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R Wee, RN Van Gelder; Sleep Disturbances in Children with Visual Dysfunction . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1365.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the prevalence of sleep dysfunction amongst: 1) children with retinal ganglion cell dysfunction, 2) children who are blind but have intact retinal ganglion cell function and 3) normal-sighted children. Methods: A prospective cohort study was performed at the Missouri School for the Blind, Central Institue for the Deaf, and Thomas Jefferson boarding school using a wrist activity monitor to record the sleeping habits of blind and normal-sighted children. Approximately 15 subjects ranging in age from 8-20 were enrolled in each of the three groups. All subjects lived in a controlled residential setting and were monitored for two weeks using wrist actigraphy, a method to record activity based on wrist movements. The recordings were examined for sleep start time, sleep latency, nocturnal awakenings, daytime napping, sleep efficiency, and wake time. Results: The subjects with retinal ganglion cell (RGC) dysfunction suffered from a higher instance of sleep disturbances than those who had intact retinal ganglion cells. ANOVA revealed that the statistically significant differences occurred in napping (22.6 +/- 14.5 min/day in RGC damage group, 13.9 +/- 9.5 min/day in visually impaired group with intact retinal ganglion cells, 3.4 +/- 7.6 min in normal-sighted group), variability in wake time as measured by standard deviation of wake times (74.5 +/- 26.5 min in RGC damage group, 40.2 +/- 9.5 min in intact RGC group, 38.6 +/- 8.0 min in normal-sighted group), and sleep latency (37.4 +/- 25.6 min in RGC damage group, 20.3 +/- 10.7 min in intact RGC group, 11.8 +/- 3.5 min in normal-sighted group). Conclusion: There is a high prevalence of sleep disorders in children with retinal ganglion cell dysfunction. The majority of subjects who displayed abnormal sleeping patterns had glaucoma, optic nerve injury, or retinopathy of prematurity. Given the high prevalence of sleep dysfunction among the blind, screening for circadian desynchrony may be appropriate.
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