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Sleep is considered a complex physiological process and an essential biological function. Therefore, changes in sleep quality can result in a deficit in the quality of life and an association with chronic diseases such as hypertension, diabetes, obesity, chronic kidney disease (CKD), among others. Among CKD patients, the prevalence of sleep disorders varies from 45 to 80%. One of the approaches to sleep disorders includes Bright Light Therapy, due to its effectiveness in regulating the sleep-wake cycle.
A randomized clinical trial (RCT) was conducted in hemodialysis clinics in Fortaleza, Ceará, Brazil, from April 2022 to June 2023. The Epworth Sleepiness Scale and DLOTCA-G scale were used to assess the level of sleepiness, sleep quality, and memory. A bright light box with 10,000 lux bulbs (study group) and a placebo light box with 500 lux LED bulbs (control group) were provided to the patients, with instructions to use the boxes in the afternoon for 30 minutes daily for 4 weeks, with the questionnaires being reapplied after this period.
During the recruitment period, approximately 140 patients were registered, encompassing the three hemodialysis clinics. Sixty-nine of them did not meet the selection criteria (age under 60 years, prior dementia, or blindness). A total of 71 elderly individuals in hemodialysis clinics were selected for randomization. Out of these, 27 declined to participate for personal reasons; 30 patients were selected. Patients’ mean age was 69 years in the placebo group and 73 years in the bright light group, with no statistically significant difference. There was no statistically significant difference in gender distribution (p=0.97), education (p=0.95), and marital status (p=0.08). The study revealed that sleepiness is related to memory and that there was an improvement in this complaint after the use of bright light. In contrast, sleepiness increased or did not improve after the use of the placebo light box, demonstrating the effectiveness of bright light in regulating sleep in elderly hemodialysis patients
There are benefits of bright light therapy in the afternoon for elderly individuals undergoing hemodialysis, especially in terms of regulating the sleep-wake cycle, with most patients experiencing an improvement in daytime sleepiness complaints. Additionally, the study shows cognitive improvement in part of the patient population assessed, indicating that bright light can also enhance cognitive performance and aid in adherence to medication and dietary treatment. This RCT will include more patients in order to better establish the results.