Evidence map›Paper›PMID 42805655›Full record

SynthesisBMJ open2026

Bright light therapy and circadian rhythm regulation for delirium prevention in hospitalised adults: a systematic review and meta-analysis.

Rayan Saleh Moussa, Layla Maree Edwards, Sungwon Chang, Annmarie Hosie, Irina Kinchin, Gideon Caplan, Joshua Wiley, Imelda Gilmore, Vanessa Yenson, Ingrid Amgarth-Duff and 5 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Rayan Saleh MoussaCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia Rayan.SalehMoussa@uts.edu.au.
Layla Maree EdwardsCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.ORCID http://orcid.org/0000-0001-9951-237X
Sungwon ChangCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Annmarie HosieCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Irina KinchinCenter for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.
Gideon CaplanPrince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
Joshua WileySchool of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Imelda GilmoreCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Vanessa YensonCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Ingrid Amgarth-DuffThe Kids Research Institute Australia, Perth, Western Australia, Australia.
Angela Rao-NewtonCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Kimberley CampbellCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Matthew GoldmanFaculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Kim OffnerFaculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
Meera AgarCentre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effects of bright light therapy (BLT) on circadian regulation and delirium incidence in hospitalised adults.

designSystematic review and meta-analysis. DATA SOURCES: Scopus, MEDLINE, EMBASE, CINAHL and PsycINFO were searched from database inception to October 2025. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials, controlled clinical trials and pilot studies evaluating BLT for delirium prevention in hospitalised adults published in English were included. DATA EXTRACTION AND SYNTHESIS: Risk of Bias was assessed using the Risk of Bias tool for randomised trials (version 2) or Risk Of Bias In Non-randomised Studies of Interventions. Publication bias was explored using visual inspection of funnel plots. Data were narratively synthesised to summarise BLT protocolisation, adherence and impact on circadian rhythm and delirium incidence. Random-effects meta-analysis was performed to estimate pooled risk ratios (RRs) for delirium incidence. Certainty of evidence was assessed using GRADE.

resultsEight studies (participants n=1190) were included. Risk of bias for delirium incidence varied, with several studies judged to have some concerns or high risk of bias. Adherence, cessation and adverse events were inconsistently measured and reported across studies. Three studies assessed circadian outcomes: two reported increased circadian cycle lengths following BLT, while one found no between-group differences. Most studies applied morning BLT at intensities ≥5000 lux for 60-120 min over 3-4 days. Meta-analysis demonstrated an uncertain effect of BLT on delirium incidence (RR 0.64, 95% CI 0.38 to 1.07; p=0.09), with moderate heterogeneity (I²=52.06%). The certainty of evidence was very low because of risk of bias, inconsistency, imprecision and potential publication bias.

conclusionsCurrent evidence remains uncertain regarding the effect of BLT on delirium incidence in hospitalised adults. Further high-quality studies are needed to determine effectiveness, identify optimal intervention characteristics and clarify the role of sleep-related mechanisms in delirium prevention. PROSPERO REGISTRATION NUMBER: CRD42020193040.

Indexed as

Circadian RhythmDeliriumPhototherapyAdultHospitalizationHumansIncidenceBright Light TherapyDeliriumMeta-analysisProgram EvaluationSleep Disorders, Circadian RhythmSystematic Review

Identifiers

PMID42805655
PMCPMC13629984

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.