Effect of Light Therapy on Sleep Disturbance and Depression in Climacteric Women

Yun Ah Kim; Mi Hae Sung

doi:10.4069/kjwhn.2015.21.3.197

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Kim and Sung: Effect of Light Therapy on Sleep Disturbance and Depression in Climacteric Women

Original Article

Korean Journal of Women Health Nursing 2015; 21(3): 197-206.

Published online: 25 September 2015

DOI: https://doi.org/10.4069/kjwhn.2015.21.3.197

Effect of Light Therapy on Sleep Disturbance and Depression in Climacteric Women

Yun Ah Kim¹, Mi Hae Sung²

¹Department of Nursing, Kaya University, Busan, Korea.

²Department of Nursing, Inje University · Institute for Health Science, Busan, Korea.

Corresponding author: Sung, Mi Hae. Department of Nursing, Inje University, 75 Bokjiro, Geageum-dong, Busanjin-gu, Busan 614-735, Korea. Tel: +82-51-890-6825, Fax: +82-51-896-9840, nursmh@inje.ac.kr

Received 6 July 2015 Revised 4 August 2015 Accepted 19 August 2015

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to examine the effects of light therapy on sleep disturbance and depression in climacteric women with menopausal symptoms.

Methods

The research design was a nonequivalent control group pre test-post test design. Data were collected from September 29, 2013 to November 11, 2013. Participants included 17 climacteric women in an artificial light therapy group, 17 climacteric women in a sun light therapy group and 16 climacteric women in a control group. Measures consisted of the sleep disturbance, depression, melatonin, and serotonin.

Results

There was a statistically significant difference of Korean Sleep Scale A (F=53.87, p<.001), and melatonin (F=31.19, p<.001) among three groups. There was a statistically significant difference of Self-Rating Depression Scale (F=121.86, p<.001), and serotonin (F=102.37, p<.001) among three groups.

Conclusion

Artificial and sun light therapy can be applied as a supportive nursing intervention to subjects with sleep disturbance and depression in climacteric women with menopausal symptoms. Artificial and sun light therapy is expected to be a complementary alternative intervention for health management of the subjects with sleep disturbance and depression in climacteric women with menopausal symptoms.

Keywords: Climacteric, Insomnia, Depression, Light, Therapy

Figures and Tables

Table 1

Homogeneity Test for General and Obstetrical Characteristics of Subjects (N=50)

Characteristics		Categories	Total (N =50)	Cont. (n=16)	Exp. I (n=17)	Exp. II (n=17)	x²	p
Characteristics		Categories	n(%)	n(%)	n(%)	n(%)	x²	p
General characteristics	Age (yr)^†	≤52	11 (22.0)	6 (37.5)	3 (17.6)	2 (11.8)	3.86	.425
		53~55	19 (38.0)	4 (25.0)	7 (41.2)	8 (47.1)
		≥56	20 (40.0)	6 (37.5)	7 (41.2)	7 (38.0)
	Marital status^†	Married	42 (84.0)	12 (75.0)	14 (82.4)	16 (94.1)	2.29	.318
	Marital status^†	Widowed	8 (16.0)	4 (25.0)	3 (17.6)	1 (5.9)	2.29	.318
	Education^†	Middle school	17 (34.0)	4 (25.0)	9 (52.9)	4 (23.5)	4.69	.321
		High school	31 (62.0)	11 (68.8)	8 (47.1)	12 (70.6)
		≥University	2 (4.0)	1 (6.3)	-	1 (5.9)
	Religion^†	No	21 (42.0)	3 (18.8)	9 (52.9)	9 (52.9)	6.15	.407
	Religion^†	Yes	29 (58.0)	13 (81.2)	8 (47.1)	8 (47.1)	6.15	.407
	Occupation^†	Housewife	36 (72.0)	12 (75.0)	13 (76.5)	11 (64.7)	0.69	.709
	Occupation^†	self-employed	14 (28.0)	4 (25.0)	4 (23.5)	6 (35.3)	0.69	.709
	Monthly income^† (10,000 won)	≤350	22 (44.0)	5 (31.3)	8 (47.1)	9 (52.9)	8.67	.070
		351~450	22 (44.0)	6 (37.5)	8 (47.1)	8 (47.1)
		≥450	6 (12.0)	5 (31.3)	1 (5.9)	-
Obstetrical characteristics	Gravidity^†	≤3	24 (48.0)	10 (62.5)	5 (29.4)	9 (52.9)	6.49	.165
		4~6	21 (42.0)	4 (25.0)	9 (52.9)	8 (47.1)
		≥7	5 (10.0)	2 (12.5)	3 (17.6)	-
	Parity^†	1	9 (18.0)	3 (18.8)	4 (23.5)	2 (11.8)	4.00	.676
		2	26 (52.0)	7 (43.8)	7 (41.2)	12 (70.6)
		3	12 (24.0)	5 (31.3)	5 (29.4)	2 (11.8)
		4	3 (6.0)	1 (6.3)	1 (5.9)	1 (5.9)
	Abortion^†	0	16 (32.0)	6 (37.5)	5 (29.4)	5 (29.4)	3.37	.497
		1~2	18 (36.0)	6 (37.5)	4 (23.5)	8 (47.1)
		≥3	16 (32.0)	4 (25.0)	8 (47.1)	4 (23.5)
	Living children^†	1	8 (16.0)	3 (18.8)	3 (17.6)	2 (11.8)	3.59	.741
		2	27 (54.0)	7 (43.8)	8 (47.1)	12 (70.6)
		3	11 (22.0)	4 (25.0)	5 (29.4)	2 (11.8)
		4	4 (8.0)	2 (12.5)	1 (5.9)	1 (5.9)
	Menarche (yr)^†	≤13	15 (30.0)	4 (25.0)	7 (41.2)	4 (23.5)	3.12	.536
		14~15	27 (54.0)	8 (50.0)	9 (52.9)	10 (58.8)
		≥16	8 (16.0)	4 (25.0)	1 (5.9)	3 (17.6)
	Menstruation cycle^†	Irregular	21 (42.0)	4 (25.0)	10 (58.8)	7 (41.2)	4.47	.346
		Menopause	20 (40.0)	9 (56.3)	4 (23.5)	7 (41.2)
		Artificial menopause	9 (18.0)	3 (18.8)	3 (17.6)	3 (17.6)
	Gynecology operation^†	Yes	33 (66.0)	9 (56.3)	13 (76.5)	11 (64.7)	1.52	.467
	Gynecology operation^†	No	17 (34.0)	7 (43.8)	4 (23.5)	6 (35.3)	1.52	.467
	Perceived health status^†	Normal	25 (50.0)	5 (31.3)	9 (52.9)	11 (64.7)	6.93	.139
		Poor	23 (46.0)	9 (56.3)	8 (47.1)	6 (35.3)
		Very poor	2 (4.0)	2 (12.5)	-	-

