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Supplemental light exposure improves sleep architecture in people with type 2 diabetes

Acta Diabetologica volume 58, pages 1201–1208 (2021)Cite this article

Abstract

Aims

People with type 2 diabetes (T2D) suffer from sleep disorders, with the mechanism not clearly understood. In T2D, the light transducing retinal photoreceptors that regulate sleep behaviours are dysfunctional; hence, we determine here whether supplemental light exposure ameliorates sleep quality and daytime sleepiness in T2D.

Methods

Supplemental light (10,000 Lux, polychromatic) was self-administered for 30 min every morning for 14 days by ten participants with T2D with no diabetic retinopathy (DR). The effectiveness of supplemental light was assessed by comparing subjective sleep questionnaire (PSQI and ESS) scores and salivary dim light melatonin onset (DLMO) before and after the light exposure as well as with a self-maintained sleep diary during the light exposure.

Results

Compared to the baseline, supplemental light significantly improved the excessive daytime sleepiness score (p = 0.004) and phase-advanced the DLMO on average by ~ 23 min. Sleep diary analyses showed that afternoon nap duration significantly shortened over the first week of supplemental light exposure (p = 0.019). Afternoon naps and midnight awakening were significantly longer in diabetic participants with thinner perifoveal retina.

Conclusions

In this case series, we provide initial evidence that supplemental bright light improves daytime sleepiness in T2D with no DR, with the critical period of light exposure showing a beneficial effect after one week. We infer that supplemental light augments photoreceptor signalling in T2D and therefore optimises circadian photoentrainment leading to improved sleep. Our findings inform the development of tailored light therapy protocols in future clinical trials for improving sleep architecture in diabetes.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding authors upon reasonable request.

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Acknowledgements

This study was supported by the Australian Research Council Future Fellowship ARC-FT180100458 (AJZ) and IHBI Vision and Eye Program 2019 Vision Research Development Grant (PA, AJZ, BF).

Author information

Authors and Affiliations

  1. Centre for Vision and Eye Research, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia

    Prakash Adhikari, Asik Pradhan, Andrew J. Zele & Beatrix Feigl

  2. School of Optometry and Vision Science, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia

    Prakash Adhikari, Asik Pradhan & Andrew J. Zele

  3. School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia

    Beatrix Feigl

  4. Queensland Eye Institute, Brisbane, Australia

    Beatrix Feigl

Authors
  1. Prakash Adhikari
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  2. Asik Pradhan
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  3. Andrew J. Zele
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  4. Beatrix Feigl
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Contributions

PA, AJZ, and BF developed the study design and supervised the project. PA, AP, AJZ, and BF conducted the experiments and formal analyses. PA, AP, AJZ, and BF wrote and revised the manuscript draft.

Corresponding author

Correspondence to Beatrix Feigl.

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The authors declare that they have no competing interests.

Ethics approval

All procedures were conducted in accordance with a QUT University Human Research Ethics Committee approval (no. 1700000699) and the 1964 Helsinki Declaration and its later amendments.

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A written informed consent was obtained from each participant before the experiment.

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A written informed consent was obtained from each participant for publication.

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Adhikari, P., Pradhan, A., Zele, A.J. et al. Supplemental light exposure improves sleep architecture in people with type 2 diabetes. Acta Diabetol 58, 1201–1208 (2021). https://doi.org/10.1007/s00592-021-01712-y

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