Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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A Comparison of the Effects between Eye-Mask and Light-Off Conditions on Psychiatric Patient Sleep

야간 조명 하 안대와 소등의 수면에 대한 효과 비교

  • Shin, Juyong (Departments of Psychiatry, National Forensic Psychiatric Hospital) ;
  • Lim, Kyoung-Ok (Departments of Psychiatry, National Forensic Psychiatric Hospital) ;
  • Cho, Seongnam (Departments of Psychiatry, National Forensic Psychiatric Hospital) ;
  • Jang, Soyeong (Departments of Psychiatry, National Forensic Psychiatric Hospital) ;
  • Cha, Seung-Min (Departments of Psychiatry, National Forensic Psychiatric Hospital) ;
  • Han, Songyi (Departments of Psychiatry, National Forensic Psychiatric Hospital) ;
  • Kim, Moojin (Departments of Psychiatry, National Forensic Psychiatric Hospital)
  • 신주용 (국립법무병원 정신건강의학과) ;
  • 임경옥 (국립법무병원 정신건강의학과) ;
  • 조성남 (국립법무병원 정신건강의학과) ;
  • 장소영 (국립법무병원 정신건강의학과) ;
  • 차승민 (국립법무병원 정신건강의학과) ;
  • 한송이 (국립법무병원 정신건강의학과) ;
  • 김무진 (국립법무병원 정신건강의학과)
  • Received : 2020.12.16
  • Accepted : 2021.06.22
  • Published : 2021.06.30
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Abstract

Objectives: The purpose of this study is to investigate the difference in the effects of eye-mask and light-off on sleep status according to a commercial fitness tracker and a sleep diary of psychiatric in-patients in correctional facilities where nocturnal light is compulsory. Methods: This study was conducted over 3 consecutive nights. In-patients of the National Forensic Psychiatric Hospital (n = 29) were assigned random subject numbers and slept as usual in the light-on condition on the first night. The subjects slept with eye-masks in the light-on condition on another night and without an eye-mask in the light-off condition on the other night. Subjects were asked to sleep wearing a commercial fitness tracker and to keep a sleep diary. The order of these changes in bedroom lighting condition on the second and third nights was assigned randomly to participants. Results: In comparison of the sleep variables between the light-on condition and the eye-mask condition, the Wakefullness After Sleep Onset (WASO) was shorter and sleep satisfaction was higher in the latter.(respectively, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017) In comparison of the sleep variables between the light-on and light-off conditions, the WASO was shorter and sleep efficiency and sleep satisfaction were higher in the latter (respectively, Z = 2.40, p < 0.017 ; Z = 3.02, p < 0.017 ; Z = 3.88, p < 0.017). However, there were no differences in the sleep variables between the eye-mask condition and the light-off condition. Conclusion: Subjective improvements in sleep variables were noted in sleep diaries of institutionalized psychiatric patients under either the 'eye-mask' or 'light-off' condition. However, there were no significant differences between the 'eye-mask' and 'light-off' conditions. Therefore, we suggest that psychiatric patients in correctional facilities use eye-masks when sleeping.

