Open AccessAssociations between sleep duration, sleep quality and diabetic retinopathy
Author(s) -
Ning Tan,
Merwyn Chew,
Yih Chung Tham,
Quang D. Nguyen,
Masayuki Yasuda,
ChingYu Cheng,
Tien Yin Wong,
Charumathi Sabanayagam
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0196399
Subject(s) - medicine , odds ratio , excessive daytime sleepiness , confidence interval , population , obstructive sleep apnea , insomnia , sleep (system call) , logistic regression , diabetes mellitus , epworth sleepiness scale , confounding , sleep apnea , polysomnography , sleep disorder , endocrinology , apnea , psychiatry , environmental health , computer science , operating system
Background Abnormal durations of sleep have been associated with risk of diabetes. However, it is not clear if sleep duration is associated with diabetic retinopathy (DR). Methods In a cross-sectional study, we included 1,231 (Malay, n = 395; Indian, n = 836) adults (mean age 64.4 ± 9.0 years, 50.4% female) with diabetes from the second visit of two independent population-based cohort studies (2011–15) in Singapore. Self-reported habitual sleep duration was categorized as short (<6 h), normal (6≤ h <8), and long (≥8 h). Questionnaires were administered to detect risk of obstructive sleep apnea (OSA), excessive daytime sleepiness, and insomnia, all of which may indicate poor quality of sleep. The associations between sleep-related characteristics with moderate DR and vision-threatening DR (VTDR) were analysed using logistic regression models adjusted for potential confounders. Results Prevalence of moderate DR and VTDR in the study population were 10.5% and 6.3% respectively. The mean duration of sleep was 6.4 ± 1.5 h. Compared to normal sleep duration, both short and long sleep durations were associated with moderate DR with multivariable odds ratio (95% confidence interval) of 1.73 (1.03–2.89) and 2.17 (1.28–3.66) respectively. Long sleep duration (2.37 [1.16–4.89]), high risk of OSA (2.24 [1.09–4.75]), and excessive daytime sleepiness (3.27 [1.02–10.30]) were separately associated with VTDR. Conclusion Sleep duration had a U-shaped association with moderate DR; long sleep duration, excessive daytime sleepiness and high risk of OSA were positively associated with VTDR.