基于Meta分析的睡眠环境照明策略研究A Meta-analysis Study on Lighting Strategies for Sleep Environment
邵戎镝,曹亦潇,郝洛西
SHAO Rongdi,CAO Yixiao,HAO Luoxi
摘要(Abstract):
睡眠环境中的光线与睡眠健康紧密相关。本文采用循证研究的荟萃分析(Meta分析)手段,分析了强光刺激、高色温光照、蓝光限制照明等不同强度、光谱特征的光刺激,在不同作用时间对褪黑激素暗光下分泌起始时间(DLMO)、睡眠效率与入睡潜伏期的影响。结果显示,无论昼夜节律、睡眠质量均受到光照非视觉生理效应的调节,但不同光照参数对昼夜节律和睡眠质量的调节效应有显著差别。总体上看,时间参数在决定昼夜节律、质量方面均起到重要作用;其次,昼夜节律指标变化呈光照强度依赖,但未发现睡眠质量指标变化与光照强度之间的明显相关性;睡眠期间极低强度光照持续作用,也将造成严重的睡眠质量破坏;此外,全天性的光环境设计更有助于改善睡眠健康。最后,在荟萃分析证据集成的基础上,本文根据“睡眠—觉醒”双过程理论,从昼夜节律和睡眠稳态两个方面,就如何通过室内照明支持睡眠健康,提供了策略建议。
Light in the sleep environment is intimately related to sleep health. This paper, conducted a series of Meta-analysis to investigate the effects of five different types of light stimuli on six sleep and circadian rhythm indicators, including dim light melatonin onset(DLMO), sleep efficiency, and sleep latency period etc. These stimuli included bright light stimulation, blue-enriched light, and blue light restricted lighting etc. The findings indicated that non-visual physiological effects of light had an impact on sleep duration and quality; nevertheless, there were substantial disparities in how light environmental elements affected these circadian rhythm and sleep factors. In general, circadian rhythm and sleep quality were highly correlated with light duration parameters; changes in circadian rhythm indicators were light intensity-dependent, but no significant relationship was found between changes in sleep quality indicators and light intensity, and continued exposure to light during sleep, even at low light intensities, would also result in poor sleep quality; furthermore, a light environment design throughout the day was more beneficial to the circadian rhythm. Finally, based on the findings of the Meta-analysis, this research offers guidelines and recommendations for improving indoor illumination to support sleep health in terms of both circadian rhythm and sleep homeostasis.
关键词(KeyWords):
睡眠环境;Meta分析;照明策略;DLMO;睡眠效率
sleep environment;Meta analysis;lighting strategies;DLMO;sleep efficiency
基金项目(Foundation): 上海市2020年度“科技创新行动计划”社会发展科技攻关项目“南极科考智能人因健康支持系统研究”(项目编号:20dz1207200);; 中央高校基本科研业务费专项资金
作者(Author):
邵戎镝,曹亦潇,郝洛西
SHAO Rongdi,CAO Yixiao,HAO Luoxi
参考文献(References):
- [1] Borbély A A,Alexander A.A two-process model of sleep regulation[J] .Hum Neurobiol,1982,1(3):195-204.
- [2] Roenneberg T,Merrow M.The circadian clock and human health[J].Current Biology,2016,26(10):R432-R443.
- [3] Foster R G.Sleep,circadian rhythms and health[J].Interface Focus,2020,10(3):20190098.
- [4] Stinchcombe A R,Hu C,Walch O J,et al.M1-type,but Not M4-type,melanopsin ganglion cells are physiologically tuned to the central circadian clock[J].Frontiers in Neuroscience,2021,15:652996.
- [5] Berson D M,Dunn F A,Takao M.Phototransduction by retinal ganglion cells that set the circadian clock[J].Science,2002,295(5557):1070-1073.
- [6] Roenneberg T,Kumar C J,Merrow M.The human circadian clock entrains to sun time[J].Current Biology,2007,17(2):R44-R45.
- [7] Szalontai ?,Tóth A,Pethü M.Homeostatic sleep regulation in the absence of the circadian sleep-regulating component:effect of short light-dark cycles on sleep-wake stages and slow waves[J].BMC Neuroscience,2021,22(1):1-17.
- [8] Borbély A A.From slow waves to sleep homeostasis:new perspectives[J].Archives Italiennes de Biologie,2001,139(1):53-61.
- [9] Borbély A A,Achermann P,Trachsel L,et al.Sleep initiation and initial sleep intensity:interactions of homeostatic and circadian mechanisms[J].Journal of Biological Rhythms,1989,4(2):37-48.
- [10] Laakso M L,Hatonen T,Stenberg D,et al.One-hour exposure to moderate illuminance (500 lx) shifts the human melatonin rhythm[J].Journal of Pineal Research,1993,15:21-26.
- [11] Carrier J,Dumont M.Sleep propensity and sleep architecture after bright light exposure at three different times of day[J].Journal of Sleep Research,1995,4(4):202-211.
- [12] Lockley S W.Investigating the effects of evening light exposure on melatonin suppression[EB/OL].Alertness and Nocturnal Sleep,2012.https://clinicaltrials.gov/ct2/show/results/NCT01586039.