목 적 : 본 연구의 목적은 침실에서 야간 조명이 강제적으로 사용되는 교정기관 내 정신과적 입원 환자들에게 상업용 활동 추적기와 수면일지를 통해 안대 착용과 완전 소등이 수면 상태에 주는 효과들의 차이를 조사하는 것이다. 방 법 : 본 연구는 3일 연속 밤 동안 수행되었다. 국립법무병원에 입원된 29명의 정신질환자들에게 무작위 연구 번호가 배정되었으며, 첫 날에는 야간 조명 환경에서 평소처럼 취침했다. 29명 연구대상자들은 다른 날에는 야간 조명환경에서 안대를 착용한 채 취침하였으며, 또 다른 날에는 완전 소등 환경에서 안대 없이 취침하였다. 29명 연구대상자들은 상업용 활동 추적기를 착용하면서 취침하도록 요청되었으며, 다음 날 아침 수면일지를 작성하였다. 연구대상자들은 이러한 둘째 밤과 셋째 밤의 침실 조도 환경 변화를 무작위로 겪도록 배정되었다. 결 과 : 조명 하 수면 환경과 안대 착용 수면 환경 비교 시, 안대 착용 수면 환경에서 수면 후 각성 시간이 짧았고, 수면 만족도가 높았다(각각, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017). 또한, 조명 하 수면 조건과 소등 하 수면 조건 비교 시, 소등 하 수면 조건에서 수면 후 각성 시간이 짧았고, 수면 효율, 수면 만족도가 높았다(각각, 31.14분 대 15.00분, Z = 2.40, p < 0.017 ; 79.40% 대 88.10%, Z = 3.02, p < 0.017 ; 2.97점 대 4.10점, Z = 3.88, p < 0.017). 그러나 안대 착용 수면과 소등 하 수면 비교에서는 유의미한 차이가 없었다. 결 론 : 본 연구 결과 정신질환자나 교정기관의 수용자에게 수면을 개선시키기 위해 완전 소등 또는 환경 개선이 불가능할 경우에는 안대 착용을 권장하는 것이 주관적인 수면의 질과 만족도를 높이는데 유용한 방법이 될 수도 있겠다.

Keywords

Acknowledgement

연구에 참여해주신 국립법무병원 병동 직원 여러분에게 감사드립니다.

