What’s New in the Patient Safety World

December 2013

Lighten Up Your Patient’s Day!



In many of our columns dealing with delirium we’ve noted the importance of using lighting in the hospital that mimics normal day/night cycles to help prevent delirium. But what about the rest of the patients in the hospital who may not be at risk for delirium? Is their condition and hospital course impacted by the lighting in the hospital?


Researchers from the Cleveland Clinic say “yes”. A new study (Bernhofer 2013) used light meters and wrist actigraphy to assess the sleep-waking patterns of hospital inpatients and correlated those parameters with patients’ pain levels and mood. Light exposure levels were low and sleep time was poor and fragmented. There was little sleep–wake synchronization with light. Fatigue and total mood disturbance scores were high and inversely associated with light. Pain levels were also high and positively associated with fatigue, but not directly with light exposure. Low light exposure significantly predicted fatigue and total mood disturbance. They concluded that inpatients were exposed to light levels insufficient for circadian entrainment. Nevertheless, higher light exposure was associated with less fatigue and lower total mood disturbance in participants with pain.


Though the study was small (40 total patients) this research demonstrates the need for further studies to see if altering light exposure for inpatients would be beneficial in affecting sleep–wake disturbances, mood and pain.


Admittedly there are lots of things other than ambient light that impact a patient’s sleep-waking patterns. See our August 6, 2013 Patient Safety Tip of the Week “Just Let Me Sleep!” for details.







Bernhofer EI, Higgins PA, Daly BJ, et al. Hospital lighting and its association with sleep, mood and pain in medical inpatients. Journal of Advanced Nursing 2013;

Article first published online : 27 OCT 2013, DOI: 10.1111/jan.12282





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