Effects of light therapy on sleep and circadian rhythm in older type 2 diabetics living in long-term care facilities: a randomized controlled trial.

Background: Light influences the secretion of melatonin in the body and regulates circadian rhythms, which play an important role in sleep and mood. The light level of rooms in long-term care facilities is usually far below the threshold required to regulate the body's circadian rhythm, and insufficient light can easily lead to sleep and mood disturbances among older residents in nursing homes. Therefore, the objective of this study was to investigate the effects of light therapy on sleep and circadian rhythm in older adults with type 2 diabetes residing in long-term care facilities. Methods: This study was a prospective, single-blind, randomized controlled trial. Participants were randomly assigned to either the light therapy (LT) group or the control group and received the intervention for four weeks. Primary outcomes included the Pittsburgh Sleep Quality Index (PSQI) and objective sleep parameters recorded by a sleep monitoring bracelet, Morningness-Eveningness Questionnaire (MEQ). The secondary outcome included glycated serum protein (GSP). Data was collected at three time points: at baseline (T0), immediate post-treatment (T1), and 4-week follow-up (T2). A linear mixed model analysis was used to analyzed the data. Results: We enrolled 45 long-term care residents. Compared with the control group, significant reductions in PSQI scores were observed at T1 and T2. At T2, the sleep score of objective sleep parameters was significantly higher in the LT group compared to the control group. Additionally, compared to the baseline T0, MEQ scores were significantly lower in the LT group at T1 and T2, with no significant difference in the control group. There was no significant difference between groups in glycated serum protein values at T1 and T2. However, compared to T0, glycated serum protein values decreased in the LT group while increased in the control group at T2. Conclusion: Light therapy had a positive effect on subjective sleep quality and circadian rhythm time type in long-term care residents with type 2 diabetes, and had a possible delayed effect on objective sleep. However, no discernible alterations in blood glucose levels were detected in this study.

Light Therapy to Improve Sleep Quality in Older Adults Living in Residential Long-Term Care: A Systematic Review.

OBJECTIVES: Because light can regulate sleep rhythms, numerous studies have investigated whether light therapy can improve sleep disorders in older people, but its efficacy remains controversial. Therefore, this systematic review aimed to examine and summarize current evidence about the efficacy of light therapy to improve sleep for older people in residential long-term care. DESIGN: Systematic review. SETTING AND PARTICIPANTS: Older people living in long-term care settings. METHODS: Systematic searches were conducted in the databases PubMed, Web of Science, Cochrane, EMBASE, CINAHL, China National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, Chinese Biomedical Literature Database, and in reference lists within relevant articles. Studies were eligible for inclusion if they evaluated light therapy for older people with sleep disorders in long-term care settings. RESULTS: This systematic review includes 21 articles, summarizing light therapy with different durations and intensities. The light intervention was typically administered between 7:00 and 12:00 am for 30-120 minutes. The interventions lasted from 1 week to several months, and the intensity of the light intervention usually ranged from 2500 to 10,000 lux. Short-term exposure (30-60 minutes) with high light levels (≥10,000 lux), relatively long-term exposure (1-2 hours) with moderate light levels (2500-10,000 lux), or long-term exposure (1-4 hours or full day) with low light levels (≤2500 lux) were associated with improved sleep indicators for older people in long-term care settings. CONCLUSIONS AND IMPLICATIONS: The efficacy of light therapy in long-term care settings may be affected by the duration of exposure, time and length of intervention, intensity of light, and equipment used to administer the therapy. Further research must be conducted to optimize light therapy parameters. Large, high-quality randomized controlled trials are needed to deepen our understanding of the effects of light therapy on sleep in older people living in long-term care settings.

[Euphorbia fischeriana extract reactivates latent HIV through nuclear factor-κB pathway].

OBJECTIVE: To investigate the effect of Euphorbia fischeriana extract on latent HIV reactivation and the pathway involved in this process and discuss the value of Euphorbia fischeriana extract in eliminating HIV. METHODS: Fresh tissues of Euphorbia fischeriana root were crushed into powder after quick freezing with liquid nitrogen and extracted with acetone followed by a three-day vacuum freeze-drying for dehydration of the extract. The extract (EFE) was separated using RP-C18 column with high-performance liquid chromatography (HPLC) and identified with mass spectrometry (MS). The activity of reactivated latent HIV was analyzed by fluorescence-activated cell sorting in a J-Lat 10.6 cell model treated with EFE (50 µg/mL) for 24 h, using TNF-α (10 ng/mL) as the positive control. The effect of a NF-κB pathway inhibitor (Bay 11-7082) on EFE activity was tested. The changes in P65 expression in the cell nuclei within 2 h and HIV protein p24 expression within 24 h were analyzed by Western blotting in cells treated with EFE. RESULTS: EFE was obtained by one-step acetone extraction, and the concentration of prostratin in the extract was around 0.53 mmol/L. About 50% of the cells showed HIV reactivation after treatment with 50 µg/mL EFE for 24 h accompanied by a significantly increased p24 expression. The activity of EFE in reactivating latent HIV was inhibited by Bay 11-7082 in a concentration-dependent manner, and p65 accumulation was detected in the cell nuclei within 2 h. CONCLUSION: EFE we obtained contains the active compounds of prostratin and its analogues and shows a strong capacity to reactivate latent HIV through classical NF-κB pathway.