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Evaluation of Blue Light Exposure, Illuminance Level and the Associations

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Evaluation of Blue Light Exposure, Illuminance Level and the Associations Evaluation of blue light exposure, illuminance level and the associations with sleep/wake patterns in two populations living with sensory impairment. Amanda Nioi Submitted for degree of Doctor of Philosophy Heriot-Watt University Energy, Geoscience, Infrastructure and Society April 2016 Abstract Exposure to sufficient light during the daytime is fundamental for the regulation of the sleep/wake cycle, with the blue part of the spectrum most influential. This thesis explores exposure to environmental blue light and level of illuminance in two populations that experience circadian disruption i.e. older people and young people with autism spectrum disorder (ASD). The aim was to examine associations between blue light exposure, illuminance level and sleep/wake and physical activity patterns. Firstly, an exploratory study was conducted in adolescents with ASD living in a residential school setting aged 13-17 years (n=8). Secondly, a cross-sectional study carried out in two seasons (summer and winter) with a comparative study between seasons of varying light exposure and sleep/wake and physical activity outcomes was conducted in older people aged 72-99 years (n=20). In both studies quantitative measures were used to examine personal light exposure and sleep/wake patterns by use of novel equipment known as an actiwatch. This research demonstrated that objective measures of sleep/wake and light monitoring could be successfully administered in two populations with complex sensory issues. Preliminary findings from the exploratory study in adolescents with ASD indicated that exposure to blue light prior to bedtime was associated with a delay in sleep onset. The methodology developed for participant recruitment and engagement in a study using body sensors proved to be successful. Results for the study in older people suggested that between seasons daytime physical activity, blue light exposure and illuminance levels were significantly higher in summer. Correlated component regression (CCR) was used to investigate predictors of sleep parameters, suggesting morning blue light exposure (a predictor of total night-time sleep), daytime activity level (a predictor of sleep efficiency) and visual function (a predictor of minutes awake during the night) may contribute to sleep quality. The findings from these studies suggested that light exposure and health outcomes, such as physical activity and visual function could be responsible for sleep quality. This has important implications for design and health interventions promoting health and wellbeing, i.e. morning light exposure and time outdoors are important for circadian entrainment and building design and routine should reflect a diurnal light pattern light. i Acknowledgement Firstly, I am immensely grateful to my supervisory team, Deshong Professor Jenny Roe, Dr Alan Gow, Professor Emeritus Peter Aspinall and David McNair, for their support and considerable amount of time they dedicated to this research during the last three years. You each brought a different aspect of expertise that truly enriched my experience. I’d like to thank Jenny for remaining committed to the supervisory role after her move to York and latterly the USA. This kindness went further than duty commanded and for this I am very grateful. I would also like to thank Alan for stepping into the role of second supervisor in my second year and showing enthusiasm for my work throughout the processes. Thanks also to Peter for his time and endless knowledge on statistics and to David for taking a deep interest on a voluntary basis. I would also like to express my gratitude to the Engineering and Physical Sciences Research Council (EPSRC) for funding my PhD and to the Scottish Government, Care and Support Division (Sensory Impairment) for answering my cheeky email and providing a grant to assist in the purchase of the sleep/activity monitoring equipment. Thanks must also go to my wonderful volunteers, both young and old, and to the staff and parents that helped to bring to fruition the studies carried out for this thesis. A special thank you to Alison Scobie at Morlich House care home and to Sheena Murray at Falkland House School – you both emanate a warmth, compassion and love for the work you do that truly inspired me to persevere when things seemed too difficult. Finally, I’d like to thank my family and friends for their unlimited love, support and patience with me throughout the PhD process. To my immensely compassionate partner, Paul, you take my stress and reduce it, never grumble at me when I’m irrational and without fail see the positive in even the bleakest situations. ii ACADEMIC REGISTRY Research Thesis Submission Name: Amanda Nioi School/PGI: Energy, Geoscience, Infrastructure and Society Version: (i.e. First, Final Degree Sought Doctor of Philosophy Resubmission, Final) (Award and Subject area) Declaration In accordance with the appropriate regulations I hereby submit my thesis and I declare that: 1) the thesis embodies the results of my own work and has been composed by myself 2) where appropriate, I have made acknowledgement of the work of others and have made reference to work carried out in collaboration with other persons 3) the thesis is the correct version of the thesis for submission and is the same version as any electronic versions submitted*. 4) my thesis for the award referred to, deposited in the Heriot-Watt University Library, should be made available for loan or photocopying and be available via the Institutional Repository, subject to such conditions as the Librarian may require 5) I understand that as a student of the University I am required to abide by the Regulations of the University and to conform to its discipline. * Please note that it is the responsibility of the candidate to ensure that the correct version of the thesis is submitted. Signature of Date: Candidate: Submission Submitted By (name in AMANDA NIOI capitals): Signature of Individual Submitting: Date Submitted: For Completion in the Student Service Centre (SSC) Received in the SSC by (name in capitals): Method of Submission (Handed in to SSC; posted through internal/external mail): E-thesis Submitted (mandatory for final theses) Signature: Date: iii Contents Chapter 1 : An introduction to light and daily human functioning .......................... 1 1.1 Introduction ...................................................................................................................... 1 1.2 Light and the visible spectrum ........................................................................................ 4 1.3 The non-image forming eye ............................................................................................. 5 1.4 Circadian rhythms and the effects of light ..................................................................... 6 1.5 Circadian regulation of sleep and links for cognitive function ................................... 10 1.6 Light exposure, duration and intensity ......................................................................... 12 1.7 Rationale for study populations .................................................................................... 16 1.7.1 Rationale for adolescents with Autism Spectrum Disorder (ASD) ........................... 17 1.7.2 Rationale for ageing population ................................................................................ 20 1.8 The research problem and thesis rationale .................................................................. 26 1.9 Aims and objective of the research ............................................................................... 28 1.10 The thesis framework ................................................................................................... 28 Chapter 2 : Light and the built environment ............................................................. 31 2.1 Introduction .................................................................................................................... 31 2.2 An architectural response to light ................................................................................. 31 2.2.1 Orientation ................................................................................................................. 32 2.2.2 Scale .......................................................................................................................... 36 2.2.3 Destination and view ................................................................................................. 38 2.3 Lighting design strategies .............................................................................................. 40 2.4 Summary ......................................................................................................................... 44 Chapter 3 : Research design and methodology .......................................................... 46 3.1 Introduction .................................................................................................................... 46 3.2 Design ............................................................................................................................... 46 3.3 Quantitative methods ..................................................................................................... 47 3.3.1 Objective sleep/wake and activity measures ............................................................. 47 iv 3.3.2 Health and wellbeing outcome measures .................................................................. 50 3.3.3 Summary
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