Association of sleep disturbance with diabetic retinopathy

Dutta, Somsubhra; Ghosh, Sambuddha; Ghosh, Srijit

doi:10.1177/1120672120974296

Cited by 10 publications

(12 citation statements)

References 35 publications

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“…A total of three ( 7 , 12 , 13 ) articles reported that the PSQI score for sleep quality revealed its relationship with DR risk. There was no homogeneity among the studies (P = 0.50, I 2 = 0%), so the fixed effect model was used.…”

Section: Resultsmentioning

confidence: 99%

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Meta-Analysis of Relationship of Sleep Quality and Duration With Risk of Diabetic Retinopathy

Zheng

Wang²,

et al. 2022

Front. Endocrinol.

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ObjectiveA meta-analysis is used to explore the relationship of sleep quality and duration with the risk of diabetic retinopathy (DR).MethodCochrane Library, PubMed, Embase, and other databases are searched from their establishment to April 2022. Literature on the relationship of sleep quality and duration with DR risk published in various databases is collected, and two researchers independently screen the literature, extract data, and evaluate the quality of the included articles. The meta-analysis is performed with Review Manage 5.4.1 software.ResultsA total of 7 articles are selected, including 4,626 subjects. The results show a strong correlation between sleep quality and DR risk. When comparing the sleep quality scores of “DR” (experimental group) and “NO DR” (control group), the Pittsburgh sleep quality index(PSQI) score of the DR group is significantly higher than that of the NO DR group (MD = 2.85; 95% confidence interval [CI] 1.92, 3.78, P<0.001), while the ESS score of the DR group is also significantly higher than that of the NO DR group (MD = 1.17; 95% confidence interval [CI] 0.14 to 2.30, P=0.04), so the sleep quality score of the DR group is higher than that of the NO DR group in both the PSQI and ESS scores, which confirms that low sleep quality is a risk factor for DR. Long sleep duration is also associated with the risk of developing DR; the number of adverse events (DR prevalence) is higher for “long sleep duration” than “normal sleep duration” [OR = 1.83, 95%CI 1.36–2.47, P < 0.001], suggesting that long sleep duration can cause increased DR risk. Short sleep duration is also associated with the occurrence of DR [OR = 1.49, 95%CI 1.15–1.94), P = 0.003] and can increase DR risk.ConclusionSleep quality and duration (including long and short sleep duration) are significantly associated with DR. To reduce DR risk, sleep intervention should be actively carried out, lifestyle changes should be made, and attention should be paid to the role of DR management.

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Section: Resultsmentioning

confidence: 99%

“…Sleep disturbances have been found to be associated with abnormal glucose metabolism and an increased risk of diabetes ( 6 ). Sleep disturbances may be due to decreased sleep duration and/or decreased sleep quality ( 7 ). At present, the amount of clinical literature on the relationship of sleep quality and duration with DR is increasing year by year.…”

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confidence: 99%

Meta-Analysis of Relationship of Sleep Quality and Duration With Risk of Diabetic Retinopathy

Zheng

Wang²,

et al. 2022

Front. Endocrinol.

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“…First, with our country being the diabetes capital of the world, there is no study reporting the screening of OSA in DR patients in India. Though a recent study from India reported a positive association between sleep disturbance and DR,[ 30 ] it did not screen for OSA in DR. However, second, while the majority of the studies have shown the prevalence of OSA in a population of DM, and not DR, its prevalence in DR population remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Screening for obstructive sleep apnea in a diabetic retinopathy clinic in a tertiary care center

Kaswan

Bansal

Katoch

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To screen for obstructive sleep apnea (OSA) in patients presenting to diabetic retinopathy (DR) clinic and to correlate its presence with the severity of DR. Methods: A prospective, cross-sectional study of diabetes mellitus patients in retina clinic of a tertiary care referral center, North India (January 2019–March 2020). All were subjected to STOP-Bang Questionnaire and Epworth Sleepiness Scale (ESS) score. Patients at high OSA risk (STOP-Bang score ≥5 and ESS score ≥10) were referred to Department of Otorhinolaryngology (sleep clinic) for polysomnography. Based on Apnea Hypopnea Index (AHI), OSA was graded as mild (AHI = 5–14/h), moderate (AHI = 15–30/h), and severe (AHI >30/h). Statistical analysis was done using three models of outcome measures: (1) “No DR” versus “any DR,” (2) “Less severe DR” versus “More severe DR,” and (3) “No diabetic macular edema (DME)” versus “DME.” Results: Of 362 patients screened, 18 (4.97%) had OSA (11 mild, 5 moderate, and 2 severe). Though OSA did not show a significant association with various outcome measures, patients with moderate–severe OSA had higher odds in developing “any DR” (OR = 7.408; 95% CI = 0.533–102.898), “more severe DR” (OR = 1.961; 95% CI = 0.153–25.215), and “DME” (OR = 2.263; 95% CI = 0.357–14.355), on multiple logistic regression. Conclusion: Ours is the first screening study of OSA in DR patients in India, the diabetes capital of the world. We detected OSA in 4.97% of patients in a DR clinic, with an increased risk of “any DR,” “more severe DR,” and “DME” in the presence of moderate–severe OSA.

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“…Recent cross-sectional studies have shown that short or long sleep duration is associated with DR ( 7 , 8 ). Another study elucidated the positive correlation of sleep quality with DR severity as well as increased sleep latency in patients with DR ( 9 ). Among elderly subjects with diabetes, DR was more prevalent in the poor sleep quality group ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Diabetic Retinopathy and Insomnia Risk: A Nationwide Population-Based Study

Kim

Jeong

et al. 2022

Front. Endocrinol.

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BackgroundPrevious studies have suggested a close link between sleep disturbances and diabetic retinopathy (DR). However, to date, no confirmatory findings have been reported. We aimed to explore the risk of insomnia in DR by considering demographic factors and diabetes mellitus (DM)-related variables.MethodsA nationwide population-based cohort of 2,206,619 patients with type 2 diabetes from the Korean National Insurance Service Database was followed up for insomnia incidence. DR, non-proliferative DR (NPDR), and proliferative DR (PDR) were defined according to ICD-10 codes. The interactive effects of sex, age, and DM-related variables were analyzed to evaluate their impact on insomnia risk in DR.ResultsCompared with the non-DR group, insomnia risk was increased in the DR [(adjusted hazard ratio (aHR): 1.125, 95% confidence interval (CI):1.108-1.142), NPDR (aHR:1.117, 95% CI:1.099-1.134), and PDR (aHR:1.205, 95% CI: 1.156-1.256), even after controlling for comorbidities, lifestyle factors, and DM-related variables. The men and youngest age groups (<40 years) were most vulnerable to insomnia risk. Sex, age, DM duration, and chronic kidney disease (CKD) status exerted interactive effects with DR status in increasing the insomnia risk. In the PDR group, sex, age, DM duration, insulin therapy status, and CKD status exerted interactive effects that increased the risk of insomnia.ConclusionInsomnia risk is significantly higher in patients with DR, and clinical attention is warranted.

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Association of sleep disturbance with diabetic retinopathy

Cited by 10 publications

References 35 publications

Meta-Analysis of Relationship of Sleep Quality and Duration With Risk of Diabetic Retinopathy

Meta-Analysis of Relationship of Sleep Quality and Duration With Risk of Diabetic Retinopathy

Screening for obstructive sleep apnea in a diabetic retinopathy clinic in a tertiary care center

Association Between Diabetic Retinopathy and Insomnia Risk: A Nationwide Population-Based Study

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