An installation of Circadian Lighting has been linked to reduced falls and many other benefits in Heanor Park Care Home, Derbyshire.

The term Circadian Lighting is defined as lighting that replicates natural light in order to support human circadian rhythms, otherwise known as our sleep-wake cycle or internal body clock. We are all governed, to some degree, by our internal body clock - the timing, intensity, colour and wavelength of light are key factors in regulating human circadian cycles and our sleep and wake patterns. Disturbances in the circadian rhythm can have a physiological and mental impact, and often causes poor sleep patterns.

The lighting mimics the colour and intensity of natural light over a 24 hour period, it automatically changes throughout the day, beginning with a warm amber light at sunrise, slowly changing into a cooler, brighter light during the day, before warming back into an amber light at sunset. In this way specific colours of the visible light spectrum are managed precisely to provide circadian stimulus to residents in the morning and then to ensure that the lighting does not interfere with their natural body clock later in the day, ensuring they get a better nights sleep.

The premise of Circadian Plus is that it entrains residents’ circadian rhythms that can become out of sync quite easily if they spend a large amount of time indoors. The circadian lighting encourages a routine that helps to encourage a better sleep pattern and therefore improved mood, alertness and even appetite.

Some of the main benefits of circadian lighting are:

  • Increased productivity
  • Increased concentration
  • Improved sleep
  • Improved mood
  • Less risk of developing certain mental and physical health conditions
  • Reduction in errors and accidents
  • Faster cognitive processing
  • Increased alertness in the morning
  • Can aid with the rehabilitation of certain medical conditions e.g. brain injuries
  • Can be beneficial for elderly residents and people with Alzheimer’s disease

Circadian rhythms are produced because of natural factors within the body, but the external environment can affect how they work. One of the most powerful synchronizers is light. The body’s master clock, or SCN, controls the production of melatonin, a hormone that makes you sleepy. It receives information about incoming light from the optic nerves, which relay information from the eyes to the brain. When there is less light—like at night—the SCN tells the brain to make more melatonin so you get drowsy and the opposite occurs when there is bright, blue toned light.

David Poxton, managing director at Heanor Park states that “residents appear to feel more active and alert at the right times of day and then as the lighting changes to mimic natural daylight throughout the day, by night time residents feel ready for bed and are getting a better night’s sleep.”

As a result, employees are able to encourage more of a routine for residents making night shifts in particular much easier as residents are sleeping, and their body clocks are synced correctly.

The 24 hour lighting cycle follows a regular pattern, starting in the morning with the highest light levels significantly above normal indoor lighting between 7am and 10am using a cool white light with a strong blue content. Precise spectral control, broadly equivalent to a CCT range of 6000K to 8000K.

The colour mix is then blended during the day to taper the blue content component towards the afternoon and then faded out for the late afternoon and evening, whilst maintaining as close as possible to a white light which appears much warmer. Brightness levels are also reduced in a carefully calibrated pattern from the early morning high.

After around 4pm the algorithm shifts towards an evening colour blend setting which is a warmer white colour, and then later in the evening it will move into the night-time setting at the warm end of the spectrum with reduced intensity levels.

The lighting design for Heanor Park was developed by expert lighting design consultation, Lorraine Calcott – who forms part of the Circadian Plus team. She advised the most effective way to deliver and manage Circadian Plus lighting for dementia care environments. Lorraine specifies that full spectrum lighting works not only with our emotional responses to light, but also on our biological response, helping reset and maintain our body’s circadian rhythms.

“This process is critical for a healthy life, so using a circadian-focused lighting product helps our body clocks to remain synchronised even when not out in natural daylight. This is particularly important for those who may struggle to get outside, such as people with dementia or Alzheimer’s, where an introduction of this technology can be life-enhancing - as well as reducing the need for support or medication,” commented, Lorraine Calcott, founder and managing director of It Does Lighting.

Another aspect of the Circadian Plus solution is the need for physical lights that are capable of outputting this level and quality of light. Swann lighting is another member of the team and they have worked tirelessly to develop a Circadian Plus range of lighting which fulfil all the circadian supportive needs.

As you can see from the diagram below the human body goes through various stages each day at approximately the same time and this is governed by light, or lack of it.

Blue light suppresses the production of melatonin and is therefore used to treat disorders for sleep disturbances. LEDs appear to emit a bright white light, but in actual fact LEDs contain high amounts of blue in the range that is known to impact the human body’s natural melatonin secretion. This blue light exposure is responsible for increased alertness and cognitive function which can be useful for shift workers as they go against their natural body clocks schedule and need a bit of extra help to adjust. Studies have also shown how blue light can help to treat seasonal affective disorders such as SAD, increasing the amount of bright light in the darker winter months, replicating the amount of light exposure typical in British summertime.

The lighting has also helped employees at Heanor Park: “It has also really helped our night shift staff who would previously get tired by the dim lights, but because the new lighting is so easily changeable, the areas where the staff work during the night are changed to replicate natural daylight to help keep them alert,” said Jodie Sharpe, marketing executive, Heanor Park.

For employees working dayshift the circadian lighting is also entraining their circadian rhythm, meaning they also get a better night’s sleep.

However, too much blue light later in the day can have a negative effect. This is why sleep experts advise people to stay off their digital devices an hour before bed in order to ensure the blue light emitted by them does not have a negative impact on an individual’s sleep. There is a balance to achieve in order to ensure residents and employees feel the benefits.

The circadian rhythm not only impacts sleep-wake cycles but also hormone release, eating habits and digestion, body temperature, and other important bodily functions. Therefore, as mentioned residents who struggle to get outside into natural light may develop a body clock that is out of sync. The knock-on effect of having an irregular rhythm for a prolonged period has been linked to major physical and mental health conditions. Some examples being: sleep disorders, obesity, diabetes, depression, bipolar disorder, and seasonal affective disorder.

Over the past decade, neuroscientific research has uncovered the existence of a previously unknown non-visual optic pathway modulated by the substance melanopsin (which has a unique sensitivity to distinct parts of the visible light spectrum). Unlike other projections of the visual system, these pathways seem to play a minimal role in perception and processing of vision and image-formation; instead they have been found to be fundamentally responsible for entrainment and maintenance of circadian rhythms and other physiological functions. This discovery helped lighting experts understand even more about the impact of light on the human body and it began to pave the way for effective measurement models that use mathematical technique to determine the quantitative impact building occupants.

“We’re incredibly proud of how this project has turned out and the end result that we’re seeing at Heanor Park…Really for us seeing what can be achieved, it is absolutely something that we would put in the refurbishment of our existing care homes and also any new projects that we have going forward,” commented, David Poxton, managing director.

Heanor Park also have the ability to customise the lighting themselves with an easy to use interface. Individual rooms can be adjusted to accommodate specific requirements for intensity levels or other needs and the system responds to staff intervention needs by immediately switching to full brightness when activated via a nurse-call system or switch.

“This is the future,” said Michelle Baker, deputy manager of Heanor Park. “I think it has revolutionised the care home.”