- [13] Hashimoto S,Kohsaka M,Nakamura K,et al.Midday exposure to bright light changes the circadian organization of plasma melatonin rhythm in humans[J].Neuroscience Letters,1997,221(2-3):89-92.
- [14] Wright H R,Lack L C.Effect of light wavelength on suppression and phase delay of the melatonin rhythm[J].Sleep,2002,25:A125.
- [15] Kubota T,Uchiyama M,Suzuki H,et al.Effects of nocturnal bright light on saliva melatonin,core body temperature and sleep propensity rhythms in human subjects[J].Neuroscience Research,2002,42:115-122.
- [16] Appleman K,Figueiro M G,Rea M S.Controlling light-dark exposure patterns rather than sleep schedules determines circadian phase[J].Sleep Medicine,2013,14:456-461.
- [17] Figueiro M G,Plitnick B,Rea M S.The effects of chronotype,sleep schedule and light/dark pattern exposures on circadian phase[J].Sleep Medicine,2014,15:1554-1564.
- [18] Kozaki T,Kubokawa A,Taketomi R,et al.Effects of day-time exposure to different light intensities on light-induced melatonin suppression at night[J].Journal of Physiological Anthropology,2015,34:1-5.
- [19] Münch M,Nowozin C,Regente J,et al.Blue-enriched morning light as a countermeasure to light at the wrong time:effects on cognition,sleepiness,sleep,and circadian phase[J].Neuropsychobiology,2016,74(4):207-218.
- [20] Te Kulve M,Schlangen L J M,Lichtenbelt W D V.Early evening light mitigates sleep compromising physiological and alerting responses to subsequent late evening light[J].Scientific Reports,2019,9(1):1-12.
- [21] Park H R,Choi S J,Jo H,et al.Effects of evening exposure to light from organic light-emitting diodes on melatonin and sleep[J].Journal of Clinical Neurology,2020,16:401-407.
- [22] Cajochen C,Dijk D J,Borbely A A.Dynamics of EEG slow-wave activity and core body-temperature in human sleep after exposure to bright light[J].Sleep,1992,15:337-343.
- [23] Munch M,Kobialka S,Steiner R,et al.Wavelength-dependent effects of evening light exposure on sleep architecture and sleep EEG power density in men[J].American Journal of Physiology-Regulatory Integrative and Comparative Physiology,2006,290:R1421-R1428.
- [24] Mottram V,Middleton B,Williams P,et al.The impact of bright artificial white and ‘blue-enriched’ light on sleep and circadian phase during the polar winter[J].Journal of Sleep Research,2011,20:154-161.
- [25] Chellappa S L,Steiner R,Oelhafen P,et al.Acute exposure to evening blue-enriched light impacts on human sleep[J].Journal of Sleep Research,2013,22:573-580.
- [26] Chellappa S L,Viola A U,Schmidt C,et al.Light modulation of human sleep depends on a polymorphism in the clock gene Period3[J].Behavioural Brain Research,2014,271:23-29.
- [27] Cho C H,Lee H J,Yoon H K,et al.Exposure to dim artificial light at night increases REM sleep and awakenings in humans[J].Chronobiology International,2016,33:117-123.
- [28] Geerdink M,Walbeek T J,Beersma D G M,et al.Short blue light pulses (30 min) in the morning support a sleep-advancing protocol in a home setting[J].Journal of Biological Rhythms,2016,31:483-497.
- [29] Danilenko K V,Hommes V.Influence of artificial dusk on sleep[J].Sleep and Biological Rhythms,2016,14:47-53.
- [30] Kayaba M,Iwayama K,Ogata H,et al.The effect of nocturnal blue light exposure from light-emitting diodes on wakefulness and energy metabolism the following morning[J].Environmental Health and Preventive Medicine,2015,20:76-77.
- [31] Rahman S A,St Hilaire M A,Lockley S W.The effects of spectral tuning of evening ambient light on melatonin suppression,alertness and sleep[J].Physiology & Behavior,2017,177:221-229.
- [32] Cho C H,Yoon H K,Kang S G,et al.Impact of exposure to dim light at night on sleep in female and comparison with male subjects[J].Psychiatry Investigation,2018,15:520-530.
- [33] Yang M Q,Ma N,Zhu Y Y,et al.The acute effects of intermittent light exposure in the evening on alertness and subsequent sleep architecture[J].International Journal of Environmental Research and Public Health,2018,15(3):524.
- [34] Chamorro R,Wilms B,Holst A,et al.Acute mild dim light at night slightly modifies sleep but does not affect glucose homeostasis in healthy men[J].Sleep Medicine,2021,84:158-164.
- [35] Vethe D,Scott J,Engstrom M,et al.The evening light environment in hospitals can be designed to produce less disruptive effects on the circadian system and improve sleep[J].Sleep,2021,44(3):zsaa194.
- [36] Choi Y J,Nakamura Y,Akazawa N,et al.Effects of nocturnal light exposure on circadian rhythm and energy metabolism in healthy adults:a randomized crossover trial[J].Chronobiology International,2022,39:602-612.