Bright light therapy for post-stroke sleep disturbances: a systematic review and meta-analysis
Abstract
Objective: Sleep disturbances are common after stroke and may adversely affect neurological recovery. Although post-stroke sleep disturbances encompass insomnia symptoms, circadian rhythm sleep-wake disturbances, and sleep-disordered breathing, research has focused predominantly on obstructive sleep apnea. This review evaluated the effects of bright light therapy (BLT), a non-pharmacological intervention that may influence circadian regulation, on sleep outcomes after stroke.
Methods: Ten electronic databases covering English-and Chinese-language literature were searched from inception to April 9, 2026. Randomized controlled trials involving adults with stroke that evaluated validated subjective or objective sleep outcomes were eligible. Data were pooled using random-effects models when studies were sufficiently comparable clinically and methodologically. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. The primary outcomes were wake after sleep onset (WASO) and subjective sleep quality. The protocol was registered in PROSPERO (CRD420251111617).
Results: Five randomized controlled trials involving 343 participants were included. Three trials involving 181 participants contributed to the WASO analysis; the pooled estimate was not statistically significant (MD = -39.17 min, 95% CI -115.34 to 36.99; P = 0.31), and heterogeneity was substantial (I2 = 96%). Four trials involving 300 participants contributed to the subjective sleep quality analysis; the pooled…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 343 participants or records.
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