Bright Light Therapy on Post-stroke Insomniawith Post-stroke Insomnia

Recruitment & Eligibility

Inclusion Criteria

first occurrence of stroke for the patient
matched International Classification of Diseases (ICD)-10 codes (nontraumatic subarachnoid hemorrhage [I60], nontraumatic intracerebral hemorrhage [I61], other and unspecified nontraumatic intracranial hemorrhage [I62], or cerebral infarction [I63]) (World Health Organization, 1997)
mild-to-moderate stroke (the National Institutes of Health Stroke Scale ≤14)
age ≥18 years
satisfactory cognitive function
post-stroke insomnia.

Exclusion Criteria

Mini Mental State Examination (MMSE) score of ≤10
recurrent stroke
aphasia
transient ischemic attack
schizophrenia, bipolar disorder, mood disorder, previous insomnia disorder, or dementia before stroke
taking sleeping pills or antidepressants for 5 or more days within a 6-month timespan before the onset of stroke
post-stroke delirium
a National Institutes of Health Stroke Scale score ≥ 14
previous eye disease or post-stroke eye disease
severe auditory impairment
the use of psychotropic medications (hypnotics, benzodiazepine, benzodiazepine agonists, antidepressants [mirtazapine or trazodone] or antipsychotics)

Study & Design

Arm && Interventions

Group	Intervention	Description
Sham Therapy	Philips EnergyUp Energy light HF3418/01 with filter	Light-therapy with filters that reduced lamp output to less than 50 lux. for 30 minutes as soon as possible after awakening.
Bright light therapy	Philips EnergyUp Energy light HF3418/01	Daily exposure to a high brightness LED light box for 30 minutes as soon as possible after awakening, preferably between 7 and 8 AM in the patient's hospital room The device emits 10,000 lux of cool-white fluorescent light at 50-75 cm from the screen to the cornea with an ultraviolet filter

Primary Outcome Measures

Name	Time	Method
wake after sleep onset in actigraphy	4 weeks	sum \[in minutes\] of all awake epochs between sleep onset and sleep end
number of awakenings in actigraphy	4 weeks	number of awakenings
total sleep duration in actigraphy	4 weeks	the sum \[in minutes\] of all sleep epochs between sleep onset and sleep end
sleep efficiency in actigraphy	4 weeks	(SE%, the percentage of time spent asleep while in bed
sleep onset latency in actigraphy	4 weeks	the interval between time-to-bed and sleep onset

Secondary Outcome Measures

Name	Time	Method
The Epworth Sleepiness Scale	4 weeks	Subjective sleep parameters, 0-24, 0-28, higher scores indicate more daytime sleepiness
the insomnia severity index	4 weeks	Subjective sleep parameters, 0-28, higher scores indicate more acute symptoms of insomnia
The World Health Organization Quality of Life Scale Abbreviated Version	4 weeks	overall quality of life through self-reporting, with four subscales in overall health: physical health, psychological health, social relationships, and environmental health. The higher sum in each subscale signified better quality of life.
the Pittsburgh Sleep Quality Index	4 weeks	Subjective sleep parameters, 0-21, higher scores indicate more poor sleep quality
the Fatigue Severity Scale	4 weeks	Subjective sleep parameters, 0-36, 0-28, higher scores indicate greater fatigue.
The Patient Health Questionnaire-9	4 weeks	depression, 0-27, higher scores indicate more severe of depression.
The generalized Anxiety Disorder-7	4 weeks	anxiety, 0-21, higher scores indicate more severe of anxiety

Recruitment & Eligibility