Article Text

Download PDFPDF
Sensory exposure of neonates in single-room environments (SENSE): an observational study of light
  1. Kobi Best1,2,
  2. Fiona Bogossian1,
  3. Karen New1
  1. 1 School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
  2. 2 Newborn Care Unit, Gold Coast University Hospital, Southport, QLD, Australia
  1. Correspondence to Kobi Best, Newborn Care Unit, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland 4215, Australia;{at}


Objectives To measure the internal and external light exposure of incubators and open cots in an Australian single-room configured neonatal unit and compare findings to current recommendations.

Methods Light meters were placed in the internal and external environment of incubators and open cots within occupied single rooms in a tertiary-level neonatal unit between 15 September and 28 October 2015. Data were recorded in one-second increments over a minimum of 48 hours per room.

Results Internal median light in incubators and open cots predominantly fell below 50 lux, with low amplitude diurnal cycling. Incubator covers substantially reduced external light exposure, contributing to very low light conditions (<10 lux). Periodically, light inside incubators peaked six times greater than the maximum recommendation of 600 lux. Overall, internal incubator and open cot lighting in the neonatal unit met American Academy of Pediatrics and American College of Obstetricians and Gynecologists recommendations for 65.1% of the time during the day and 25.6% overnight. Australasian Health Infrastructure Alliance recommendations were met for 6.7% of the time during the day and 2.4% overnight.

Conclusions Overall, light levels fell predominantly below 50 lux with peak periods of extreme light exposure. Low amplitude cyclic light was evident, but it remains unknown if this is sufficient to produce an effect on circadian entrainment, especially in preterm neonates. Current guidelines do not stipulate optimal cyclic light levels in neonatal units to promote circadian rhythms in the newborn population. Further research to determine well-defined lighting parameters for neonates of different gestations is paramount.

  • Neonatology
  • Neurodevelopment
  • Nursing
  • Nursing Care
  • Intensive Care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors KB conceptualised and designed the study, conducted the data collection and analysis, drafted the initial manuscript and approved the final manuscript as submitted. FB and KN assisted with conceptualising study design, critically reviewed and revised the manuscript and approved the final manuscript as submitted.

  • Funding Funding for this study was provided by Queensland Health, Gold Coast University Hospital Private Practice Trust, The University of Queensland and Parker Healthcare and Australian College of Neonatal Nurses.

  • Competing interests None declared.

  • Ethics approval Ethics approval was granted by the hospital HumanResearch Ethics Committee (HREC/14/QGC/252) and The University of Queensland (NMSW2015/03).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There is no unpublished data available outside of this proposed publication.