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P.O. Lundmark, G.E. Trope, C.M. Shapiro, J.G. Flanagan; Polysomnographic Findings In Stable And Progressive Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4784.
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To investigate the difference in objective measures of sleep between patients with stable and progressive glaucoma.
Twenty–nine consecutive patients with primary open angle glaucoma (POAG) or normal tension glaucoma (NTG) were recruited from a tertiary care hospital clinic in Toronto, Canada. They were between 50 and 70 yrs and had been followed for at least 3 years. Patients were classified as stable (n = 17, f/m: 6/11) or progressive (n = 12, f/m: 6/6) based on their VFs and/or presence of disk hemorrhage(s). In addition, 11 controls (f/m: 6/5) in the same age range were recruited by advertising for volunteers within the hospital. Global exclusion criteria were major health and / or sleep problems and the use of drugs known to affect sleep. Full overnight polysomnography (PSG) was performed during 2 standardized nights (11 pm – 6 am) in a dedicated hospital sleep laboratory. The PSG of the second night was analyzed. Outcome measures were compared within gender specific groups.
Females with progressive glaucoma tended to have more deep sleep (stage 3 & 4) than stable cases and normal controls (19.2 % vs. 14.4 % vs. 12.5 %, p = 0.116). The proportion of females with deep sleep in the upper 50th percentile was greater in progressive cases than in stable cases (83.3 % vs. 16.7 %, p = 0.041). Males did not differ between the groups, except for a trend towards more light sleep in stable males than in controls and progressive cases (55.9 % vs. 47.2 % vs. 47.4 %, p = 0.169). Measures of respiratory disturbance were similar among comparison groups in both genders. Slow wave sleep was pronounced in all patients with progressive NTG.
Results indicate for the first time that deep sleep may represent a risk factor in progressive glaucoma, and that this effect may be specific for women. Further research combining overnight polysomnography with blood pressure monitoring is warranted.
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