References

  1. Ameen MS, Cheung LM, Hauser T, Hahn MA, Schabus M. About the Accuracy and Problems of Consumer Devices in the Assessment of Sleep Sensors (Basel) 2019;19:4160. https://doi.org/10.3390/s19194160
  2. Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak CP. The role of actigraphy in the study of sleep and circadian rhythms. Sleep 2003;26:342-392. https://doi.org/10.1093/sleep/26.3.342
  3. Aoki H, Yamada N, Ozeki Y, Yamane H, Kato N. Minimum light intensity required to suppress nocturnal melatonin concentration in human saliva. Neurosci Lett 1998;252:91-94. https://doi.org/10.1016/S0304-3940(98)00548-5
  4. Broughton RJ. The circasemidian sleep rhythm and its relationships to the circadian and ultradian sleep-wake rhythms: In, Koella WP, Obal F, Schulz H, Visser P. (eds) Sleep'86. Stuttger Fisher Verlag;1988. p.41-43.
  5. Cajochen C, Munch M, Kobialka S, Krauchi K, Steiner R, Oelhafen P, et al. High sensitivity of human melatonin, alertness, thermoregulation, and heart rate to short wavelength light. J Clin Endocrinol Metab 2005;90:1311-1316. https://doi.org/10.1210/jc.2004-0957
  6. Carney CE, Buysse DJ, Ancoli-Israel S, Edinger JD, Krystal AD, Lichstein KL, et al. The consensus sleep diary: standardizing prospective sleep self-monitoring. Sleep 2012;35:287-302. https://doi.org/10.5665/sleep.1642
  7. Cho AR, Cho CH, Yoon HK, Moon JH, Lee HJ, Kim L. Impact of Dim Artificial Light at Night (dALAN) Exposure during Sleep on Human Fatigue. Sleep Med Psychophysiol 2016;23:53-60. https://doi.org/10.14401/KASMED.2016.23.2.53
  8. Cho CH, Lee HJ, Yoon HK, Kang SG, Bok KN, Jung KY, et al. Exposure to dim artificial light at night increases REM sleep and awakenings in humans. Chronobiol Int 2016;33:117-123. https://doi.org/10.3109/07420528.2015.1108980
  9. Cirelli C, Tononi G. Is sleep essential? PLoS Biol 2008;6:e216. https://doi.org/10.1371/journal.pbio.0060216
  10. Degroote L, Hamerlinck G, Poels K, Maher C, Crombez G, De Bourdeaudhuij I, et al. Low-cost consumer-based trackers to measure physical activity and sleep duration among adults in free-living conditions. Validation Study JMIR Mhealth Uhealth 2020;8:e16674. https://doi.org/10.2196/16674
  11. Dewa LH, Kyle SD, Hassan L, Shaw J, Senior J. Prevalence, associated factors and management of insomnia in prison populations: an integrative review. Sleep Med Rev 2014;24:13-27. https://doi.org/10.1016/j.smrv.2014.12.002
  12. Dominoni D, Quetting M, Partecke J. Artificial light at night advances avian reproductive physiology. Proceedings of the Royal Society of London B: Biological Sciences 2013;280:20123017. https://doi.org/10.1098/rspb.2012.3017
  13. Duffy JF, Wright KP Jr. Entrainment of the human circadian system by light. J Biol Rhythms 2005;20:326-338. https://doi.org/10.1177/0748730405277983
  14. Elger BS. Prison life: Television, sports, work, stress and insomnia in a remand prison. Int J Law Psychiatry 2009;32:74-83. https://doi.org/10.1016/j.ijlp.2009.01.001
  15. Fazel S, Seewald K. Severe mental illness in 33,588 prisoners worldwide: Systematic review and meta-regression analysis. Br J Psychiatry 2012;200:364-373. https://doi.org/10.1192/bjp.bp.111.096370
  16. Figueiro MG, Rea MS. Preliminary evidence that light through the eyelids can suppress melatonin and phase shift dim light melatonin onset. BMC Research Notes 2012;5:1. https://doi.org/10.1186/1756-0500-5-1
  17. Gooley JJ, Chamberlain K, Smith KA, Khalsa SBS, Rajaratnam SM, Van Reen E, et al. Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. J Clin Endocrinol Metab 2010;96:E463-E472.
  18. Kubala AG, Gibbs BB, Buysse DJ, Patel SR, Hall MH, Kline CE. Field-based measurement of sleep: agreement between six commercial activity monitors and a validated accelerometer, Behav Sleep Med;2019.
  19. Lavidor M, Weller A, Babkoff H. How sleep is related to fatigue. Br J Health Psychol 2003;8:95-105. https://doi.org/10.1348/135910703762879237
  20. Levin BH, Brown WE. Susceptibility to boredom of jailers and law enforcement officers. Psychol Rep 1975;36:190. https://doi.org/10.2466/pr0.1975.36.1.190
  21. McCarney R, Warner J, Iliffe S, van Haselen R, Griffin M, Fisher P. The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol 2007;7:30. https://doi.org/10.1186/1471-2288-7-30
  22. Narisada K, Schreuder D. Light pollution handbook, Springer Science & Business Media;2013.
  23. Philibert I. Sleep loss and performance in residents and nonphysicians: a meta-analytic examination. SLEEP-NEW YORK THEN WESTCHESTER- 2005;28:1392.
  24. Scott J, Grierson A, Gehue L, Kallestad H, MacMillan I, Hickie IJS. Can consumer grade activity devices replace research grade actiwatches in youth mental health settings? Sleep Biol Rhythms 2019;17:223-232. https://doi.org/10.1007/s41105-018-00204-x
  25. Stevens RG. Light-at-night, circadian disruption and breast cancer: assessment of existing evidence. Int J Epidemiol 2009;38:963-970. https://doi.org/10.1093/ije/dyp178
  26. Tam KM, Cheung SY. Validation of consumer wearable activity tracker as step measurement in free-living conditions. FinJeHeW 2019;11.
  27. Weaver RG, Beets MW, Perry M, Hunt E, Brazendale K, Decker L, et al. Changes in children's sleep and physical activity during a 1-week versus a 3-week break from school: a natural experiment. Sleep 2019;42:zsy205.
  28. Wulff K, Gatti S, Wettstein JG, Foster RG. Sleep and circadian rhythm disruption in psychiatric and neurodegenerative disease. Nat Rev Neurosci 2010;11:589-599. https://doi.org/10.1038/nrn2868
  29. Zeitzer JM, Dijk DJ, Kronauer R, Brown E, Czeisler C. Sensitivity of the human circadian pacemaker to nocturnal light: melatonin phase resetting and suppression. J Physiol 2000;526 Pt 3:695-702. https://doi.org/10.1111/j.1469-7793.2000.00695.x