Prakash Adhikari1,2, Asik Pradhan1,2, Andrew J Zele1,2, Beatrix Feigl3,4,5. 1. Centre for Vision and Eye Research, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia. 2. School of Optometry and Vision Science, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia. 3. Centre for Vision and Eye Research, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia. b.feigl@qut.edu.au. 4. School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia. b.feigl@qut.edu.au. 5. Queensland Eye Institute, Brisbane, Australia. b.feigl@qut.edu.au.
Abstract
AIMS: People with type 2 diabetes (T2D) suffer from sleep disorders, with the mechanism not clearly understood. In T2D, the light transducing retinal photoreceptors that regulate sleep behaviours are dysfunctional; hence, we determine here whether supplemental light exposure ameliorates sleep quality and daytime sleepiness in T2D. METHODS: Supplemental light (10,000 Lux, polychromatic) was self-administered for 30 min every morning for 14 days by ten participants with T2D with no diabetic retinopathy (DR). The effectiveness of supplemental light was assessed by comparing subjective sleep questionnaire (PSQI and ESS) scores and salivary dim light melatonin onset (DLMO) before and after the light exposure as well as with a self-maintained sleep diary during the light exposure. RESULTS: Compared to the baseline, supplemental light significantly improved the excessive daytime sleepiness score (p = 0.004) and phase-advanced the DLMO on average by ~ 23 min. Sleep diary analyses showed that afternoon nap duration significantly shortened over the first week of supplemental light exposure (p = 0.019). Afternoon naps and midnight awakening were significantly longer in diabetic participants with thinner perifoveal retina. CONCLUSIONS: In this case series, we provide initial evidence that supplemental bright light improves daytime sleepiness in T2D with no DR, with the critical period of light exposure showing a beneficial effect after one week. We infer that supplemental light augments photoreceptor signalling in T2D and therefore optimises circadian photoentrainment leading to improved sleep. Our findings inform the development of tailored light therapy protocols in future clinical trials for improving sleep architecture in diabetes.
AIMS: People with type 2 diabetes (T2D) suffer from sleep disorders, with the mechanism not clearly understood. In T2D, the light transducing retinal photoreceptors that regulate sleep behaviours are dysfunctional; hence, we determine here whether supplemental light exposure ameliorates sleep quality and daytime sleepiness in T2D. METHODS: Supplemental light (10,000 Lux, polychromatic) was self-administered for 30 min every morning for 14 days by ten participants with T2D with no diabetic retinopathy (DR). The effectiveness of supplemental light was assessed by comparing subjective sleep questionnaire (PSQI and ESS) scores and salivary dim light melatonin onset (DLMO) before and after the light exposure as well as with a self-maintained sleep diary during the light exposure. RESULTS: Compared to the baseline, supplemental light significantly improved the excessive daytime sleepiness score (p = 0.004) and phase-advanced the DLMO on average by ~ 23 min. Sleep diary analyses showed that afternoon nap duration significantly shortened over the first week of supplemental light exposure (p = 0.019). Afternoon naps and midnight awakening were significantly longer in diabeticparticipants with thinner perifoveal retina. CONCLUSIONS: In this case series, we provide initial evidence that supplemental bright light improves daytime sleepiness in T2D with no DR, with the critical period of light exposure showing a beneficial effect after one week. We infer that supplemental light augments photoreceptor signalling in T2D and therefore optimises circadian photoentrainment leading to improved sleep. Our findings inform the development of tailored light therapy protocols in future clinical trials for improving sleep architecture in diabetes.
Authors: Elisabeth Anne Obara; Jens Hannibal; Steffen Heegaard; Jan Fahrenkrug Journal: Invest Ophthalmol Vis Sci Date: 2017-04-01 Impact factor: 4.799
Authors: M Trento; F Broglio; F Riganti; M Basile; E Borgo; C Kucich; P Passera; P Tibaldi; M Tomelini; F Cavallo; E Ghigo; M Porta Journal: Acta Diabetol Date: 2008-08-07 Impact factor: 4.280
Authors: C M Altimus; A D Güler; K L Villa; D S McNeill; T A Legates; S Hattar Journal: Proc Natl Acad Sci U S A Date: 2008-12-05 Impact factor: 11.205