Abstract
Abstract Introduction Sleep and circadian physiology are influenced by external light, particularly within the short-wavelength portion of the visible spectrum (~450–480 nm). Most personal light-emitting electronic devices (e.g., tablets, smartphones, computers) are enriched in this so-called “blue” light. Interventions to reduce short-wavelength light exposure to the eyes before bedtime may help mitigate adverse effects of light-emitting electronic devices on sleep. Methods We conducted a meta-analysis of intervention studies on the effects of wearing color-tinted lenses (e.g., orange or amber) in frames in the evening before sleep to selectively filter short-wavelength light exposure to the eyes. Outcomes were self-reported or objective (wrist-accelerometer) measures of nocturnal sleep. Databases (MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL, AMED) were searched from inception to November 2019. PROSPERO Registration: CRD42018105854. Results Ten studies were identified (7 randomized controlled trials; 3 before-after studies). Findings of individual studies were inconsistent, with some showing benefit and others showing no effect of intervention. For objective sleep onset latency, there was a significant modest-sized combined effect (Hedge’s g=-0.52, 95% CI: -1.27-0.24, Z=-2.94, p=0.003, I2=16.6%, k=3). There was a minor but non-statistically significant combined effect for objective sleep efficiency (Hedge’s g=0.24, 95% CI: -0.16–0.64, Z=1.69, p=0.09, I2=23.7%, k=5). There were no significant combined effects for objective measures of total sleep time and wake after sleep onset. For self-reported total sleep time, there was a statistically significant medium-sized combined effect (Hedge’s g=0.61, 95% CI: 0.14–1.09, Z=5.56, p<0.01, I2=0%, k=3). Conclusion There is mixed evidence that this approach can improve sleep. Relatively few studies have been conducted, and most did not assess light levels or melatonin. The “blue-blocker” intervention may be particularly useful in individuals with insomnia, delayed sleep phase syndrome, or attention-deficit hyperactive disorder. Considering the ubiquitousness of short wavelength-enriched light sources and the potential for widespread sleep disturbance, future controlled studies examining the efficacy of this approach to improve sleep are warranted. Support N/A
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