Background: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression. Results: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014). Conclusion: Results suggest that photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine.

The impacts of lighting conditions on human circadian rhythms, sleep quality, and cognitive performance have been extensively investigated in the past two decades; however, these studies have yielded inconclusive and variable outcomes. For older adults who are at a higher risk of developing serious physiological and mental illnesses, such as Alzheimer’s or dementia, light therapy has emerged as a low-risk intervention to improve sleep quality and cognitive function. Nevertheless, the optimal methodology for evaluating the efficacy of light therapy in older adults remains unclear. This review has been conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and critically analyzes methodologies in previous studies on lighting's impact on sleep and cognitive performance in healthy older adults, focusing on how these approaches affect the findings. The review is structured into six domains: study setting and type, participant characteristics, lighting conditions, study design, sleep quality evaluation methods, and cognitive performance evaluation methods. Diverse study designs, methods, and population characteristics have influenced the outcomes. Bright light, applied from early morning to early evening, has been shown to enhance sleep and cognitive functions, notably working memory and concentration. It also benefits from dawn simulation throughout the day, which regulates circadian rhythms and improves sleep quality, although the ideal timing is yet to be determined. Intense short-wavelength lights and strong placebo conditions can counteract these positive effects, and using bright light in the evening may impair sleep and indirectly worsen cognitive performance in older adults. Further real-world experimental studies on this demographic, meticulous study designs, a combination of objective and subjective evaluation methods, and comprehensive reporting of lighting interventions are crucial for identifying the optimal lighting design approach for this population.

Background: Recent studies have highlighted the significant impact of combined thermal and lighting conditions on human comfort. However, there is limited understanding of how these factors influence cognitive performance in older adults. This study explored the effects of complex thermal and lighting conditions on various cognitive functions and physiological responses in older adults. Additionally, a predictive cognitive model was developed using physiological indicators as well as demographic factors. Methods: Twenty-two older adults participated in a within-subject design experiment under different thermal and lighting combinations. The study focused on two temperature conditions, 18 °C and 28 °C, and two lighting conditions, 480 nm with 5500 K and 644 nm with 3200 K. Conclusions: The finding showed that males significantly performed better at 18 °C under 480 nm lighting, while females excelled at 28 °C under 644 nm lighting. Electrodermal activity (EDA) increased in warmer conditions with warmer lighting, and pupil size expanded similarly but decreased under cooler conditions. Males’ EDA was negatively correlated with cognitive performance, while females’ pupil size and BMI were positively correlated. Using the classification and regression tree (CART) algorithm, predictive model demonstrated 89.7% accuracy. These findings emphasize the potential of optimizing thermal and lighting conditions to enhance cognitive functions and predict performance in older adults

Background. Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aims to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods. A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), and sleep-related impairments (SRI). Each model was controlled for age, sex, anxiety, and depression. Results. A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), and SRI (p = 0.014), after controlling for age, sex, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.001), SDis (p < 0.001), and SOL (p = 0.016). Conclusion. Results suggest that photophobia is a risk factor for sleep disorders in those with migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine.