Blue-wavelength light therapy for post-traumatic brain injury sleepiness, sleep disturbance, depression, and fatigue: A systematic review and network meta-analysis

Karan Srisurapanont, Yanisa Samakarn, Boonyasit Kamklong, Phichayakan Siratrairat, Arina Bumiputra, Montita Jaikwang, Manit Srisurapanont, Karan Srisurapanont, Yanisa Samakarn, Boonyasit Kamklong, Phichayakan Siratrairat, Arina Bumiputra, Montita Jaikwang, Manit Srisurapanont

Abstract

Objective: This review aimed to determine the efficacy of blue-wavelength light therapy (BWLT) for post-traumatic brain injury (TBI) sleepiness, sleep disturbance, depression, and fatigue.

Methods: Pubmed, Scopus, Web of Science, Cochrane Library, Academic Search Complete, and CINAHL. Included trials were randomized controlled trials (RCTs) of BWLT in adults with a history of TBI. Outcomes of interest included sleepiness, sleep disturbance, depression, or fatigue. Two reviewers independently screened the searched items, selected the trials, extracted the data, and rating the quality of trials. We aggregated the data using a random-effect, frequentist network meta-analysis (NMA).

Results: We searched the databases on July 4, 2020. This review included four RCTs of 117 patients with a history of TBI who were randomized to received BWLT, amber light therapy (ALT), or no light therapy (NLT). Moderate-quality evidence revealed that: i) BWLT was significantly superior to NLT in reducing depression (SMD = 0.81, 95% CI = 0.20 to 1.43) ii) BWLT reduced fatigue at a significantly greater extent than NLT (SMD = 1.09, 95% CI = 0.41 to 1.76) and ALT (SMD = 1.00, 95% CI = 0.14 to 1.86). Low-quality evidence suggested that BWLT reduced depression at a greater extent than ALT (SMD = 0.57, 95% CI = 0.04 to 1.10). Low-quality evidence found that the dropout rates of those receiving BWLT and ALT were not significantly different (RR = 3.72, 95% CI = 0.65 to 21.34).

Conclusion: Moderate-quality evidence suggests that BWLT may be useful for post-TBI depression and fatigue.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. PRISMA flow from literature search…
Fig 1. PRISMA flow from literature search to study inclusion.
Fig 2
Fig 2
Network graphs of light therapy for behavioral symptoms of post-traumatic brain injury (A) sleepiness (6 pairwise comparisons of 3 treatments in 4 RCTs); (B) sleep disturbance and depression (5 pairwise comparisons of 3 treatments in 3 RCTs); (C) fatigue (4 pairwise comparisons of 3 treatments in 2 RCTs). Nodes in the graph layout correspond to the types of light therapy, and edges display the observed treatment comparisons. Edge thickness and the numbers on edges indicates the number of comparisons. Gray triangles display the presence of three-arm comparisons. ALT: Amber Light Therapy; NLT: No Light Therapy; BWLT: Blue-Wavelength Light Therapy.
Fig 3. Forest plots for the efficacy…
Fig 3. Forest plots for the efficacy of ALT and NLT for behavioral symptoms of post-traumatic brain injury compared to BWLT.
(A) SMDs for the reduction of sleepiness; (B) SMDs for the reduction of sleep disturbance; (C) SMDs for the reduction of depression; and (D) SMDs the reduction of fatigue. SMDs > 0 indicate the superiority of BWLT against ALT or NLT. ALT: Amber Light Therapy; NLT: No Light Therapy; BWLT: Blue-Wavelength Light Therapy.
Fig 4. Forest plots for the dropout…
Fig 4. Forest plots for the dropout rates of BWLT compared with ALT in patients with a history of traumatic brain injury.
ALT: Amber Light Therapy; BWLT: Blue-Wavelength Light Therapy.

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