An artificial circadian rhythm can be implemented with the use of LED lights that fluctuate over a 24-hour cycle, mimicking the gradual change of sunlight from sunrise through nighttime. These effects involve both intensity and wavelength variations in perceived lighting (Ellis, Gonzalez & McEachron, 2013).
Patients should be exposed to:
- Bright white light at 2,500 – 8,000 lux at the cornea for at least one hour in the morning;
- Followed by bright white light at >1,000 lux at the cornea.
- In the evening, patients should be exposed to short- wavelength light at 30 lux at the cornea for approximately two hours.
- Nighttime should be spent in complete darkness (Figuerora, Plitnick, Lok, et al., 2014).
Light box therapy can also be used during the day in the form of 300–400 lux of a bluish-white light, which has proven to significantly improve sleep efficiency, Pittsburgh Sleep Quality Index (PSQI) scores, decreased depression (CSDD), and agitation (CMAI) scores (Figuerora, Plitnick, Lok, et al., 2014).
In keeping with the concept of the institutionalized circadian rhythm, Torrington & Tregenza have recommended the implementation of scenes from nature (2016). These natural themes help people feel connected to the outside which helps create a pleasant and relaxing atmosphere, for both patient and staff. The reduction of a hectic atmosphere also lends to faster recovery times as it helps calm them (Phillips, n.d.).