Fiat Lux: The Light Became Therapy. An Overview on the Bright Light Therapy in Alzheimer's Disease Sleep Disorders

Abstract

Background: A system of photosensitive retinal ganglion cells provides 'non-visual' information on the circadian sequences of light to the suprachiasmatic nucleus (SCN), which, as the 'master clock', synchronizes the chronobiological mechanisms of all the biological clocks. Damage to SCN structure alters circadian behavioral and hormonal rhythms and interferes with a regular sleep-wake pattern. Several studies have shown that, in aging and in Alzheimer's disease (AD), circadian rhythms change their synchronization with the environment and behavior loses sync with light.

Objective: The current overview aims to examine research studies showing the effect of bright light therapy (BLT) on sleep disorders and sleep-wake patterns in AD.

Methods: A literature search was conducted, taking into consideration the relevant studies over the last 20 years. Fifteen studies have been thorough: seven followed an environmental-architectural approach and eight followed a treatment devices approach.

Results: Studies agree in considering BLT as a promising non-pharmacological intervention to compensate for circadian rhythm alterations and they support the need for standardized protocols that allow a comparison between multicenter studies.

Conclusion: Interestingly, in an attempt to contain the spread of the COVID-19 pandemic, health authorities have forced the population to stay home. Therefore, AD people are not currently able to enjoy exposure to sunlight. It is predictable that they may experience an exacerbation of circadian disturbances and that the BLT can be an effective response to prevent such exacerbation.

Keywords: Alzheimer’s disease; biological clocks; bright light therapy; circadian rhythms; light boxes; retinal ganglion cells; sleep disorder; suprachiasmatic nucleus.