Cont.=Control group: Artificial light of less than 300 Lux; Exp.=Experimental group; Exp. I=Sun light therapy; Exp. II=Artificial light therapy.

^†Fisher's exact test.

Table 2

Homogeneity Test for Menopause Symptom Index, Sleep Disturbance, and Depression among Three Groups (N=50)

Variables	Categories	Cont. (n=16)	Exp. I (n=17)	Exp. II (n=17)	F	p
Variables	Categories	M±SD	M±SD	M±SD	F	p
Menopause symptom	MENSI	29.93±5.59	29.11±4.02	28.00±4.56	0.74	.481
Sleep disturbance	Sleep scale A	32.00±3.88	30.94±3.09	31.35±2.34	0.47	.627
Sleep disturbance	Melatonin (pg/mL)	10.71±3.01	10.50±3.70	10.80±3.88	0.03	.969
Depression	SRDS	67.18±4.00	70.00±2.59	69.58±4.21	2.80	.071
Depression	Serotonin (ng/mL)	79.52±19.85	83.35±24.66	86.97±27.26	0.39	.679

MENSI=Menopause symptom index; SRDS=Self-rating depression scale; Cont.=Control group: Artificial light of less than 300 Lux; Exp.=Experimental group; Exp. I=Sun light therapy; Exp. II=Artificial light therapy.

Table 3

Comparison of Sleep Scale A and Melatonin among Three Groups (N=50)

Variables	Categories	Groups	Pretest	Posttest	Difference	Paired-t (p)	F (p)
Variables	Categories	Groups	M±SD	M±SD	M±SD	Paired-t (p)	F (p)
Sleep disturbance	Sleep scale A	Cont. (n=16)^a	32.00±3.88	31.87±4.15	-0.81±2.92	-1.11 (.284)	53.87 (<.001) b, c>a
		Exp. I (n=17)^b	30.94±3.09	40.47±2.23	9.53±4.58	10.63 (<.001)
		Exp. II (n=17)^c	31.35±2.34	43.35±3.33	12.11±4.49	11.10 (<.001)
	Melatonin	Cont. (n=16)^a	10.71±3.01	10.70±2.86	-0.01±0.27	-0.25 (.801)	31.19 (<.001) b, c<a
		Exp. I (n=17)^b	10.50±3.70	4.77±0.82	-5.72±2.97	-7.92 (<.001)
		Exp. II (n=17)^c	10.80±3.88	4.47±0.86	-6.32±3.11	-8.37 (<.001)
Depression	SRDS	Cont. (n=16)^a	67.18±4.00	67.81±2.45	0.62±2.87	0.87 (.389)	121.86 (<.001) b, c<a
		Exp. I (n=17)^b	70.00±2.59	52.52±3.59	-17.48±5.43	-15.49 (<.001)
		Exp. II (n=17)^c	69.58±4.21	48.58±4.45	-21.00±5.59	-15.48 (<.001)
	Serotonin	Cont. (n=16)^a	79.52±19.85	82.40±9.94	2.88±10.55	1.09 (.292)	102.37 (<.001) b, c>a
		Exp. I (n=17)^b	83.35±24.66	147.12±28.55	63.77±11.97	21.96 (<.001)
		Exp. II (n=17)^c	86.97±27.26	155.98±31.87	69.01±19.62	14.50 (<.001)

Cont.=Control group: Artificial light of less than 300 Lux; Exp.=Experimental group; Exp. I=Sun light therapy; Exp. II=Artificial light therapy.

a, b, c=Scheffé test.

Notes

This manuscript is a condensed form of the first author's doctoral thesis from Inje University.

Summary Statement

▪ What is already known about this topic?

Sleep disturbance and depression are symptoms of climacteric women. Light therapy can decrease depression in patients. But there is lack of study as to the effects of light therapy for climacteric women.

▪ What this paper adds?

Light therapy was related with sleep disturbance, and depression in climacteric wmoen. Light therapy can be applied as a supportive nursing intervention to subjects with sleep disturbance and depression in climacteric women.

▪ Implications for practice, education and/or policy

Light therapy can be applied in clinical practice, and patient education can help in the achievement of better outcomes for climacteric women having sleep disturbance and depression.

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