USING MORE DATA FOR LIGHTING SCIENCE
Shadab A. Rahman Ph.D., M.P.H.
Instructor in Medicine - Harvard Medical School Division of Sleep Medicine Associate Neuroscientist - Brigham and Women’s Hospital Division of Sleep and Circadian Disorders
Financial Disclosure
• SAR holds IP for Prevention of Circadian Rhythm Disruption Using Optical Filters, and Improving sleep performance in subject exposed to light at night; • SAR owns equity in Melcort Inc., which owns a stake in Circadian ZircLight Inc., • SAR is a co-investigator on studies sponsored by Biological Illuminations, LLC; Vanda Pharmaceuticals Inc. • SAR is a paid consultant for Sultan and Knight t/a Circadia SPL / NASA / NOAA / GETTY IMAGES Let there be light
https://www.edouardstenger.com/wp-content/uploads/2014/10/Evolution-of-lights-sources.jpg Source: http://www.lightpollution.it/ © 2001 P. Cinzano, F. Falchi, C.D. Elvidge Lighting characteristics that modulate biological response
INTENSITY DURATION
HISTORY WAVELENGTH
PATTERN TIMING Application of basic studies
Sleep at Night
n=94, cross-over, 8 weeks 7.9
7.3
6.6 Sleep Quality Totalsleep time (h)
Control Baseline Intervention -1.27
Rahman et al., Chronobiol Int 2013 PSQI score -0.53 n=9, longitudinal, 7 weeks Δ
Control Intervention
Viola et al., Scand J Work Environ Health 2008 Problems of limited sample size
• Limited statistical power
• High false discovery rate
• Limited reproducibility
• LIMITED GENERALIZABILITY
Advantages of large sample size
• Accuracy
• Subgroup analysis
• Diversity and outliers
• GOOD GENERALIZABILITY
Sources of “Big Data”
EHR EMR
Social Medical Media Claims
Patient Mobile/ Registries Wearables
Characterization Better Exploration Test Health Prevalence of sleep disorder risk in first responders (US)
% total respondents at high risk Sleep disorder Firefighters Police (n=6933) (n=4957) Obstructive sleep apnea 28% 34% Insomnia 6% 7% Restless legs syndrome 3% 2%
Shift-work disorder 9% 15%
One or more sleep disorder 37% 40%
Barger et al., J Clin Sleep Med 2015; Rajaratnam et al., JAMA 2011 Global sleep patterns
n=5450, cross-sectional, 1 year
Walch et al., Science Advances 2016 Light at night and breast cancer
Association between light at night and breast cancer
1.2
1.15
1.1
1.05
RATIO HAZARD 1
0.95 James et al., Environ Health Perspect. 2017
0.9 n=109,672, longitudinal, 24 years LAN Q- LAN Q- LAN Q- LAN Q- LAN Q- tile 1 tile 2 tile 3 tile 4 tile 5 Operation Stay Alert Federal Emergency Management Agency Harvard Work Hours, Health and Safety Group n=1,189 Disability Days Randomized Paired Design 46% reduction 1 year
2.6 Control 16 stations ~588 firefighters p=0.003
Intervention 1.4 16 stations ~601 firefighters
Control Intervention
Sullivan et al., SLEEP 2017
MEASURING THE EFFECTS OF LIGHT FROM ELECTRONIC DEVICES ON SLEEP
Rahman et al., Unpublished F.Lux study map
Participants = 5154
Sleep diary data = 2709
Nights of data = 19,217
~460/condition
Rahman et al., Unpublished Intervention results
2691 2388
Male Female TST (hours) Energetic 7.9 52.5
52 7.8 51.5
51 7.7 50.5
7.6 50 B C A D E F B C A D E F
Rahman et al., Unpublished Future directions for using more data in lighting science
• Study the impacts of light on: • Worker/provider safety • Production • Health USE EXISTING DATA • Take advantage of “natural experiments” • Retrofits (pre- post-designs) • New fits (parallel designs) • Between sites (dose response)
Future directions for using more data in lighting science
• Prospective studies with industry partners because: • Perfectly define exposure • Perfectly model light environment • Limit data collection bias • COST EFFECTIVE STUDIES
Summary
• “Big data” is the way forward
• BUT…controlled “small data” studies are not a thing of the past
Acknowledgements
University of Toronto Toronto Western Nursing Executive and Management Robert Casper, MD committees Theodore Brown, PhD Toronto Western Nursing staff Colin Shapiro, MD, PHD Shai Marcu, MD Physician, nursing and technical staff at Center for Clinical Brigham and Women’s Hospital Investigation, Brigham and Women’s Hospital Salim Qadri
Jason Sullivan Melissa St. Hilaire, PhD Erin Flynn-Evans, PhD MPH Steven Lockley, PhD Charles Czeisler, MD PHD F.Lux Michael Herf Lorna Herf Thank you…