The more we learn about sleep, the more important it becomes. Most of us would agree that a good night’s sleep makes you feel better. Recently published research supports that notion and finds links between light, sleep, and health.
We can use this research as a basis for innovative design solutions that improve the quality of life for residents in senior living communities. Here are a few examples.
Alzheimer’s disease
It is well established that Alzheimer’s disease causes disrupted sleep. Beginning in the early stages of the disease, and long before cognitive symptoms begin, sleep patterns begin to change that reduce the length and quality of sleep. As the disease progresses, the disturbance becomes more pronounced.
New research from Scientists at Washington University in St. Louis shows that disturbed sleep can accelerate the progression of Alzheimer’s. In this article, the authors discuss emerging evidence that shows that the sleep-wake cycle affects the accumulation of amyloid plaque in the brain, which is associated with the disease. The accumulation of plaque has been shown to disturb sleep, which suggests a bidirectional relationship in which the disease disturbs sleep; and disturbed sleep advances the disease. One clinical application suggested by the authors is to see if improved sleep can reduce the risk of developing the disease, or at least delay the progression of it.
For the design community, it may be that we should include improving sleep as a design consideration. Since light and darkness are the most powerful environmental cues that keep our biological rhythms in sync, a building designed to include these elements would support restful, restorative sleep. Skylights in common areas are one possible solution, and innovative entries to bedrooms to preserve darkness at night would also help.
Cancer
Research into the growth and spread of cancer suggests that while patients are sleeping, their tumors are sleeping; and at that same time the immune system is at peak activity to destroy the tumors. Researcher David Blask has found that the hormone melatonin is key to keeping tumors at bay while natural defenses are at work. Melatonin in the blood stream tells cancer cells that it’s night, and thereby suppresses the growth of tumors.
Since light suppresses melatonin, it’s very important that we find ways of preserving darkness in bedrooms at night. This could allow the immune system to destroy cancerous cells before they have a chance to grow larger. Design solutions include window treatments to exclude exterior light and night lights that provide enough low-level light that normal room lights aren’t needed.
Caregivers
Caregivers are changing behaviors as a result of evidence that links light, sleep, and health. Based on a three-year study of resident sleep, clinicians in Minnesota are beginning to include sleep as part of their care plan.
Empira, a collaborative and cooperative effort of older adult service providers in Minnesota, launched its
Restorative Sleep Vitality Program, developed by Cindy Morris and Sue Guilderman and presented at an educational session at Leading Age 2015. They began with an assessment of residents sleep patterns and then compared that with their operations schedule. The analysis revealed that resident sleep was being compromised for the convenience of the caregivers.
By including sleep as part of a care plan, they motivated changes to scheduled activities like restocking linens and cleaning residents’ toilet rooms to avoid nighttime disturbance. Caregivers also changed their behavior to reduce noise and avoid intrusive light in resident bedrooms after dark. Rather than switch on the lights when entering resident rooms at night, caregivers carried a personal light with them to minimize disruptions to resident sleep.
The researchers reported reduced falls and improved resident quality of life by prioritizing sleep.
Michael David White, LC, EDAC, LEED AP, is senior lighting designer for Schuler Shook (Minneapolis). He can be reached at [email protected].
