Specifically, light stimulation has proven effective in the treatment of circadian rhythm sleep-wake disorders-that is a misalignment between the person’s sleep–wake pattern and the pattern that is desired or considered as the societal norm. Based on this knowledge, light stimulation is used as an adjunct or even primary treatment in various fields. While morning light advances the circadian clock, evening and nocturnal light induce phase delays. This is primarily through its effects on intrinsically photosensitive ganglion cells in the retina that express the photopigment melanopsin and relay information to the circadian pacemaker in the SCN. around 460–480 nm) entrains circadian rhythms. In more detail, especially short-wavelength light (i.e. It is well-known that ambient light is the primary zeitgeber (from German something that “gives time”/synchronizes) that acts on the SCN. The most prominent example for such rhythms is probably the sleep–wake cycle, which is paralleled by circadian changes of other parameters such as body temperature, blood pressure, heart rate (variability), and hormone secretion. rhythms with a period length of approximately 24 h) and are under tight control of a biological “master clock” that is located in the suprachiasmatic nuclei (SCN) of the hypothalamus. Many biological and psychological processes of virtually all living beings follow circadian patterns (i.e. This underlines the importance of adequate room lighting in patient rooms as an adjunct therapeutic approach. Indeed, we demonstrate that biodynamic room lighting entrains and stabilizes circadian rhythms in patients with DOC after only 1 week of exposure to biodynamic room lighting as compared to standard clinic lighting. We thus investigated if exposure to biodynamic room lighting, which mimics the spectral composition and changes in illuminance of natural daylight, can support rhythm entrainment. While light therapy has shown to be effective in re-entraining circadian rhythms, the potential of such an intervention has not yet been evaluated systematically in patients with DOC. In severely brain-injured patients with disorders of consciousness (DOC) circadian (~24 h) rhythms are often strongly altered.
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