Let there be Light

And God said, Let there be light: and there was light.

And God saw the light, that it was good...
Genesis 1:3,4

One of my co-workers was asking if I thought the full moon affected the behaviour of patients on our unit, many of whom have various types of dementia. We often notice increased restlessness, pacing and agitation starting about midafternoon and staff who work nights have their hands full with very active patients during throughout their shift. Those of us who work days come in to find the same people asleep and difficult to arouse in the morning. I have never noticed a consistent correlation with the phases of the moon though.

It is likely that the sun has more effect on behaviour than the moon does. I met a physician this weekend at the 'bed and breakfast' and we were discussing various sleep disorders. He referred me to a study done in the Netherlands which was published in the Journal of the American Medical Association in June 2008. Here is a partial summary of the article from Medscape written by Susan Jeffrey.

Brighter Lighting Improves Symptoms in Patients With Dementia

June 12, 2008 — A new study finds that a strategy as simple as increasing levels of daytime lighting in care facilities may improve a variety of cognitive and noncognitive symptoms in patients with dementia.

Researchers carried out a randomized trial using a factorial design to study the effects of light and melatonin, both of which modulate circadian rhythm, or the combination of both light and melatonin among patients with dementia living in 12 group care facilities in the Netherlands.

They found that increasing levels of daytime lighting in the facility had a "modest" benefit in improving some symptoms of disturbed cognition, mood, behavior, functional abilities, and sleep.*

Sunset over Lake Erie, Leamington, Ontario

The sun has plenty of bad press in recent years as excessive exposure may lead to cataracts, cancer, wrinkles and premature aging of the skin. But sunlight also improves mood, produces Vitamin D, and regulates circadian rhythms. Our patients are on a locked unit and the individuals with the most significant negative behaviours do not get taken outdoors. Now that nicer weather is here, I take some patients outdoors as often as possible during their therapy sessions, and I can justify that with the findings of this study. It may be beneficial for institutions to provide a sitting room for patients equipped with full spectrum light.

Whether we have dementia or not, light is essential to health and well being.

And we see that light is good!

*Effect of Bright Light and Melatonin on Cognitive and Noncognitive Function in Elderly Residents of Group Care Facilities
A Randomized Controlled Trial
Rixt F. Riemersma-van der Lek, MD; Dick F. Swaab, MD, PhD; Jos Twisk, PhD; Elly M. Hol, PhD;
Witte J. G. Hoogendijk, MD, PhD; Eus J. W. Van Someren, PhD
JAMA. 2008;299(22):2642-2655.