Depressed visual field and mood are associated with sleep disorder in glaucoma patients

Abstract

The aim of the present study was to evaluate sleep and mood disorders and related ocular parameters in glaucoma patients. We focused on visual fields and the retinal nerve fibre layer, because decreased circadian photoreception by damaged intrinsically photosensitive retinal ganglion cells is suspected in glaucoma. A cross-sectional study was performed on 140 subjects: 69 with glaucoma and 71 normal controls. Individuals with cataract, dry eye, or retinal pathology were excluded from the study. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) and underwent comprehensive ophthalmological examinations for glaucoma. Patients with advanced glaucoma had significantly worse PSQI scores than normal controls (P < 0.05). Stepwise multivariate linear regression analysis revealed PSQI was significantly correlated with the mean deviation in the worse eye, the number and frequency of medications, and anxiety and depression subscores of the HADS after adjustment for age and sex (P < 0.05). We did not find a significant correlation between PSQI scores and the thickness of retinal nerve fibre layer. In conclusion, the subjective sleep quality of glaucoma patients was correlated with visual field loss and mood status.

Schlafstörungen und schlafassoziierte Erkrankungen beim Glaukom

“…1). Eine Korrelation zwischen der Dicke der retinalen Nervenfaserschicht (RNFL-Dicke) und dem Auftreten von Schlafstörungen konnte allerdings bisher nicht nachgewiesen werden [1].…”

Intrinsically Photosensitive Retinal Ganglion Cell Function, Sleep Efficiency and Depression in Advanced Age-Related Macular Degeneration

“…Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, 36 a self-assessed screening tool that has been used to determine sleep disturbances in glaucoma 37,38 and to determine sleep quality prior to measurement of the circadian response of ipRGCs. 8 The questionnaire is primarily designed to measure sleep based on a global score.…”

Image and Non-Image Forming Melanopsin Function in Age-Related Macular Degeneration

“…There is a high frequency of sleep disturbances in people with vision loss who retain light perception, becoming more severe and more common in people with total vision loss and no light perception (Tabandeh et al 1998). Sleep disorders have been linked to glaucoma (Agorastos et al 2013;Ayaki, Shiba, Negishi & Tsubota 2016;Jean-Louis, Zizi, Lazzaro & Wolintz 2008;Wang, Zhang, Ding & Wang 2013) which has further been associated with ipRGC dysfunction (Gracitelli et al 2016;Gracitelli et al 2014;Gracitelli et al 2015). Altered sleep duration has been demonstrated in AMD patients (Khurana et al 2016;Pérez-Canales et al 2016) although no link has been established with ipRGC function.…”

“…The PSQI has high test-retest reliability (Backhaus, Junghanns, Broocks, Riemann & Hohagen 2002;Buysse et al 1989), as well as a diagnostic sensitivity of 89.6% and specificity of 86.5% (Buysse et al 1989). The PSQI has been used to determine sleep disturbances in glaucoma (Ayaki et al 2016;Wang et al 2013) and the circadian response of ipRGCs (Zele et al 2011).…”

“…Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire (Buysse et al 1989), a self-assessed screening tool that has been used to determine sleep disturbances in glaucoma (Ayaki et al 2016;Wang et al 2013) and to assess sleep quality prior to measurement of the circadian response of ipRGCs (Zele et al 2011). The PSQI is primarily designed to measure sleep based on a global score.…”