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Deprato A, Haldar P, Navarro JF, Harding BN, Lacy P, Maidstone R, Moitra S, Palomar-Cros A, Durrington H, Kogevinas M, Moitra S, Adan A. Associations between light at night and mental health: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2025; 974:179188. [PMID: 40154089 DOI: 10.1016/j.scitotenv.2025.179188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 03/12/2025] [Accepted: 03/18/2025] [Indexed: 04/01/2025]
Abstract
Light at night (LAN) disrupts the circadian rhythm by altering the natural light-dark cycle. With increasing interest in the relationship between LAN and mental health, there is value in an updated systematic review and meta-analysis considering prominent mental health conditions that also critically appraises LAN exposure assessment. We conducted a systematic review of six databases, two registries, and Google Scholar to identify studies examining the associations between indoor and outdoor LAN exposure (high vs. low exposure) and mental health outcomes (depression, bipolar disorder, anxiety, and schizophrenia), completing inverse-variance random-effects meta-analyses. Nineteen studies with a total population of 556,861 were included in the review. LAN exposure was associated with increased odds of depression prevalence (odds ratio [OR]: 1.18; 95 % confidence interval [CI]: 1.09 to 1.28), with stronger associations for bedside (OR: 1.45; 95 % CI: 1.03 to 2.04) or wrist-measured indoor LAN (OR: 1.30; 95 % CI: 1.22 to 1.38) than satellite-measured outdoor LAN exposure (OR: 1.10; 95 % CI: 1.04 to 1.17) and in older adults (OR: 1.56; 95 % CI: 1.24 to 1.96) compared to general adults (OR: 1.16; 95 % CI: 1.06 to 1.28) or youth (OR: 1.07; 95 % CI: 0.99 to 1.16). LAN exposure was also associated with an increased prevalence of bipolar disorder (OR: 1.19; 95 % CI: 1.08 to 1.31) and anxiety (OR: 1.10; 95 % CI: 1.02 to 1.20) and increased incidence of anxiety (hazard ratio [HR]: 1.08; 95 % CI: 1.02 to 1.15) and schizophrenia (HR: 1.55; 95 % CI: 1.01 to 2.39); however, the incidence of depression did not achieve statistical significance (HR: 1.53; 95 % CI: 0.98 to 2.38). Overall, our results suggest that LAN exposure influences adverse mental health conditions, with differences in results appreciated for depression prevalence depending on how LAN exposure was measured. Additional research is needed on the effects of LAN given its undoubted interest in the prevention and treatment of mental disorders.
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Affiliation(s)
- Andy Deprato
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; Alberta Respiratory Centre, Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Prasun Haldar
- Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, India
| | - José Francisco Navarro
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Málaga, Málaga, Spain
| | - Barbara N Harding
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; College of Population Health, University of New Mexico, Albuquerque, NM, United States
| | - Paige Lacy
- Alberta Respiratory Centre, Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert Maidstone
- Division of Immunology, Immunity to Infection, and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Saibal Moitra
- Department of Allergy and Immunology, Apollo Gleneagles Hospital, Kolkata, India
| | - Anna Palomar-Cros
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain; University Institute for Primary Health Care Research Jordi Gol i Gurina Foundation (IDIAPJGol), Barcelona, Spain
| | - Hannah Durrington
- Division of Immunology, Immunity to Infection, and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Manolis Kogevinas
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Subhabrata Moitra
- Alberta Respiratory Centre, Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada; Bagchi School of Public Health, Ahmedabad University, Ahmedabad, Gujarat, India
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
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Yang HY, Wu SH, Zhang S, Zou HX, Wang LB, Lin LZ, Gui ZH, Zeng XW, Yang BY, Liu RQ, Dong GH, Hu LW. Association between outdoor light at night exposure and executive function in Chinese children. ENVIRONMENTAL RESEARCH 2024; 257:119286. [PMID: 38824987 DOI: 10.1016/j.envres.2024.119286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/11/2024] [Accepted: 05/29/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Recent evidences highlight the potential impact of outdoor Light at Night (LAN) on executive function. However, few studies have investigated the association between outdoor LAN exposure and executive function. METHODS We employed data from 48,502 Chinese children aged 5-12 years in a cross-sectional study conducted in Guangdong province during 2020-2021, to examine the association between outdoor LAN and executive function assessed using the validated parent-completed Behavior Rating Inventory of Executive Function. We assessed children's outdoor LAN exposure using the night-time satellite images based on the residential addresses. We used generalized linear mixed models to estimate the association between outdoor LAN exposure and executive function scores and executive dysfunction. RESULTS After adjusting for potential covariates, higher quintiles of outdoor LAN exposure were associated with poorer executive function. Compared to the lowest quintile (Q1), all higher quintiles of exposure showed a significant increased global executive composite (GEC) score with β (95% confidence intervals, CI) of 0.58 (0.28, 0.88) in Q2, 0.59 (0.28, 0.9) in Q3, 0.85 (0.54, 1.16) in Q4, and 0.76 (0.43, 1.09) in Q5. Higher quintiles of exposure were also associated with higher risks for GEC dysfunction with odd ratios (ORs) (95% CI) of 1.34 (1.18, 1.52) in Q2, 1.40 (1.24, 1.59) in Q3, 1.40 (1.23, 1.59) in Q4, and 1.39 (1.22, 1.58) in Q5. And stronger associations were observed in children aged 10-12 years. CONCLUSIONS Our study suggested that high outdoor LAN exposure was associated with poor executive function in children. These findings suggested that future studies should determine whether interventions to reduce outdoor LAN exposure can have a positive effect on executive function.
