Table 7.

Bright Light Therapy

Study	Subjects	Design	Target symptom	Outcome measures	Results
(Satlin et al. 1992, 1028– 1032)	10 hospital patients with AD	Open trial with 1 week of evening BLT	Sleep and agitation	Activity monitor and nursing observation	Improvement in sleep-wake cycle
(Mishima et al. 1994, 1–7)	14 patients with AD and 10 controls	Prospective 2 month study with 4 week morning BLT exposure	Sleep and behavior	Observation for sleep.	Improved nocturnal sleep and reduced daytime sleep
(Van Someren et al. 1997, 955–963)	22 patients with dementia	Open trial of indirect illumination for 4 weeks	sleep	Wrist actigraphy	Improved sleep-wake rhythm
(Koyama, Matsubara, and Nakano 1999, 227–229)	6 nursing home patients with dementia	Open trial of BLT	Sleep	Sleep log	Increased nocturnal sleep and increased daytime wakefulness
(Lyketsos et al. 1999, 520– 525)	15 chronic care facility residents	Randomized controlled crossover trial	Agitation with sleep and secondary outcome	Sleep log Behave –AD CSDD	BLT showed a significant improvement in nocturnal sleep from a mean of 6.4 hours/night to 8.1 hours/night 4 weeks later (p<0.05).
(Ancoli-Israel et al. 2002, 282–289)	77 nursing home residents with severe dementia	Randomized clinical trial to evening bright light, morning bright light, evening dim red light, and daytime sleep restriction for 10 days	Sleep	Wrist actigraphy	No change in nocturnal sleep or daytime alertness. Increasing exposure to morning bright light improved circadian rhythm activity
(Ancoli-Israel et al. 2003, 22– 36)	92 nursing home residents	Randomized clinical trial to morning BLT, morning red dim light and evening BLT	Sleep improvement	Actigraphy	Increased sleep periods.
(Fetveit, Skjerve, and Bjorvatn 2003, 520–526)	11 nursing home residents	Open trial	Sleep improvement	Actigraphy	Less nocturnal awakening and improved sleep efficiency
(Skjerve et al. 2004, 343– 347)	10 institutionalized patients	Open clinical trial	Improvement in sleep and behavior	Actigraphy	Phase advance
(Dowling et al. 2005, 221– 236)	46 residents in long-term care facilities	Randomized, placebo- controlled, clinical trial of BLT for 10 weeks	Nighttime sleep, and the rest–activity rhythm.	Wrist actigraphy	Some stabilization in those with aberrant rest activity rhythm
(Fetveit and Bjorvatn 2005, 420–423)	11 nursing home patients with dementia	Open trial with 2 weeks and BLT and 16 week post- treatment follow up	Daytime sleep	Wrist actigraphy and nursing staff observation	Significant reduction of daytime sleep (P=0.042)
(Sloane et al. 2007, 1524- 1533)	66 patients in inpatient and residential care facility	Crossover intervention trial	Night time sleep	Actigraphy and observation.	Improved total night time sleep, phase advance and inconsistent daytime sleep.