Leger D, Guilleminault C, Defrance R, Domont A, Paillard M
Centre du Sommeil, Hotel Dieu, 75001 Paris, France and Stanford Sleep Disorders Center, Stanford University, 401 Quarry Road, Suite 3301A, Stanford, CA 94305, USA.
Clin Sci (Lond). 1999 Aug;97(2):193-9.
Blind individuals are not only handicapped by their loss of vision, but are also affected because the loss of sight may have a secondary impact on functioning of their biological clock. The objective of the present study was to determine the impact of visual loss on sleep/wake disorders. A prospective 48-item questionnaire survey was distributed to blind individuals through the French Association Valentin Haüy, which serves blind persons. A control group matched by age, sex, geographical location and professional activity/non-activity was obtained from a panel of 20000 households representative of the French population, and this group also completed the questionnaire. From a potential blind population of 1500 subjects, 1073 questionnaires (71.5%) were completed and usable for analysis, and from a potential 1000 control subjects, 794 (79. 4%) of the questionnaires were returned and analysed. Criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 4th revision, and the International Classification of Sleep/Wake Disorders (1990) were used to determine pathology. Individuals determined to be 'totally blind' and 'almost blind' (i.e. with less than 10% vision left in only one eye) presented a significantly higher occurrence of sleep/wake disorders than controls. Nocturnal sleep disruption, daytime somnolence, and (to a lesser degree) a 'free-running' condition are significantly more common in blind individuals. There is an increased use of sleeping pills, and a higher incidence of inappropriate involuntary daily naps. In conclusion, individuals with blindness report a significant curtailment of total sleep time and hence resulting daytime somnolence, which impacts on daytime activities. A 'free-running' condition is also a common sleep/wake impairment that may compound the handicap of blindness.
盲人不仅因视力丧失而行动不便，而且由于失明可能对其生物钟功能产生次要影响，他们也受到了影响。本研究的目的是确定视力丧失对睡眠/觉醒障碍的影响。通过为盲人服务的法国瓦朗坦·阿尤协会，向盲人发放了一份包含48个项目的前瞻性问卷调查。从代表法国人口的20000户家庭组成的样本中选取了一个在年龄、性别、地理位置和职业活动/非职业活动方面相匹配的对照组，该组也完成了问卷调查。在1500名潜在的盲人中，有1073份问卷（71.5%）填写完整且可用于分析；在1000名潜在的对照受试者中，有794份问卷（79.4%）被收回并进行分析。采用《精神疾病诊断与统计手册》第4版和《睡眠/觉醒障碍国际分类》（1990年）中概述的标准来确定病理情况。被判定为“完全失明”和“几乎失明”（即单眼仅余不到10%的视力）的个体出现睡眠/觉醒障碍的发生率明显高于对照组。夜间睡眠中断、日间嗜睡以及（程度较轻的）“生物钟失调”状况在盲人中明显更为常见。安眠药的使用增加，不适当的非自愿日间小睡发生率更高。总之，失明个体报告总睡眠时间显著减少，进而导致日间嗜睡，这会影响日间活动。“生物钟失调”状况也是一种常见的睡眠/觉醒障碍，可能会加重失明带来的不便。