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Affiliation(s)
- Han-Yu Yang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Si-Han Wu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shuo Zhang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hong-Xing Zou
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Le-Bing Wang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Zi Lin
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhao-Huan Gui
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiao-Wen Zeng
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ru-Qing Liu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Wen Hu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Menculini G, Cirimbilli F, Raspa V, Scopetta F, Cinesi G, Chieppa AG, Cuzzucoli L, Moretti P, Balducci PM, Attademo L, Bernardini F, Erfurth A, Sachs G, Tortorella A. Insights into the Effect of Light Pollution on Mental Health: Focus on Affective Disorders-A Narrative Review. Brain Sci 2024; 14:802. [PMID: 39199494 PMCID: PMC11352354 DOI: 10.3390/brainsci14080802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/04/2024] [Accepted: 08/08/2024] [Indexed: 09/01/2024] Open
Abstract
The presence of artificial light at night has emerged as an anthropogenic stressor in recent years. Various sources of light pollution have been shown to affect circadian physiology with serious consequences for metabolic pathways, possibly disrupting pineal melatonin production with multiple adverse health effects. The suppression of melatonin at night may also affect human mental health and contribute to the development or exacerbation of psychiatric disorders in vulnerable individuals. Due to the high burden of circadian disruption in affective disorders, it has been hypothesized that light pollution impacts mental health, mainly affecting mood regulation. Hence, the aim of this review was to critically summarize the evidence on the effects of light pollution on mood symptoms, with a particular focus on the role of circadian rhythms in mediating this relationship. We conducted a narrative review of the literature in the PubMed, Scopus, and Web of Science datasets. After the screening process, eighteen papers were eligible for inclusion. The results clearly indicate a link between light pollution and the development of affective symptoms, with a central role of sleep disturbances in the emergence of mood alterations. Risk perception also represents a crucial topic, possibly modulating the development of affective symptoms in response to light pollution. The results of this review should encourage a multidisciplinary approach to the design of healthier environments, including lighting conditions among the key determinants of human mental health.
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Affiliation(s)
- Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Federica Cirimbilli
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Veronica Raspa
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Francesca Scopetta
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Gianmarco Cinesi
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Anastasia Grazia Chieppa
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Lorenzo Cuzzucoli
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Patrizia Moretti
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Pierfrancesco Maria Balducci
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
- CSM Terni, Department of Mental Health, Local Health Unit USL Umbria 2, 05100 Terni, Italy
| | - Luigi Attademo
- Department of Mental Health, North West Tuscany Local Health Authority, 57023 Cecina, Italy;
| | - Francesco Bernardini
- SPDC Pordenone, Department of Mental Health, AsFO Friuli Occidentale, 33170 Pordenone, Italy;
| | - Andreas Erfurth
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria; (A.E.); (G.S.)
- Klinik Hietzing, 1st Department of Psychiatry and Psychotherapeutic Medicine, 1130 Vienna, Austria
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria; (A.E.); (G.S.)
