Apnea Hypopnea Index During Rapid Eye Movement Sleep With Diabetic Retinopathy in Patients With Type 2 Diabetes

Nishimura, Akihiro; Kasai, Takatoshi; Kikuno, Shota; Nagasawa, Kaoru; Okubo, Minoru; Narui, Koji; Mori, Yusaku

doi:10.1210/jc.2018-00946

Cited by 15 publications

(9 citation statements)

References 42 publications

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“…Sleep deprivation may play a role in the pathogenesis of DR but remains unclear. Recent studies confirm that obstructive sleep apnoea syndrome (OSAS), characterized as sleep disturbance, is an independent risk factor for the presence and progression of DR.[12,14,26,27] Sleep duration has recently been reported to be related to DR risk, and it has been well documented that CT is changed in DR patients. [28,29] This study first assessed the relationship between posterior segment structures and sleep duration in diabetic patients, and found a positive correlation between MCT and sleep duration in diabetic patients without DR, but no significant association in DR patients.…”

Section: Discussionmentioning

confidence: 99%

“…[9-11] Emerging evidence suggests that sleep duration and sleep quality may possibly affect the incidence of diabetes and DR, as well as being associated with insulin resistance and poor glycaemic control. [12-14] However, little is known about the relationship of physical activity, sleep, and posterior segment structure, including the choroid and retina, in diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

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Influence of physical activity and sleep duration on the retinal and choroidal structure in diabetic patients: An SS-OCT study

Liu

Wang

Qiu

et al. 2020

Preprint

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Purpose: To assess the association between physical activity, sleep duration, sitting time, and alterations of posterior segment structures with swept-source optical coherence tomography (SS-OCT). Methods: Patients with diabetic retinopathy (DR) were recruited, and diabetic patients without retinopathy (non-DR) who matched for age and duration of diabetes were used as control. The physical activity, siting time, and sleep duration were obtained by using standardized questionnaire. OCT parameters included: retinal nerve fibre layer (RNFL) thickness, ganglion cell inner plexiform layer (GC-IPL) thickness, retinal thickness, and choroidal thickness (CT). Linear regression was conducted to analyse the association. Results: Each group included 116 diabetic patients. Average macular CT was positively correlated with metabolic equivalents (MET) only in the DR group, independent of age, gender, and other potential confounding factors (β = 1.163, P = 0.006). Average macular CT was also positively correlated with sleep duration only in the non-DR group, independent of age, gender, and other potential confounding factors (β = 10.54, P = 0.031). No correlation was found between MET, sleep duration, and other OCT parameters. Sitting time was not significantly correlated with OCT parameters either. Conclusions: Physical activity and sleep duration are both positively correlated with macular choroidal thickness; this suggests that more time in physical activity and sleep benefit the retina, while there was no association between sedentary time and OCT parameters. Further studies are warranted to clarify the underlying mechanisms and the role of physical activity and sleep in CT alterations and DR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of physical activity and sleep duration on the retinal and choroidal structure in diabetic patients: An SS-OCT study

Liu

Wang

Qiu

et al. 2020

Preprint

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“…A cross-sectional study of 92 patients found that vision-threatening DR was associated with a higher AHI and higher risk of moderate OSA (OR: 1.06 and 4.73, respectively) [ 168 ]. Mori et al demonstrated that AHI was independently associated with DR, and the OR of developing DR rose to 12.9 in patients with diabetes and OSA having AHI scores in the top quartile [ 169 ]. The 4% oxygen desaturation index (4% oxygen desaturation events per hour) may be a potential predictor of DR in patients with OSA.…”

Section: Osa-associated Complications In Posterior Segment Of Eyementioning

confidence: 99%

“… Chew, 2020 [ 168 ] Singapore 92 Vision-threatening DR was associated with a higher AHI (OR (95% CI): 1.06 (1.02–1.10)) and higher risk of moderate OSA (OR: 4.73 (1.46–15.31)). Mori, 2019 [ 169 ] Japan 131 The severity of OSA by AHI was independently associated with the development of DR. Shiba, 2019 [ 170 ] Japan 132 The 4% oxygen saturation index (4% oxygen desaturation events per hour) was significantly higher in the PDR group than in the NPDR group. Smith, 2019 [ 178 ] USA 321 Patients with OSA who were compliant with CPAP therapy had a significantly lower risk of developing DR as compared to noncompliers (OR (95% CI): 0.54 (0.31–0.94), p = 0.04).…”

Section: Table A1mentioning

confidence: 99%

Ocular Complications of Obstructive Sleep Apnea

Liu

Chiu

Wang

et al. 2021

JCM

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Obstructive sleep apnea (OSA), the most common form of sleep-disordered breathing, is characterized by repetitive episodes of paused breathing during sleep, which in turn induces transient nocturnal hypoxia and hypercapnia. The high prevalence of OSA and its associated health consequences place a heavy burden on the healthcare system. In particular, the consequent episodic oxygenic desaturation/reoxygenation series and arousals from sleep in patients with OSA have the potential to trigger oxidative stress, elevated systemic inflammatory responses, and autonomic dysfunction with sympathetic activation. Given these adverse side-effects, OSA is highly correlated to many eye diseases that are common in everyday ophthalmic practices. Some of these ocular consequences are reversible, but they may permanently threaten a patient’s vision if not treated appropriately. Here, this article seeks to review the ocular consequences and potential pathophysiologic associations in patients with OSA. Understanding these OSA-related eye diseases may help clinicians provide comprehensive care to their patients.

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“…19 Studies demonstrate that OSA patients treated with CPAP early have a significantly lower prevalence of retinopathy compared to those who were not treated (OR 0.54, P=0.04). 22 Although early treatment with CPAP improves the anatomical outcomes in patients with OSA, retinal nerve fiber layer thickness, and macular thickness, improvement in visual functions of the eye is not observed. 23 This indicates that the role of CPAP is to stop the progression of DR in OSA patients, which might help the standard DR treatment achieve the maximum therapeutic goal.…”

Section: Two-way Relationshipmentioning

confidence: 99%

Association of Retinal Vascular Manifestation and Obstructive Sleep Apnea (OSA): A Narrative Review

Saeed

Alshabib

Taisan

et al. 2021

OPTH

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Obstructive sleep apnea (OSA) is characterized by frequent episodes of partial or complete obstruction of the airway during sleep causing repeated episodes of apnea. OSA is more prevalent in middle-aged and older adults. OSA is associated with numerous ocular manifestations, including retinal manifestations. Literature highlighted the clear association between OSA and numerous ocular conditions including glaucoma and papilledema. This comprehensive and narrative review aims to summarize up-to-date clinical research concerning the association of OSA and vascular conditions that affect the retina. OSA is associated with the central serous chorioretinopathy (CSC), retinal vein occlusion (RVO), hypertensive retinopathy (HTRP) and development of diabetic retinopathy (DR). Sympathetic activation, hypoxia, and hormonal dysregulation all lead to serious retinal vascular conditions that will worsen OSA patients' quality of life. It is important to refer patients with newly diagnosed OSA to an ophthalmology clinic for the appropriate test.

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Apnea Hypopnea Index During Rapid Eye Movement Sleep With Diabetic Retinopathy in Patients With Type 2 Diabetes

Cited by 15 publications

References 42 publications

Influence of physical activity and sleep duration on the retinal and choroidal structure in diabetic patients: An SS-OCT study

Influence of physical activity and sleep duration on the retinal and choroidal structure in diabetic patients: An SS-OCT study

Ocular Complications of Obstructive Sleep Apnea

Association of Retinal Vascular Manifestation and Obstructive Sleep Apnea (OSA): A Narrative Review

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