Abstract
To investigate the longitudinal effects of cataract extraction on sleep quality in two discrete population cohorts. 301 participants who had senile cataract in both eyes at the baseline examination were selected from two large longitudinal epidemiologic studies of age-related eye disease, hearing, olfaction, and cognition. The participants were divided into two groups: one had cataract surgery (CS) in both eyes, and the other had no cataract surgery (NCS) in either eye by the follow up examination. Cataract was graded from photos or digital images using a standardized protocol. The quality of sleep was assessed using a modified Wisconsin Sleep Cohort Study Questionnaire. The NCS and CS groups were compared as to the change in the number of sleep problems reported from the baseline to the follow-up examination. Systemic co-morbidity data were included as potential confounders, including diabetes mellitus, obesity, hypertension, cerebrovascular disease, thyroid disease, tobacco and alcohol use, and the SF-12 physical component and mental component summary scores. The average (mean±SD) age was 71.0±8.8 years in the NCS (n=237) group and 73.4±9.1 years (n=64) in the CS group. There was no statistically significant difference in the change in the number of sleep problems reported between the NCS and CS groups (mean: -0.068 for NCS and 0.016 for CS, p=0.57). The multivariable linear regression models, when adjusted for confounders, yielded similar results. In this longitudinal, community-based population study, we found no significant impact of cataract extraction on sleep quality. Studies of the effect of cataract extraction on sleep should allow a longer follow up to demonstrate sustainability.
Highlights
An increasing body of evidence from experimental animals has suggested that the eye serves a critical role in regulating sleep and rest-activity patterns by conducting external ambient light to the brain sleep center[1,2,3]
The multivariable linear regression models, when adjusted for confounders, yielded similar results. In this longitudinal, community-based population study, we found no significant impact of cataract extraction on sleep quality
There were no significant differences in demographic characteristics, functional status (MCS and physical component summary (PCS)), and systemic comorbidity (CVD, Diabetes, history of heavy drinking, hypertension, tobacco use, and history of thyroid disease) between no cataract surgery (NCS) and cataract surgery (CS) group (p>0.05)
Summary
An increasing body of evidence from experimental animals has suggested that the eye serves a critical role in regulating sleep and rest-activity patterns by conducting external ambient light to the brain sleep center[1,2,3]. Age-related ocular diseases, such as glaucoma and cataract, have been associated with sleep disruption, presumably due to a deterioration of the eye’s ability to transmit external ambient light to the brain[4,5,6,7,8,9]. Evidence supporting the negative impact of cataract on sleep is based on the fact that the age-related increase in crystalline lens light absorption and pupil size reduction, taken together, decreases the photoreception in a healthy aging adult by 50% at age 45 and 90% at age 90 compared to a healthy 10-yearold[10, 11]. A cross-sectional study (n=970) among adults aged 30 to 60 years found that the risk of sleep disturbance was significantly higher when the transmission of blue light was decreased by the aging lens[12]. Several studies among patients undergoing cataract extraction surgery found an improved sleep quality following cataract removal[4, 5, 13]
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