Visual Impairment and Circadian Rhythm Sleep Disorders

Lockley, Steven W.; Arendt, Joséphine; Skene, Debra J.

doi:10.1016/b978-0-12-378610-4.00486-1

Cited by 23 publications

(45 citation statements)

References 87 publications

(109 reference statements)

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“…Reportedly, visually impaired individuals without LP are more likely to have an abnormal melatonin rhythm because of the inhibited transmission of a light signal, which might contribute to the occurrence of irregular sleep-wake patterns. 15,16,21,26,27,32 In addition, misaligned rhythms of core body temperature or cortisol secretion can be explanations for their sleep-related difficulties. 16,33 Furthermore, the dysregulated circadian rhythm negatively affects their ability to sleep and to maintain daytime vigilance.…”

Section: Discussionmentioning

confidence: 99%

“…15,16,21,26,27,32 In addition, misaligned rhythms of core body temperature or cortisol secretion can be explanations for their sleep-related difficulties. 16,33 Furthermore, the dysregulated circadian rhythm negatively affects their ability to sleep and to maintain daytime vigilance. 14,16,21,32 In the present study, sleep-related problems such as nonrestorative sleep and excessive daytime sleepiness were found to be associated with lower mental and physical QOL in visually impaired individuals with LP and the controls.…”

Section: Discussionmentioning

confidence: 99%

“…16,33 Furthermore, the dysregulated circadian rhythm negatively affects their ability to sleep and to maintain daytime vigilance. 14,16,21,32 In the present study, sleep-related problems such as nonrestorative sleep and excessive daytime sleepiness were found to be associated with lower mental and physical QOL in visually impaired individuals with LP and the controls. Several The data were controlled for gender, age at the onset of visual impairment, morbidity length of visual impairment, employment status, residential status, alcohol use, smoking habits and total walking time per day.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Indeed, the rate of circadian-related sleepwake disorders is likely to be higher among visually impaired individuals without LP than among those with LP.…”

Section: -10mentioning

confidence: 99%

“…[11][12][13][14][15] Reportedly, especially in people without light perception (LP), inhibited transmission of light signals to the suprachiasmatic nuclei might cause sleeprelated problems because of external desynchronization of the biological clock. 16,17 Indeed, the rate of circadian-related sleepwake disorders is likely to be higher among visually impaired individuals without LP than among those with LP. 12 In Japan, no large nationwide study of this subject has ever been reported.…”

Section: Introductionmentioning

confidence: 99%

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A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life

Tamura

Sasai-Sakuma

Morita

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. Methods: This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. Results: Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleepwake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. Conclusions: Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP. Keywords: circadian rhythm sleep-wake disorder, health-related quality of life, light perception, prevalence, sleep-related problems, visual impairment I NTRO DUCTI O NVisually impaired individuals are likely to have any of several comorbid mental/physical disorders including diabetes mellitus, hypertension, cognitive impairment, and depression/ anxiety. [1][2][3][4][5][6] The severity of these mental/physical disorders is reportedly correlated with visual impairment.1-9 Therefore, those individuals might be at risk for lower health-related quality of life (QOL). 7-10Sleep-related problems have been observed frequently in visually impaired individuals.11-15 Reportedly, especially in people without light perception (LP), inhibited transmission of light signals to the suprachiasmatic nuclei might cause sleeprelated problems because of external desynchronization of the biological clock. 16,17 Indeed, the rate of circadian-related sleepwake disorders is likely to be higher among visually impaired individuals without LP than among those with LP.12 In Japan, no large nationwide study of this subject has ever been reported. The actual prevalence of sleep-related problems amon...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…16,17 Indeed, the rate of circadian-related sleepwake disorders is likely to be higher among visually impaired individuals without LP than among those with LP.…”

Section: -10mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life

Tamura

Sasai-Sakuma

Morita

et al. 2016

Journal of Clinical Sleep Medicine

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Pharmacokinetics of the dual melatonin receptor agonist tasimelteon in subjects with hepatic or renal impairment

Torres

Kramer

Baroldi

2015

The Journal of Clinical Pharma

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Tasimelteon is a circadian regulator that resets the master clock in the suprachiasmatic nuclei of the hypothalamus by binding to both melatonin MT1 and MT2 receptors making it a dual melatonin receptor agonist. Tasimelteon has been approved by the United States Food and Drug Administration for the treatment of Non-24-Hour Sleep-Wake Disorder (Non-24). Two prospective, single-center, open-label studies evaluated the pharmacokinetics of tasimelteon and its main metabolites after a single 20 mg dose administered to subjects with mild or moderate hepatic impairment or severe renal impairment, including subjects on dialysis compared to healthy controls. In subjects with mild or moderate hepatic impairment, exposure to tasimelteon after a single 20 mg dose, as measured by area under the plasma concentration-time curve to infinity, was increased by approximately 2-fold. There was no apparent relationship between tasimelteon clearance and renal function. No safety concerns were apparent in either study. Based on these results, the changes in the pharmacokinetics of tasimelteon due to mild or moderate hepatic or severe renal impairment are not considered clinically relevant, and no dose adjustment is necessary in these patients.

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Melatonergic Sleep Promotion: Fundamental Chronobiological Issues Concerning Sleep Onset and Maintenance, Dose and Duration of Action

Hardeland

2017

Sleep Vigilance

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Purpose This review summarizes the conditions under which sleep promotion by melatonin or other melatonergic drugs can be successfully achieved or not. Importantly, the chronobiological rules are outlined which have to be followed in cases in which an etiology of circadian deviations is responsible for sleep difficulties. Dose and Duration of Action Sleep initiation is already possible with low doses (below 1 mg) of immediate-release melatonin. Prolonged actions have only caused moderate improvements of sleep maintenance. At elevated doses, melatonin may occasionally cause sleep fragmentation in some patients. Low doses (below 1 mg) of short-acting melatonin are also suitable for entraining and readjusting circadian rhythms, because circadian oscillators are particularly sensitive to nonparametric synchronizing signals. Phase Response Curve Successful entrainment of circadian rhythms is only possible if the phase response curve (PRC) is considered, which consists of phases of a silent zone with poor resetting, a delay and an advance part. Notably, the dim light melatonin onset (DLMO) is still in the silent zone. Conclusions For purposes of melatonergic treatment, the knowledge of synchronization-sensitive phases within the circadian cycle is helpful in correcting circadian rhythm sleep disorders, otherwise poorly entrainable rhythms, e.g., in blind people, and mood disorders with circadian etiology. The disregard of the PRC leads to false conclusions on inefficacy of melatonin or other melatonergic drugs. Correcting actions by melatonin should not be inhibited by other drugs. For instance, attempts of shortening a circadian oscillation by well-timed melatonin should not be counteracted by period-lengthening drugs, such as lithium.

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Visual Impairment and Circadian Rhythm Sleep Disorders

Cited by 23 publications

References 87 publications

A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life

A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life

Pharmacokinetics of the dual melatonin receptor agonist tasimelteon in subjects with hepatic or renal impairment

Melatonergic Sleep Promotion: Fundamental Chronobiological Issues Concerning Sleep Onset and Maintenance, Dose and Duration of Action

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