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
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Guindon GE, Murphy CA, Milano ME, Seggio JA. Turn off that night light! Light-at-night as a stressor for adolescents. Front Neurosci 2024; 18:1451219. [PMID: 39145296 PMCID: PMC11321986 DOI: 10.3389/fnins.2024.1451219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 07/19/2024] [Indexed: 08/16/2024] Open
Abstract
Light-at-night is known to produce a wide variety of behavioral outcomes including promoting anxiety, depression, hyperactivity, abnormal sociability, and learning and memory deficits. Unfortunately, we all live in a 24-h society where people are exposed to light-at-night or light pollution through night-shift work - the need for all-hours emergency services - as well as building and street-lights, making light-at-night exposure practically unavoidable. Additionally, the increase in screentime (tvs and smart devices) during the night also contributes to poorer sleep and behavioral impairments. Compounding these factors is the fact that adolescents tend to be "night owls" and prefer an evening chronotype compared to younger children and adults, so these teenagers will have a higher likelihood of being exposed to light-at-night. Making matters worse is the prevalence of high-school start times of 8 am or earlier - a combination of too early school start times, light exposure during the night, and preference for evening chronotypes is a recipe for reduced and poorer sleep, which can contribute to increased susceptibility for behavioral issues for this population. As such, this mini-review will show, using both human and rodent model studies, how light-at-night affects behavioral outcomes and stress responses, connecting photic signaling and the circadian timing system to the hypothalamic-pituitary adrenal axis. Additionally, this review will also demonstrate that adolescents are more likely to exhibit abnormal behavior in response to light-at-night due to changes in development and hormone regulation during this time period, as well as discuss potential interventions that can help mitigate these negative effects.
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Affiliation(s)
| | | | | | - Joseph A. Seggio
- Department of Biological Sciences, Bridgewater State University, Bridgewater, MA, United States
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Jin J, Han W, Yang T, Xu Z, Zhang J, Cao R, Wang Y, Wang J, Hu X, Gu T, He F, Huang J, Li G. Artificial light at night, MRI-based measures of brain iron deposition and incidence of multiple mental disorders. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 902:166004. [PMID: 37544462 DOI: 10.1016/j.scitotenv.2023.166004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Epidemiologic evidence on whether iron accumulation in brain modified the association between artificial light at night (ALAN) and incident mental disorders is lacking. The authors aims to investigate modification of brain iron deposition on the associations of ALAN with multiple mental disorders in the middle-aged and older adults. METHODS This prospective study used data from the UK Biobank. ALAN was drawn from satellite datasets. Susceptibility-weighted magnetic resonance imaging was used to ascertain iron content of each brain region. T2* signal loss was used as indices of iron deposition. The main outcomes are impacts of ALAN exposure on onset of wide spectrum of physician-diagnosed mental disorders, which was estimated by time-varying Cox proportional hazard model. The authors further conducted stratified analyses by levels of iron brain deposition to examine the potential modifying effects. RESULTS Among 298,283 participants followed for a median of 10.91 years, higher ALAN exposure was associated with increased risk of mental disorders. An IQR (11.37 nW/cm2/sr) increase in annual levels of ALAN was associated with an HR of 1.050 (95 % CI: 1.034,1.066) for any mental disorder, 1.076 (95 % CI: 1.053,1.099) for substance use disorder, and 1.036 (95 % CI: 1.004,1.069) for depression disorder in fully adjusted models. The exposure-response curves showed steeper trends at lower ALAN levels and a plateau at higher exposures. The associations were stronger in participants with high iron deposition in left hippocampus, left accumbens and left pallidum. CONCLUSIONS ALAN was associated with multiple mental disorders in the middle-aged and older adults, and the findings indicated stricter standards of ALAN is needed and targeted preventive measures are warranted, especially with high brain iron deposition.
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Affiliation(s)
- Jianbo Jin
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Wenxing Han
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Jin Zhang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Ru Cao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Jiawei Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Xin Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Tiantian Gu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Fan He
- Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Peking University Institute for Global Health and Development, Beijing, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Environmental Research Group, School of Public Health, Imperial college London, London, UK.
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Esaki Y, Obayashi K, Saeki K, Fujita K, Iwata N, Kitajima T. Circadian variability of objective sleep measures predicts the relapse of a mood episode in bipolar disorder: findings from the APPLE cohort. Psychiatry Clin Neurosci 2023; 77:442-448. [PMID: 37092883 DOI: 10.1111/pcn.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/28/2023] [Accepted: 04/15/2023] [Indexed: 04/25/2023]
Abstract
AIM Sleep disturbance, a core feature of bipolar disorder, is closely associated with mood symptoms. We examined the association between actigraphy sleep parameters and mood episode relapses in patients with bipolar disorder. METHODS This prospective cohort study analyzed 193 outpatients with bipolar disorder who participated in the Association between the Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. The participants' sleep was objectively evaluated via actigraphy over seven consecutive days for the baseline assessment and then at the 2-year follow-up appointment for mood episode relapses. The actigraphy sleep parameters were presented using the mean and variability (standard deviation) of each sleep parameter for 7 days. RESULTS Of the 193 participants, 110 (57%) experienced mood episodes during follow-up. The participants with higher variability in total sleep time had a significantly shorter mean estimated time to mood episode relapses than those with lower variability (12.5 vs. 16.8 months; P < 0.001). The Cox proportional hazards model, when adjusted for potential confounders, demonstrated that variability in total sleep time was significantly associated with an increase in the mood episode relapses (per hour; hazard ratio [HR], 1.407; 95% confidence interval (CI), 1.057-1.873), mainly in the depressive episodes (per hour; HR, 1.477; 95% CI, 1.088-2.006). CONCLUSIONS Our findings suggest that consistency in sleep time might be useful, as an adjunct therapy, in preventing the recurrence or relapse of mood episodes in bipolar disorder.
