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Jacob Yuhang Chin, Zhi Hong Toh, Ying Tai Loh, Tian Yun Wang, Owen Kim Hee, Boon Ang Lim, Augustinus Laude, Hon Tym Wong, ELIZABETH WONG, Leonard Wei Leon Yip; Sleep disturbances in Patients with Primary Glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2580.
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© ARVO (1962-2015); The Authors (2016-present)
Melanopsin retinal ganglion cells (RGC) in the eye have been found to be an important part of the regulation of diurnal rhythms in humans such as sleep. These cells may also be damaged in primary glaucoma. This study aims to investigate the impact of primary glaucoma (primary open angle glaucoma (POAG) and pimary angle closure glaucoma (PACG)) on sleep quality and daytime sleepiness of patients.
This is a prospective, case-control study. Subjects were recruited from a tertiary ophthalmology referral centre. The validated questionnaires, Pittsburgh Sleep Quality Index (PSQI) and Epsworth Sleepiness Scale (ESS) were administered to subjects. The Patient Health Questionnaire 2 (PHQ-2) was used as a screen for depression, a possible confounder. Clinical and demographic subject data were also collected. The severity of glaucoma was based on Humphrey Visual Field (HVF) 24-2 perimetry results. Differences in the frequency of poor sleep quality (PSQI score >5) and excessive daytime sleepiness (ESS scores) were assessed between cases and controls. Associations between PSQI and ESS and mean deviation (MD) values, and visual acuity (VA) for the worse eye and better eye were analysed.
A total of 79 POAG, 27 PACG patients and 89 controls were recruited. The median PSQI score of PACG patients was higher than that of control or POAG patients (Kruskal-Wallis test, p=0.004), and the proportion of PACG patients with poor sleep quality was greater than that of controls or POAG patients (Pearson chi-square [χ2], p<0.001). The mean deviatation (glaucoma severity) was also worse in PACG patients than POAG patients (p=0.046). Using logistic regression analysis, a PACG patient is 3.41 times more likely to have poor sleep quality(95% C.I 1.37-8.47) compared to controls, having adjusted for age and gender (p=0.008). A patient with VA 6/60 or worse in the worse eye is 5.59 times more likely to suffer from poor sleep quality compared to VA 6/12 or better, having adjusted for control/POAG/PACG groupings (95% CI 1.24-25.2, p=0.025). There was no statistically significant association between ESS or PHQ-2 scores with glaucoma type or severity.
Primary glaucoma was associated with poor sleep quality but not excessive daytime sleepiness. Poor sleep quality was associated with worse VA and type of glaucoma (PACG).
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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