The Effect of a Light-Dark Cycle on Premature Infants in the Neonatal Intensive Care Unit: A Randomized Controlled Study


Purpose To investigate potential differences in discharge time, feeding methods and amounts, daily weight gain, vital signs, pain, and comfort levels among preterm infants born at 28–32 weeks' gestation who were hospitalized in the neonatal intensive care unit during long-term follow-up while implementing a light-dark cycle. Design and methods This is a randomized controlled study conducted with the support of a day-night cycle in premature infants born at 28–32 weeks' gestation and admitted to the neonatal intensive care unit of a teaching and research hospital affiliated with the Ministry of Health. The study compared the follow-up results from hospitalization to discharge over a period of 8 weeks. Results 50% of premature infants admitted to the unit are multiple pregnancies. There was no significant difference in discharge weight, comfort level, pain level, vital signs of the infants included in the study (p > 0.05). The optimal development of infant feeding patterns was examinedand it was observed that the study group had significantly improved before the control group in terms of the time to switch to full enteral feeding and oral feeding (p < 0,05). The daily weight gain of the babies was examined, it was seen that the weight gain was higher in the study group compared to the control group (p < 0,05). The mean duration of hospitalization was compared, it was seen that the babies in the study group were discharged significantly earlier (p < 0,05). Conclusion The study compared the long-term outcomes of premature babies hospitalized in neonatal intensive care and babies exposed to a light-dark cycle and regularly monitored in standard care. The results showed that the babies in the study group had higher daily weight gain and were discharged earlier than the control group. There were also no statistically significant differences in comfort and pain scores, vital signs or oxygen saturation between the study and control groups. Practice implications A light-dark cycle was found to be a feasible and promising intervention for infants at 28–32 weeks' gestation. It was a nurse-led management of care that could be integrated into the usual care of 28–32-week-old babies in neonatal units.


Published by The Journal of Pediatric Nursing: Nursing Care of Children and Families;; Ayşe Betül Olgun, Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, Izmir, Turkey; Didem Yüksel, Assistant Professor, Atılım University Faculty of Health, Department of Nursing, Child Health and Diseases Nursing, Ankara, Turkey, ORCID: 0000-0003-2120-7679; Figen Yardımcı, Associate Professor, Ege University, Faculty of Nursing, Department of Child Health and Diseases Nursing, Izmir, Turkey.


Prematurity, Circadian Rhytm, Sleep, Cycled light