Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
Department of Ophthalmology, National University Hospital, Singapore.
PLoS One. 2018 May 24;13(5):e0196399. doi: 10.1371/journal.pone.0196399. eCollection 2018.
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).
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.
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.
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.
睡眠时长异常与糖尿病风险相关。然而，睡眠时长是否与糖尿病视网膜病变（DR）相关尚不清楚。
在一项横断面研究中，我们纳入了来自新加坡两项独立人群队列研究（2011-15 年）的 1231 名（马来人，n=395；印度人，n=836）糖尿病患者（平均年龄 64.4±9.0 岁，50.4%为女性）。习惯性睡眠时长自报告分为短（<6 小时）、正常（6≤小时<8 小时）和长（≥8 小时）。问卷调查用于检测阻塞性睡眠呼吸暂停（OSA）、日间嗜睡和失眠风险，所有这些都可能表明睡眠质量较差。使用多变量逻辑回归模型调整潜在混杂因素后，分析睡眠相关特征与中度 DR 和视力威胁性 DR（VTDR）之间的关联。
研究人群中中度 DR 和 VTDR 的患病率分别为 10.5%和 6.3%。平均睡眠时间为 6.4±1.5 小时。与正常睡眠时间相比，短睡眠时间和长睡眠时间与中度 DR 均相关，多变量比值比（95%置信区间）分别为 1.73（1.03-2.89）和 2.17（1.28-3.66）。长睡眠时间（2.37[1.16-4.89]）、高 OSA 风险（2.24[1.09-4.75]）和日间嗜睡（3.27[1.02-10.30]）分别与 VTDR 相关。
睡眠时长与中度 DR 呈 U 型关联；长睡眠时间、日间嗜睡和高 OSA 风险与 VTDR 呈正相关。
