Associations of Sleep Measures with Retinal Microvascular Diameters among Police Officers

ABSTRACT

Purpose

We examined cross-sectional associations of sleep measures with central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) and investigated whether sex and race/ethnicity modified these associations.

Methods

Participants (N = 202; 78% white; 71% men) were enrolled in the Buffalo Cardio-metabolic Occupational Police Stress study (2011–2014). Wrist actigraphy was used to assess sleep measures including sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, number of awakenings, and longest wake episode. CRAE and CRVE were obtained from fundus photography of retina and were averaged from both eyes per officer.

Results

We observed significant associations between sleep efficiency and CRVE (β = -2.81 µm; P= .046), and between longest wake episode and CRVE (β = 3.24 µm; P= .021). Adjustments for demographics, lifestyles, and physical and psychological factors attenuated these associations. Sex modified the independent associations of sleep onset latency and longest wake episode with CRVE. One standard deviation (SD) increase in sleep onset latency was associated with 4.81 µm larger CRVE (P= .028) (P-interaction = 0.098), and one SD increase in longest wake episode was associated with 4.62 µm larger CRVE (P= .032) (P-interaction = 0.115) among men. Race/ethnicity also modified the association between longest wake episode and CRVE (P-interaction = 0.088). A significant association was observed only among white officers (β = 4.96 µm; P= .025).

Conclusions

We found that poor sleep quality, measured by longest wake episode, was positively and independently associated with retinal venular diameter among white and male officers. Longitudinal studies are warranted to assess whether poor sleep quality is a risk factor for retinal diameter changes.

KEYWORDS:

• Actigraphy
• fundus photography
• police officer
• retinal microvasculature
• sleep quality

Acknowledgments

The IVAN software used in the present study was developed by Dr. Nicola Ferrier of the University of Wisconsin, Madison School of Engineering and the Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, U.S.A.

Disclaimers

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention.

Financial support

All the authors prepared the manuscript during their official hours of work.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the National Institute for Occupational Safety and Health, (contract no. 200-2003-01580) and grant (grant no: 1R01OH 009640-01A1).