Original articleSleep disturbances in young subjects with visual dysfunction☆
Section snippets
Materials and methods
Twenty-five visually impaired children and young adults (ages 12–20) were recruited from the Missouri School for the Blind, a residential school. Twelve subjects with normal sight were recruited from the Thomas Jefferson boarding school. The students were prospectively placed into 3 groups based on established visual diagnosis, confirmed through a complete eye examination: (1) optic nerve disease (n = 11), (2) visual impairment without evidence of optic nerve disease (n = 14), and (3) normal
Results
Full 14-day datasets were obtained on 37 subjects. One dataset from a visually impaired subject was lost due to a lost activity watch. Demographic information for the 11 visually impaired subjects with optic nerve disease, 14 visually impaired subjects with intact optic nerves, and 12 subjects with normal sight is shown in Table 1. All 3 groups were similar in age. No subjects were excluded based on a screen for depression, medication use, or illness. Thirty-six of the 37 subjects in the study
Discussion
Previous studies have suggested that visually impaired subjects are at risk for both self-reported1 and objectively measured sleep disorders.18 These sleep disorders are thought to arise, at least in part, from inability of the circadian clock to entrain correctly to external light and dark signals in visually impaired individuals.19 In the present field study of children and young adults with visual impairment, we confirmed that a subset of visually impaired subjects had abnormally high levels
Acknowledgements
The authors thank Karen Steger-May, MA, and Mae Gordon, PhD, of the Washington University Division of Biostatistics for statistical advice. They especially thank the Missouri School for the Blind and the Thomas Jefferson School for assisting in subject recruitment.
References (33)
- et al.
Disturbance of sleep in blindness
Am J Ophthalmol
(1998) - et al.
Sleep disturbance and blindness
Lancet
(1996) Retinohypothalamic projection in mammalsa comparative study
Brain Res
(1973)- et al.
The eye as metronome of the body
Surv Ophthalmol
(2002) - et al.
Loss of circadian rhythm in sleep-wakefulness cycle in the rat by suprachiasmatic nucleus lesions
Brain Res
(1975) - et al.
Melatonin treatment of a non-24-hour sleep-wake cycle in a blind retarded child
Biol Psychiatry
(1995) - et al.
Sleep disorders in children with blindness
Ann Neurol
(1999) - et al.
Sleep and activity rhythms are related to circadian phase in the blind
Sleep
(1999) - et al.
Prevalence of sleep/wake disorders in persons with blindness
Clin Sci (Lond)
(1999) Blind people often sleep poorly; research shines light on therapy
JAMA
(1998)
Circadian rhythms in man
Science
Light suppresses melatonin secretion in humans
Science
Circadian photoreception in the retinally degenerate mouse (rd/rd)
J Comp Physiol [A]
Non-visual ocular photoreception
Ophthalmic Genet
Phototransduction by retinal ganglion cells that set the circadian clock
Science
The role of actigraphy in the study of sleep and circadian rhythms
Sleep
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Manuscript no. 220703.
Dr Wee was supported by the Doris Duke Foundation, New York, New York. Dr Van Gelder was supported by career development awards from Research to Prevent Blindness, Inc. (New York, New York); the Becker/Association of University Professors of Ophthalmology/Research to Prevent Blindness Physician–Scientist Award; the Culpepper Physician–Scientist Award; the National Alliance for Schizophrenia and Affective Disorders; and the National Institutes of Health (K08EY00403).