A longitudinal population study of the impact of cataract extraction on sleep quality

Abstract

Purpose: To investigate the longitudinal effects of cataract extraction on sleep quality in two discrete population cohorts. Methods: 301 participants who had senile cataract in both eyes at the baseline examination were selected from two large longitudinal epidemiologic studies of age-related eye disease, hearing, olfaction, and cognition. The participants were divided into two groups: one had cataract surgery (CS) in both eyes, and the other had no cataract surgery (NCS) in either eye by the follow up examination. Cataract was graded from photos or digital images using a standardized protocol. The quality of sleep was assessed using a modified Wisconsin Sleep Cohort Study Questionnaire. The NCS and CS groups were compared as to the change in the number of sleep problems reported from the baseline to the follow-up examination, adjusted for systemic co-morbidity data and the SF-36 physical component and mental component summary scores. Results: The average (mean ± SD) age was 71.0 ± 8.8 years in the NCS (n = 237) group and 73.4 ± 9.1 years in the CS (n = 64) group. There was no statistically significant difference in the change in the number of sleep problems reported between the NCS and CS groups (mean: −0.068 for NCS and 0.016 for CS, p = 0.57). The multivariable linear regression models, when adjusted for confounders, yielded similar results. Conclusion: In this longitudinal, community-based population study, we found no significant impact of cataract extraction on sleep quality. Studies of the effect of cataract extraction on sleep should allow a longer follow up to demonstrate sustainability.

Keywords:

• cataract
• cataract extraction
• sleep
• population study
• longitudinal

Public Interest Statement

The external ambient light plays an essential role in the regulation of various brain activities, such as sleep, body temperature, and hormonal secretion. Age-related ocular diseases have a significant impact on these physiologic activities by blocking the transmission of the external ambient light to the brain. This perspective article studies whether removal of cataract, an age-related ocular condition that causes reduced light transmission due to yellowing of the crystalline lens, can help improve sleep quality, in a large epidemiologic study of aging, the Beaver Dam Offspring Study. The study found no significant impact of cataract removal on sleep quality. Sleep disruption is common in the elderly and has a negative impact on the physical and psychosocial wellbeing of the aging population. Therefore, further study is needed to assess the relation between age-related ocular disease and sleep which may help with the development of interventional strategies to promote sleep.

Competing Interest

The authors declare no competing interest.

Additional information

Notes on contributors

Yanjun Chen

As a neuro-ophthalmologist, I diagnose and treatment vision problems associated with a variety of neurologic and systemic diseases. My research focuses on how ocular diseases influence our general health, in particular, non-visual brain behaviors such as sleep and cognition. I use pupil reactivity produced by a special group of retinal photoreceptors, the intrinsically photosensitive retinal ganglion cell (ipRGC), as a biomarker to relate age-related ocular disease to these general health outocome measures. I also research if lighting intervention can help promote sleep, cognition, and work performance. Lines of investigation will add to our understanding of how the viusal system—from the eyes to the brain—works to influence human behavior, and facilitate the development of strategies to overcome the negative impact of age-related ocular diseases on the physical and psychosocial wellbeing of the aging population.