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Affiliation(s)
- Yuichi Esaki
- Department of Psychiatry, Okehazama Hospital, Toyoake, Japan
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Kiyoshi Fujita
- Department of Psychiatry, Okehazama Hospital, Toyoake, Japan
- Department of Psychiatry, The Neuroscience Research Center, Toyoake, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tsuyoshi Kitajima
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
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Esaki Y, Obayashi K, Saeki K, Fujita K, Iwata N, Kitajima T. Habitual light exposure and circadian activity rhythms in bipolar disorder: A cross-sectional analysis of the APPLE cohort. J Affect Disord 2023; 323:762-769. [PMID: 36538951 DOI: 10.1016/j.jad.2022.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/04/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Circadian activity rhythm disruption is a core feature in bipolar disorder. We investigated whether light exposure in daily life is associated with circadian activity rhythms in patients with bipolar disorder. METHODS In a cross-sectional study, we enrolled 194 outpatients with bipolar disorder who were participants of the Association between Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. The participants' physical activity and daytime illuminance were measured using an actigraph over 7 consecutive days. Nighttime illuminance in the bedroom was measured using a portable photometer. Circadian activity rhythm parameters were calculated using cosinor analysis and a nonparametric circadian rhythm analysis. RESULTS The median daytime illuminance and nighttime illuminance were 224.5 lx (interquartile range, 154.5-307.5 lx) and 2.3 lx (0.3-9.4 lx), respectively. Multivariable linear regression analysis, adjusted for potential confounding factors, showed that higher daytime illuminance was significantly associated with higher amplitude and most active continuous 10-hour period, advanced acrophase, higher interdaily stability, and lower intradaily variability. Higher nighttime illuminance was significantly associated with lower relative amplitude, delayed onset of the least active continuous 5-hour period, and higher intradaily variability. LIMITATIONS As this was a cross-sectional study, the results do not necessarily imply that light exposure alters circadian activity rhythms. CONCLUSIONS Daytime light exposure was associated with a positive effect and nighttime light exposure with a negative effect on circadian activity rhythms in bipolar disorder.
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Affiliation(s)
- Yuichi Esaki
- Department of Psychiatry, Okehazama Hospital, Aichi, Japan; Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan.
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kiyoshi Fujita
- Department of Psychiatry, Okehazama Hospital, Aichi, Japan; The Neuroscience Research Center, Aichi, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan
| | - Tsuyoshi Kitajima
- Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan
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Tancredi S, Urbano T, Vinceti M, Filippini T. Artificial light at night and risk of mental disorders: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:155185. [PMID: 35417728 DOI: 10.1016/j.scitotenv.2022.155185] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Emerging evidence suggests a possible association between artificial light at night (LAN) exposure and physiological and behavioral changes, with implications on mood and mental health. Due to the increased amount of individuals' LAN exposure, concerns have been raised regarding harmful impact of light pollution on mental health at the population level. AIM To perform a systematic review of observational studies to investigate if light at night, assessed both indoor and outdoor, may be associated with an increased risk of mental diseases in humans. METHODS We reviewed the epidemiological evidence on the association between LAN exposure, assessed either via satellite photometry or via measurements of bedroom brightness, and mental disorders. We systematically searched the PubMed, Embase and Web of Science databases up to April 1, 2022. Studies were included if they assessed the link between indoor or outdoor artificial light at night and one or more mental disorders in human populations. RESULTS Nine eligible studies were included in this review: six studies had a cross-sectional design, two had a longitudinal design with a median follow-up of 24 months, and one was a case-cohort study. Overall, we found moderate evidence of a positive association between LAN exposure and depressive symptoms and to a lesser extent other mental disorders, though the number of studies was limited and potential residual confounding such as socioeconomic factors, noise, or air pollution may have influenced the results. CONCLUSIONS Although more robust evidence is needed, the epidemiological evidence produced so far seems to support an association between LAN and risk of depressive disorders.
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Affiliation(s)
- Stefano Tancredi
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Teresa Urbano
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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