Cross-sectional study of intraocular cataract lens replacement, circadian rest–activity rhythms, and sleep quality in older adults

Sleep

article

Chellappa, Sarah L¹  Bromundt, Vivien²  Frey, Sylvia³  Schlote, Torsten⁵  Goldblum, David⁶  Cajochen, Christian³ 

[1] Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne;Sleep-Wake-Epilepsy-Center, Department of Neurology, Inselspital, Bern University Hospital;Centre for Chronobiology, Psychiatric Hospital of the University of Basel;Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel;Augenarztpraxis Klingentalstrasse;University of Basel;Pallas-Kliniken

关键词: cataract;    rest–activity rhythms;    sleep;    light exposure;    mood;    alertness;    circadian photosensitivity;    wearable technology;   

DOI  :  10.1093/sleep/zsac027

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Age-related cataract decreases light transmission at the most sensitive spectrum for circadian photoentrainment, with negative ramifications for human health. Here, we assessed whether intraocular lens replacement (IOL) in older patients with previous cataract was associated with increased stability and amplitude of circadian rest–activity rhythms, and improved sleep quality.Methods Our cross-sectional study included sixteen healthy older individuals without ocular diseases (controls; 55–80 years; 63.6 ± 5.6y; 8 women) and 13 patients with previous cataract and bilateral IOL (eight with blue-blocking [BB] lens and five with ultraviolet-only [UV] blocking lens; 55–80 years; 69.9 ± 5.2y; 9 women). The study comprised three weeks of at home rest–activity assessments using wrist-worn actigraphs, and each week preceded a laboratory protocol. Primary outcomes were actigraphy-derived interdaily stability, intradaily variability, and relative amplitude of circadian rest–activity rhythms. Secondary outcomes were actigraphy-assessed sleep quality (i.e. time in bed, sleep duration, sleep efficiency, mean wake bout time and fragmentation index).Results Patients with IOL had significantly higher interdaily stability (“Group” effect: pFDR =.001), but not intradaily variability (“Group” effect: pFDR = n.s.), and significantly higher relative amplitude of rest–activity rhythms (“Group” effect: pFDR < .001). Moreover, patients with IOL had significantly higher activity levels during the day and lower levels during the evening, as compared to healthy older controls (“Group” effect: pFDR = .03). Analyses of actigraphy-derived sleep parameters yielded no significant differences across groups (“Group” effect: all p .1).Conclusions Our cross-sectional study suggests that enhancing spectral lens transmission in patients with cataract may benefit their circadian health.

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