0308 Impact of Customized Lighting on Sleep in Hospitalized Patients

Abstract Introduction Inpatient sleep may be disrupted for myriad reasons, including lighting exposure that is typically fixed at constant intensity and spectra. In this study we employed customized lighting that promotes circadian entrainment by exposing patients to blue-augmented lighting during the morning and blue-suppressed lighting evening to improve sleep timing and duration. Methods Two Mount Sinai hospital rooms (with 2 beds each) were outfitted with Eight Mattress sensors that use a combination of movement, breathing, heart rate, and temperature variables to estimate wake and sleep vigilance states in 30-second epochs. One room contained customized lighting between 7 am and 11 pm, while the other room contained standard hospital lighting. The current analysis includes 60 participants (30 in the control room and 30 in the custom lighting room), who were matched for time-of-year hospital admission date. We first analyzed the probability of sleep during any given 30-second epoch across each subject’s admission and compared the distributions of sleep probability across the 24-hour cycle for all subjects in the lighting vs control conditions. We additionally evaluated total nocturnal sleep duration(11 PM – 7 AM) by 1) summating all sleep epochs on nights containing at least 50% valid data and 2) normalizing all measured sleep epochs to all valid sleep/wake outputs (excluding indeterminate epochs). Results The distribution of sleep probability was significantly different in the lighting vs control condition (p < 0.001) with most apparent diversion of the distributions between 9 pm and 9 am. The average raw nocturnal sleep duration was significantly higher in lighting condition (270.0 ± 23 minutes vs 201 ± 23 min in control, p = 0.037), as was the average minutes of sleep per hour of valid recording (36.9 ± 15 minutes vs 28.4 ± 13 in control, p = 0.022). There were no significant differences in the number of nocturnal wake or indeterminate epochs between conditions. Conclusion Custom lighting appears to promote sleep in hospitalized patients, but the interpretation is tempered by absence of full validation of the mattress sensor against polysomnography. Future work will evaluate differences in sleep timing and continuity between conditions. Support (if any) McClung Foundation, R01 AG066870