Influence of evening light exposure on polysomnographically assessed night-time sleep: A systematic review with meta-analysis

Abstract

Evening exposure to electric light can acutely suppress melatonin levels and adversely affect subsequent sleep. We conducted a systematic review with meta-analysis investigating the influence of evening illuminance levels on polysomnographically (PSG)-assessed sleep. We also explored how melanopsin (expressed in melanopic equivalent daylight illuminance (EDI) affects human sleep features. We included polysomnographic laboratory sleep studies with healthy humans for effects of illuminance and exposure duration, for pre-sleep exposures between 6:00 p.m. to 1:00 a.m. From 440 identified articles, 114 met eligibility criteria for screening, and 21 also reported type of light source/spectral characteristics, with 12 identified as eligible for review. Meta-analysis showed evening light affects sleep latency, sleep efficiency and slow wave sleep, with overall effect sizes (95% confidence interval) of 0.69 (−0.50; 1.88), 0.34 (−0.13; 0.82) and −0.61 (−1.85; 0.62), respectively. Estimated melanopic EDI in the range of 100–1000 lx yielded clear dose–response relationships for sleep latency and sleep efficiency, but not for slow wave sleep. Whilst illuminance and duration indicated no apparent effects for a single evening light exposure on PSG-assessed sleep latency, sleep efficiency and slow wave sleep, we observed evidence for a relationship between light exposure and sleep effects based on melanopic EDI. Hence, melanopic EDI may provide a robust predictor of non-visual responses on human sleep.