Hospital room lighting may worsen patients' mood, pain

New York Wed Nov 6, 2013 4:37pm EST

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New York (REUTERS) - Patients in an average hospital room are exposed to so little light during the day that their bodies cannot adopt a normal sleep-wake cycle, a small study suggests.

Researchers found the lowest levels of daytime light exposure were tied to worse mood and more fatigue and pain among patients, compared to those whose rooms were better-lit during the day.

"Until now, no one has looked at the associations among light and outcomes such as sleep, mood and pain experienced in the hospital," said Esther Bernhofer, lead author of the study and a nurse researcher at the Cleveland Clinic's Nursing Institute.

"This study forms a basis for testing future lighting interventions to improve sleep-wake patterns, mood and pain in hospitalized adults," Bernhofer told Reuters Health.

Past research has shown that exposure to light during the day is important for setting the body's internal clock. Too little light and too much - or exposure to light at the wrong times - can affect sleep quality at night and mood during the day.

To see whether light might play a role in hospital patients' healing, Bernhofer and her colleagues gathered data on 40 men and women admitted between May 2011 and April 2012 to a large academic hospital.

The patients wore a wrist device for 72 hours to measure their sleep-wake patterns and light exposure, and completed questionnaires to evaluate their mood and pain levels.

The researchers found that patients were exposed to low levels of light around the clock, including overnight.

And like many hospital patients, those in the study slept poorly, with frequent interruptions and an average of only about four hours of sleep per night. Patients who had less light exposure during the day reported having a more depressed mood and being more fatigued than those exposed to more light.

On average, patients in the study were exposed to only about 105 lux, a measure of light emission in a given area. Normal office lighting provides about 500 lux and a sunny day can represent as much as 100,000 lux.

Past studies have found that a minimum of 1500 lux for 15 minutes per day is necessary to establish a normal sleep-wake cycle but at least 4000 lux over the course of eight hours is preferred for sleep health, Bernhofer's team writes in the Journal of Advanced Nursing.

The results of her group's small study could potentially open the door to simple ways to boost patient wellbeing in the hospital, Bernhofer said.

More research is needed, but "Further findings might result in a cost-effective way to provide supportive therapy for sleep and pain - common issues in hospitalized patients affecting their ability to heal and be well," Bernhofer said.

"These findings are preliminary and should not dictate any policy or practice changes for healthcare institutions until more specific research can be done," Bernhofer added.

Still, there are few risks to exposing a loved one in the hospital to more light during the day, she said.

"It makes sense that if a loved one is recovering, and they can be moved to an area with brighter, more natural light such as that directly in front of a window, that their mood may improve and that they may sleep better," she said.

SOURCE: bit.ly/17UKPtx Journal of Advanced Nursing, online October 27, 2013.

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Comments (2)
lphock wrote:
Hospital room/bed is good if you have an illness that require constant management by skilled medical personnel. Otherwise, you are better off at home or nursing home. The chance of cross infection is high at hospital than home or nursing home where there is lesser or no turnover of ailing persons. Having undergone a minor surgery with one night stay in twin sharing room, it was not pleasant as the other bed changed two patients in one night. It was between a coughing patient and another with his wife nagging him throughout the stay. Actually, leaving the hospital was a relief and would have save me lot of unnecessary costs and inconvenience. Most hospitals run like a profit organisation and you can figure that out for the medical profession.

Nov 07, 2013 9:40pm EST  --  Report as abuse
MFleming wrote:
How much light is only part of the problem. A directive for more light is an invitation to put the lighting climate in the hands of maintenance and repair people who may even be outsourced and who have NO idea about a patient’s needs. In one hospital last year, the blazing ceiling light over my bed may have been okay to check whether I turned blue or fell out of bed. Unfortunately, it was shining right in my eyss. PAIN. It was so bright that I couldn’t read – which is often the best thing a patient has to distract from discomfort.

Nov 08, 2013 10:13am EST  --  Report as abuse
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