Effects of a daylight intervention in the morning on circadian rhythms and sleep in geriatric patients: a randomized crossover trial

Eur Geriatr Med. 2024 Dec 3. doi: 10.1007/s41999-024-01100-z. Online ahead of print.

Abstract

Purpose: During hospitalization, circadian rhythms and sleep are often disrupted, which has negative effects on health outcomes. Therefore, we aimed to investigate whether a daylight intervention in the morning could improve the circadian rhythms of cortisol and melatonin and enhance objective and subjective sleep quality in geriatric patients.

Methods: The present study is a randomized, two-period crossover trial conducted in a geriatric ward in 15 non-demented geriatric trauma patients with a mean age of 83.1 ± 5.4 years. All patients underwent a daylight intervention period, during which they were exposed to a daylight lamp from 8:00 to 13:00 h, and a control period of 6 days each. Cortisol and melatonin levels were measured on day 5 of each period. Objective and subjective sleep quality were assessed using actigraphy and questionnaires, respectively. Within-participant differences between periods were investigated for all parameters.

Results: A trend towards improvement in cortisol and melatonin rhythmicity was found. An increase in mean melatonin levels from 0.3 ± 0.1 to 0.9 ± 0.8 ng/L was observed during the intervention period (p = .063). There was also a trend towards increased sleep efficiency, whereas subjective sleep quality tended to decrease. None of the results were significant.

Conclusion: A daylight intervention in the morning led to a positive trend in cortisol and melatonin rhythmicity, whereas no improvement in subjective sleep quality was found.

Trial registration: DRKS00028626 at German Clinical Trials Register, 13.06.2022.

Keywords: Actigraphy; Circadian rhythm; Cortisol; Melatonin; Sleep; Subjective sleep quality.