration with lighting experts from Chromaviso developed a Circadian Lighting solution which is designed to maintain the natural circadian rhythm by emulating the sun’s natural lighting during a day and thereby creating the necessary composition of light shifts and darkness during the day. The goal was to investigate whether light exposure could provide patients with a better and faster recovery than medication. The main challenge in the collaboration was to get permission from both patients, relatives and the patient association to measure various parameters on patients during the stay of 2-6 weeks.
The development of the project
Doctor Anders West has in a PhD project researched the effect of the natural circadian lighting on the patients’ health at the Apoplexy Unit for stroke rehabilitation. The project is the first international research project that measures the effect of circadian lighting on hospitalized patients.
It is a randomised clinical controlled research project which included 90 patients in total, where half of the patients were treated in a unit with circadian lighting and the other half, the control group, were in a unit with standard lighting. Methods included the Hamilton Rating Scale for Depression, the Major Depression Inventory scale, the Epworth Sleepiness Scale, the Multidimensional Fatigue Inventory questionnaire, and Rested Statement and Visual Analog Scale for fatigue.
Circadian Lighting’s effect on apoplexy patients
The outcome of the project was reduced depression, reduced fatigue, reduced anxiety, improved circadian rhythm according to the measurements of cortisol and melatonin, and overall, an improved well-being.
The research done to date has not been able to explain the fatigue that apoplexy patients experience. The fatigue is presumed to be caused by brain damage, and not just necessarily because of the bad sleep that most of the patients experience. This research project about circadian lighting is the first non-pharmacologically randomised research project with a control group that shows an effect by a non-medical stimulation in connection with the fatigue of apoplexy patients.
We have in collaboration with Chromaviso developed a lighting protocol which is customised to the patients. The lighting protocol indicates the exact interaction between colour temperature, intensity, timing, and duration of lighting during the day, explains Anders West.
