Increasing Sleep Duration Is Associated With Geographic Atrophy and Age-Related Macular Degeneration

Abstract

Longer sleep duration is associated with geographic atrophy secondary to AMD. These altered sleep patterns may be another morbidity of AMD, but further study is necessary.

Intrinsically Photosensitive Retinal Ganglion Cell Function, Sleep Efficiency and Depression in Advanced Age-Related Macular Degeneration

“…Intrinsically photosensitive RGCs also signal to the olivary pretectal nucleus (OPN) for mediation of the pupil light reflex (PLR) 12,13 and in particular the post-illumination pupil response (PIPR), [12][13][14][15] which is an emerging method for the direct assessment of ipRGC function in healthy and diseased eyes and in persons with chronobiological disorders. [4][5][6][12][13][14][16][17][18] Two recent studies observed that sleep duration was altered in advanced AMD patients; sleep duration decreased in wet AMD and increased in dry AMD, 19,20 but the effect of aberrant ipRGC signaling in AMD 5,6 as a contributing factor was not evaluated. Supporting evidence for an association between ipRGC dysfunction and sleep disorders is provided in primary open angle glaucoma patients, 1,3 where there is also decreased sleep quality.…”

Image and Non-Image Forming Melanopsin Function in Age-Related Macular Degeneration

“…The effects of AMD extend beyond visual function, with poor sleep and high prevalence of depression associated with the disease (Augustin et al 2007;Casten & Rovner 2008;Khurana et al 2016;Pérez-Canales et al 2016). This study showed a correlation between ipRGC function and sleep efficiency, therefore this thesis suggests that clinicians should consider using pupillometry along with screening sleep questionnaires when assessing the health and well-being of AMD patients.…”

“…Sleep disorders have been linked to glaucoma (Agorastos et al 2013;Ayaki, Shiba, Negishi & Tsubota 2016;Jean-Louis, Zizi, Lazzaro & Wolintz 2008;Wang, Zhang, Ding & Wang 2013) which has further been associated with ipRGC dysfunction (Gracitelli et al 2016;Gracitelli et al 2014;Gracitelli et al 2015). Altered sleep duration has been demonstrated in AMD patients (Khurana et al 2016;Pérez-Canales et al 2016) although no link has been established with ipRGC function. The association between sleep and ipRGC function in AMD may provide further insight into the ipRGC projections to the SCN and the effect of AMD on these projections.…”

“…Studies in melanopsin knock-out mice show sleep disturbances where they sleep for approximately one hour less than wild-type mice (Tsai et al 2009) while human studies show that ipRGC deficits are associated with sleep disorders in glaucoma (Gracitelli et al 2015) and their function is reduced in seasonal affective disorder (Roecklein et al 2013). With the high prevalence of depression in AMD (Brody et al 2001;Casten & Rovner 2013) and altered sleep duration that is dependent on AMD type (wet or dry) (Khurana et al 2016;Pérez-Canales, Rico-Sergado & Pérez-Santonja 2016), ipRGC dysfunction in AMD may contribute to these disorders. Experiment 3 (Chapter 6) determined the relationship between ipRGC function and sleep or depression disorders and demonstrated that ipRGCs contribute to reduced sleep efficacy in advanced stages of AMD.…”

“…IpRGCs also signal to the olivary pretectal nucleus (OPN) for mediation of the pupil light reflex (PLR) (Gamlin et al 2007;Kawasaki & Kardon 2007) and in particular the post-illumination pupil response (PIPR) (Adhikari et al 2016a;Gamlin et al 2007;Kawasaki & Kardon 2007;Markwell et al 2010), which is an emerging method for the direct assessment of ipRGC function in healthy and diseased eyes and in persons with chronobiological disorders Feigl et al 2012b;Gamlin et al 2007;Gracitelli et al 2016;Gracitelli et al 2014;Gracitelli et al 2015;Kawasaki & Kardon 2007;Markwell et al 2010;Maynard et al 2015). Two recent studies observed that sleep duration was altered in advanced AMD patients; sleep duration decreased in wet AMD and increased in dry AMD (Khurana et al 2016;Pérez-Canales et al 2016) but the effect of aberrant ipRGC signalling in AMD Maynard et al 2015) as a contributing factor was not evaluated. Supporting evidence for an association between ipRGC dysfunction and sleep disorders is provided in primary open angle glaucoma patients (Feigl et al 2011b;Kankipati et al 2011) where there is also decreased sleep quality (Gracitelli et al 2016;Gracitelli et al 2015).…”