title: Bright light therapy for sleep disturbance in dementia is most effective for mild to moderate Alzheimer's type dementia: a case series.
abstract: BACKGROUND
  Sleep problems in people with dementia are common and place a high burden on caregivers. Although hypnotic agents are often used to treat sleep disturbances, their use is associated with a considerable number of high-risk side-effects such as daytime sleepiness, amnesia, and an increased frequency of falling. The administration of bright light therapy (BLT) in the morning was a non-pharmacological remedy that was expected to treat sleep disorders in patients with dementia by entraining the circadian rhythm to ameliorate disturbances to the normal sleep-wake cycle. However, there are some unsolved issues related to the application of BLT, including the types of dementia for which it is effective and its efficacy in the different stages of cognitive decline and dementia. Furthermore, a protocol for effective BLT has not yet been proposed.
  
  
  METHODS
  In this study, we explored the efficacy of BLT in the treatment of 17 participants, including those with Alzheimer's type dementia (AD) (n = 8), vascular dementia (n = 4), and dementia with Lewy bodies (n = 5). Patients sat in front of the light box for 1 h/day from 0900 to 1000. The patients underwent treatment every day for 2 weeks.
  
  
  RESULTS
  BLT led to the improvement of sleep disturbance in four participants, all of whom were AD patients. The four AD patients showed a shorter duration of illness and/or had mild to moderate AD.
  
  
  CONCLUSIONS
  BLT could be an effective strategy for treating dementia patients, depending on their type and grade of their dementia. To confirm this hypothesis, it would be necessary to study a larger number of cases. Non-pharmacological therapies for sleep disorders should be emphasized as a safe form of treatment for patients with dementia.
authors.affiliation: Department of Psychiatry, Okehazama Hospital Fujita Mental Care Center, Toyoake, Japan.|Brain System Clinical Research Center, Toyoake, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sekiguchi
authors.affiliation: Department of Psychiatry Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Iritani
authors.affiliation: Department of Psychiatry, Okehazama Hospital Fujita Mental Care Center, Toyoake, Japan.|Brain System Clinical Research Center, Toyoake, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Fujita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D002940:Circadian Rhythm; D060825:Cognitive Dysfunction / Q000150:complications*; D015140:Dementia, Vascular / Q000150:complications*; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010789:Phototherapy; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
keywords: 
  Alzheimer's type dementia; bright light therapy; case series; dementia with Lewy bodies; vascular dementia