Integrative Lighting Aimed at Patients with Psychiatric and Neurological Disorders
Abstract
:1. Introduction
- Daytime: the recommended minimum MEDI is 250 lux at the eye measured in the vertical plane at ∼1.2 m height (i.e., vertical illuminance at eye level when seated), noting that, if available, daylight should be used in the first instance to meet these levels;
- Evening: this covers the light recommendations for residential and other indoor environments during the evening, starting at least 3 h before bedtime; the recommended maximum MEDI is 10 lux measured at the eye level in the vertical plane ∼1.2 m height. In order to help achieve this, where possible, white light should have a spectrum depleted in short wavelengths close to the peak of the melanopic action spectrum;
- Nighttime: the light recommendations for the sleep environment. The sleeping environment should be as dark as possible. The recommended maximum ambient MEDI is 1 lux measured at the position of the eye;
- For unavoidable activities where vision is required during the nighttime, the recommended maximum MEDI is 10 lux measured at the eye in the vertical plane at ∼1.2 m height.
2. Results
2.1. Measurement Scheme
2.2. Key Parameters
- Illuminance (lux): a measure of how much the incident light illuminates a given surface. It can be seen as how “bright” the reflected light is perceived by the human eye.The value should be high enough to provide enough lighting for people to see things clearly but not too high, as this causes discomfort glare. Depending on the work environment, the requirements can be found in DS/EN12464-1:2021 [37]. In addition, GLG has published its age-correlated recommendations for illuminance levels [36].
- MEDI (lux): this describes the response of the nonvisual photo-receptors, i.e., ipRGCs, in the human eye in correspondence to a standardized D65 illuminant. This response is indicative of the photo-biological effect of a given illumination condition on the circadian system of the exposed subjects and is a combination of the spectrum of light and intensity. It provides an indication of the ability of a light stimulus to entrain the circadian system as well as suppress melatonin in the blood. A high MEDI during the day is usually supportive of alertness, the circadian rhythm, and a good night’s sleep. At night-time, a low MEDI promotes sleep [23].
- Melanopic daylight efficacy ratio (MDER): a spectral metric of the biological effect of an artificial light source compared to daylight (6500 K), which is then divided by the photopic response (ratio) to estimate the nonvisual light. The ratio provides a shorthand to estimate the relative nonvisual stimulus of a light source while maintaining visual standards. As a rule of thumb, a higher ratio will have a higher melanopic content (a DER bigger than 0.8 represents stimulating light), and a lower ratio represents lower melanopic content (a DER lower than 0.3 represents sleep-promoting light). Typically, artificial lighting has a lower biological effect than daylight, with the MDER being below 1 [23].
- Correlated color temperature (CCT, K): a visual measure to describe the colored appearance provided by a white light source perceived by the human eye. CCT is based on the temperature in kelvin needed to warm a blackbody to achieve the color appearance. A range of 2700–3000 K is called ‘warm color’, and a CCT above 5000 K is called ‘cool color’.
- Color rendering index (CRI, Ra): the ability of a light source to render the colors of various objects faithfully in comparison with an ideal or natural light source. The higher the CRI, the more accurate the color rendering of a given light source is, with the maximum achievable value being 100.
2.3. Point Measurement
2.4. Data Logging
3. Melatonin Suppression
3.1. Prayag et al.
3.2. Giménez et al.
3.3. Numerical Evaluation of the Models
4. Discussion
4.1. Discussion of the Results
4.2. Perspectives and Future Work
4.3. Limitations
5. Materials and Methods
5.1. Materials and Equipment
5.2. Data Processing and Presenting the Results
5.3. Setup and Measurement Procedure of the Case Study
- Five measurement points have been chosen. Points 1 to 3 were chosen near the bed, imitating the patient-lying position in the bed facing a different direction;
- Points 1 and 2 at 90 cm in height, facing west (window) and east, respectively, and point 3 at 104 cm in height, facing south;
- Points 4 and 5 were chosen on each side of the bed at 175 cm in height, imitating the medical staff performing visual tasks in a standing position. Please note that this height would correspond to a male nurse or doctor, and therefore, a lower height should have been considered to assess the light exposure of a female nurse. However, the difference is too small to have a huge impact;
- The spectrometer was mounted on a tripod facing the sensor, as indicated above, imitating eye height.
6. Conclusions
6.1. Summary of Results
6.2. Significance and Outlook
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
IF | Image-Forming |
NIF | Non-Image-Forming |
ipRGCs | Intrinsically Photo-sensitive Retinal Ganglion Cells |
-opic EDIs | -opic Equivalent Daylight Illuminances |
MEDI | Melanopic-EDI |
GLG | Good Light Group |
CIE | Commission Internationale de l’Éclairage |
MDER | Melanopic Daylight Efficacy Ratio |
CCT | Correlated Color Temperature |
TAT | Time Above Threshold |
MLIT | Mean Light Timing |
SPD | Spectral Power Distribution |
SI | International System of Units |
CS | Circadian Stimulus |
CLA | Circadian Light |
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Recommended Minimal Light Levels on the Eye in MEDI | <30 Years | ∼50 Years | >75 Years |
---|---|---|---|
Daytime (7 a.m.–7 p.m.) | MEDI ≥ 250 lux | MEDI ≥ 300 lux | MEDI ≥ 425 lux |
Evening (7 p.m.–11 p.m.) | MEDI ≤ 10 lux | MEDI ≤ 12 lux | MEDI ≤ 17 lux |
Nighttime (11 p.m.–7 a.m.) | MEDI ≤ 1 lux | MEDI ≤ 1 lux | MEDI ≤ 2 lux |
Measurement Point | 1 | 2 | 3 | 4 | 5 |
---|---|---|---|---|---|
Orientation | West | East | South | West | East |
Measurement time | 10:03:34 a.m. | 10:04:31 a.m. | 10:08:45 a.m. | 10:14:22 a.m. | 10:17:50 a.m. |
Measurement Height (cm) | 90 | 90 | 104 | 175 | 175 |
Illuminance (lx) | 234.2 | 148 | 190.3 | 278.8 | 231.9 |
CCT (K) | 7475 | 5848 | 6793 | 7924 | 6198 |
CRI (Ra) | 96.4 | 96.3 | 96.4 | 96.1 | 96.1 |
MEDI (lx) | 252.8 | 136.6 | 193.9 | 310.8 | 222.1 |
MDER | 1.08 | 0.92 | 1.02 | 1.12 | 0.96 |
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Zeng, X.; Soreze, T.S.C.; Ballegaard, M.; Petersen, P.M. Integrative Lighting Aimed at Patients with Psychiatric and Neurological Disorders. Clocks & Sleep 2023, 5, 806-830. https://doi.org/10.3390/clockssleep5040052
Zeng X, Soreze TSC, Ballegaard M, Petersen PM. Integrative Lighting Aimed at Patients with Psychiatric and Neurological Disorders. Clocks & Sleep. 2023; 5(4):806-830. https://doi.org/10.3390/clockssleep5040052
Chicago/Turabian StyleZeng, Xinxi, Thierry Silvio Claude Soreze, Martin Ballegaard, and Paul Michael Petersen. 2023. "Integrative Lighting Aimed at Patients with Psychiatric and Neurological Disorders" Clocks & Sleep 5, no. 4: 806-830. https://doi.org/10.3390/clockssleep5040052