Sleep disturbances in young subjects with visual dysfunction.
OBJECTIVE
To determine whether the type of ophthalmic disease is predictive of sleep and wakefulness disturbances in young subjects with visual dysfunction.


METHODS
Prospective cohort study.


METHODS
Twenty-five subjects (ages 12-20) were recruited from the Missouri School for the Blind. Twelve controls with normal sight were recruited from a residential school.


METHODS
Daily activity was monitored for 14 days using wrist actigraphy. Sleep and wakefulness measures were derived from actigraphy records by automated analysis. Visually impaired subjects were prospectively stratified by presence or absence of optic nerve disease.


METHODS
Daytime napping and regularity of awakening time (wake-up time instability).


RESULTS
Subjects with optic nerve disease napped in the daytime significantly more than other visually impaired children or normal sighted controls: 28.1+/-4.0 minutes per day (mean +/- standard error) versus 11.9+/-2.4 minutes per day in equally visually impaired subjects with intact optic nerve function versus 6.2+/-2.2 minutes per day in subjects with normal sight (P<0.0001). These subjects also showed significantly more variable awakening times than the other groups. Logistic regression revealed that subjects with optic nerve disease are 9.1 times more likely to demonstrate daily napping of more than 20 minutes per day than equally blind subjects without optic nerve disease (95% confidence interval [CI] = 1.4-58.7, P = 0.02). Blind subjects with optic nerve disease are 21.3 times more likely than children with normal sight to nap more than 20 minutes on average per day (95% CI = 1.2-378, P = 0.04).


CONCLUSIONS
Optic nerve disease is predictive of increased daytime napping in young visually impaired subjects, suggesting that the nature and presence of ophthalmic disease affect the probability of concomitant sleep timing disorders.
Wee
Raymond
R
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Van Gelder
Russell N
RN
D000293:Adolescent; D000328:Adult; D002648:Child; D006801:Humans; D009901:Optic Nerve Diseases / Q000150:complications* / Q000175:diagnosis; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis; D014786:Vision Disorders / Q000150:complications* / Q000175:diagnosis; D014792:Visual Acuity; D019987:Persons with Visual Disabilities; D014851:Wakefulness