The effect of phototherapy on sleep during acute rehabilitation after traumatic brain injury: a randomized controlled trial

ABSTRACT

Objective: To examine the impact of bright white light (BWL) exposure on sleep quality in persons with recent traumatic brain injury (TBI).

Design: Randomized, controlled device-sham study

Setting: 3 TBI Model System inpatient rehabilitation units

Participants: 131 participants (mean 40.9 years, 68% male)

Intervention: Intervention group (N = 65) received BWL (1260 lux at 20 inches, 440–480 nanometers length) for 30 minutes each morning at 12–24 inches from the face. Control group (N = 66) received red light (<450 lux, no light between 440 and 480 nanometers) for the same period. Planned intervention was maximum of 10 treatments or until discharge.

Main Outcome Measure: Sleep duration and quality using actigraphic recording.

Results: There were no differences found between groups on the primary outcomes nor on the secondary outcomes (sleepiness, mood, cooperation with therapy).

Conclusion: BWL treatment during acute rehabilitation hospitalization does not appear to impact sleep or measures commonly associated with sleep. While studies have indicated common complaints of sleep difficulties after TBI, we were unable to document an effect for phototherapy as a treatment. With growing evidence of the effect of sleep on neural repair and cognition, further study is needed to understand the nature and treatment of sleep disorders after TBI.

Clinicaltrials.gov Identifier: NCT02214212

KEYWORDS:

• Traumatic Brain injury
• sleep disorders
• actigraphy

Acknowledgments

We are grateful to the patients enrolled in the Traumatic Brain Injury Model System for their participation in this study. In addition, we would like to acknowledge those involved in data collection: Erica Wasmund, Lauren Nelson, Tausif Billah, and Alexandra Landau.

Declaration of interest

The authors report no financial conflicts of interest.

Disclaimers

The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Veterans Affairs position or any other federal agency, policy, or decision unless so designated by other official documentation. The participating agencies’ institutional review boards approved this study, and informed consent was obtained after the details of the study were thoroughly explained to participants. The authors have no conflicts of interest to declare.

Additional information

Funding

Funding was provided by the National Institutes on Disability, Independent Living, and Rehabilitation Research, Agency on Community Living, (90DP0031, 90DPTB0008, 90DP0045, 90DPTB0013, 90DPTB0009 and 90DP0038) and the National Institutes of Health (K01HD076183). The Polytrauma Rehabilitation Center Traumatic Brain Injury (TBI) Model System collaboration is funded collaboration between the Department of Veterans Affairs and the Department of Health and Human Services (National Institute on Disability, Independent Living, and Rehabilitation Research). This research is also sponsored by VHA Central Office VA TBI Model System Program of Research.