Hybrid effectiveness-implementation study of two novel spectrally engineered lighting interventions for shiftworkers on a high-security watchfloor

Sara C Bessman; Elizabeth M Harrison; Alexandra P Easterling; Michelle N Snider; Sebastian M M Preilipper; Gena L Glickman

doi:10.1093/sleepadvances/zpad051

Hybrid effectiveness-implementation study of two novel spectrally engineered lighting interventions for shiftworkers on a high-security watchfloor

Sleep Adv. 2023 Nov 21;4(1):zpad051. doi: 10.1093/sleepadvances/zpad051. eCollection 2023.

Authors

Sara C Bessman^{1

2}, Elizabeth M Harrison^{1

2}, Alexandra P Easterling^{1

2}, Michelle N Snider^{1

2}, Sebastian M M Preilipper^{1

2}, Gena L Glickman²

Affiliations

¹ Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, USA.
² Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA.

Abstract

Shiftwork leads to myriad negative health and safety outcomes. Lighting countermeasures can benefit shiftworkers via physiological effects of light (e.g. alerting, circadian adjustment), and short-wavelength light is the most potent for eliciting those responses; however, limited work indicates it may not be required for alerting. We developed similar-appearing light boxes (correlated color temperature: 3000-3375 K; photopic illuminance: 260-296 lux), enriched (SW+, melanopic EDI: 294 lux) or attenuated (SW-, melanopic EDI: 103 lux) in short-wavelength energy, and implemented them on a high-security watchfloor. Efficacy and feasibility of these two novel lighting interventions were assessed in personnel working 12-hour night shifts (n = 47) in this within-participants, crossover study. For each intervention condition, light boxes were arranged across the front of the watchfloor and illuminated the entire shift; blue-blocking glasses were worn post-shift and before sleep; and sleep masks were used while sleeping. Comparisons between baseline and intervention conditions included alertness, sleep, mood, quality of life (QOL), and implementation measures. On-shift alertness (Karolinska Sleepiness Scale) increased in SW- compared to baseline, while changes in SW+ were more limited. Under SW+, both mood and sleep improved. Psychomotor vigilance task performance did not vary by condition; however, perceived performance and QOL were higher, and reported caffeine consumption and sleep onset latency were lower, under SW-. For both interventions, satisfaction and comfort were high, and fewer symptoms and negative feelings were reported. The addition of spectrally engineered lights to this unique work environment improved sleep, alertness, and mood without compromising visual comfort and satisfaction. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.

Keywords: alertness; circadian; implementation; intervention; light; melanopic; shiftwork; sleep; spectrum.