Abstract
Purpose: :
To investigate the difference in objective measures of sleep between patients with stable and progressive glaucoma.
Methods: :
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.
Results: :
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.
Conclusions: :
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.
Keywords: circadian rhythms