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The Impact of Optic Nerve Disorders on Sleep Wake / SARAH STEVENSON

Swansea University Author: SARAH STEVENSON

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DOI (Published version): 10.23889/SUthesis.65368

Abstract

Background: Sleep is mediated by photic input from photosensitive retinal ganglion cells via the optic nerves which form part of the retinohypothalamic tract to the suprachiasmatic nuclei, which act as an endogenous circadian pacemaker. Previous studies have shown increased circadian dysfunction in...

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Published: Swansea, Wales, UK 2023
Institution: Swansea University
Degree level: Doctoral
Degree name: M.D
Supervisor: John, Ann and Hutchings, Hayley (Swansea University); Downes, Susan M. and Foster, Russell G. (University of Oxford)
URI: https://cronfa.swan.ac.uk/Record/cronfa65368
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>65368</id><entry>2023-12-21</entry><title>The Impact of Optic Nerve Disorders on Sleep Wake</title><swanseaauthors><author><sid>fe4a18f05e3b2b6bf75af0d336ea7bf8</sid><firstname>SARAH</firstname><surname>STEVENSON</surname><name>SARAH STEVENSON</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-12-21</date><abstract>Background: Sleep is mediated by photic input from photosensitive retinal ganglion cells via the optic nerves which form part of the retinohypothalamic tract to the suprachiasmatic nuclei, which act as an endogenous circadian pacemaker. Previous studies have shown increased circadian dysfunction in ocular disorders and blindness; however, no large-scale studies demonstrating the impact of optic nerve disorders (OND) on sleep have been performed. Hypothesis: It was hypothesised that individuals with OND would have poorer sleep quality and timing than individuals with normal visual function. Aims: The aim of this research was to investigate the nature of the relationship between OND and sleep quality and timing. Methods: A general literature review of the physiology of normal and abnormal human sleep and OND was undertaken. A systematic review of published research specific to sleep in OND was also carried out. An observational study of sleep quality and timing in OND based on the SOMNUS study was conducted. In the prospective component of this study, participants were recruited from ophthalmology clinics and completed standardised questionnaires including the Pittsburgh Sleep Quality Index (PSQI); the Epworth Sleepiness Scale (ESS); The Morningness-Eveningness Questionnaire (MEQ) to evaluate chronotype; the SF-36 Questionnaire to evaluate quality of life (QOL); and the Hospital Anxiety and Depression Scale (HADS) to assess mood. A pool of normally sighted control subjects was also recruited. In the retrospective component, data from patients with autoimmune and demyelinating optic neuropathies was descriptively analysed. Summary of Findings: In the prospective study, 122 participants with OND were compared to 302 control participants. Poor sleep was present in 65.6% of individuals with OND and in 39.7% of controls (p&lt;0.0001). Sleep timing was worse in OND (p=0.02). Daytime sleepiness (ESS), chronotype and anxiety were comparable between groups, but HADS depression score was worse in OND (p=0.04). QOL scores for all parameters except for emotional wellbeing were worse in OND (p&lt;0.05). Data were retrospectively analysed from 34 participants with neuromyelitis optica spectrum disorder, which revealed prevalence of poor sleep in the presence of depression, sphincter dysfunction, pain, psychiatric medication and glucocorticoid use. Conclusions: In the prospective component of this study, participants with OND had poorer sleep quality and timing than those with normal visual function. In the retrospective component, subjects with autoimmune and demyelinating OND had systemic associations which may contribute to poor sleep. 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(University of Oxford)</supervisor><degreelevel>Doctoral</degreelevel><degreename>M.D</degreename><degreesponsorsfunders>Wellcome Trust, National Institute for Health Research (NIHR); University of Oxford Sleep and Circadian Neuroscience Institute; NIHR Thames Valley and South Midlands Clinical Research Network Fellowship; Eye Research Group Oxford</degreesponsorsfunders><apcterm/><funders>Wellcome Trust, National Institute for Health Research (NIHR); University of Oxford Sleep and Circadian Neuroscience Institute; NIHR Thames Valley and South Midlands Clinical Research Network Fellowship; Eye Research Group Oxford.</funders><projectreference>Wellcome Trust (098461/Z/12/Z; Wellcome Enhancement 090684/Z/09/A); National Institute for Health Research (NIHR) Oxford Biomedical Research Centre of Excellence based at Oxford University Hospitals NHS Trust (A90305 and A92181); OHSRCG Grant (8166 – OHSRC 980); Thames Valley NIHR Clinical Research Network (10558).</projectreference><lastEdited>2023-12-21T12:49:18.9463593</lastEdited><Created>2023-12-21T12:29:47.8840536</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>SARAH</firstname><surname>STEVENSON</surname><order>1</order></author></authors><documents><document><filename>65368__29312__1ff5be09fddc4675b5ee559e9e5b2723.pdf</filename><originalFilename>2023_Stevenson_SR.final.65368.pdf</originalFilename><uploaded>2023-12-21T12:40:26.3026473</uploaded><type>Output</type><contentLength>4952955</contentLength><contentType>application/pdf</contentType><version>E-Thesis – open access</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: The Author, Sarah R. Stevenson, 2023. Distributed under the terms of a Creative Commons Attribution 4.0 International License (CC BY 4.0).</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 65368 2023-12-21 The Impact of Optic Nerve Disorders on Sleep Wake fe4a18f05e3b2b6bf75af0d336ea7bf8 SARAH STEVENSON SARAH STEVENSON true false 2023-12-21 Background: Sleep is mediated by photic input from photosensitive retinal ganglion cells via the optic nerves which form part of the retinohypothalamic tract to the suprachiasmatic nuclei, which act as an endogenous circadian pacemaker. Previous studies have shown increased circadian dysfunction in ocular disorders and blindness; however, no large-scale studies demonstrating the impact of optic nerve disorders (OND) on sleep have been performed. Hypothesis: It was hypothesised that individuals with OND would have poorer sleep quality and timing than individuals with normal visual function. Aims: The aim of this research was to investigate the nature of the relationship between OND and sleep quality and timing. Methods: A general literature review of the physiology of normal and abnormal human sleep and OND was undertaken. A systematic review of published research specific to sleep in OND was also carried out. An observational study of sleep quality and timing in OND based on the SOMNUS study was conducted. In the prospective component of this study, participants were recruited from ophthalmology clinics and completed standardised questionnaires including the Pittsburgh Sleep Quality Index (PSQI); the Epworth Sleepiness Scale (ESS); The Morningness-Eveningness Questionnaire (MEQ) to evaluate chronotype; the SF-36 Questionnaire to evaluate quality of life (QOL); and the Hospital Anxiety and Depression Scale (HADS) to assess mood. A pool of normally sighted control subjects was also recruited. In the retrospective component, data from patients with autoimmune and demyelinating optic neuropathies was descriptively analysed. Summary of Findings: In the prospective study, 122 participants with OND were compared to 302 control participants. Poor sleep was present in 65.6% of individuals with OND and in 39.7% of controls (p<0.0001). Sleep timing was worse in OND (p=0.02). Daytime sleepiness (ESS), chronotype and anxiety were comparable between groups, but HADS depression score was worse in OND (p=0.04). QOL scores for all parameters except for emotional wellbeing were worse in OND (p<0.05). Data were retrospectively analysed from 34 participants with neuromyelitis optica spectrum disorder, which revealed prevalence of poor sleep in the presence of depression, sphincter dysfunction, pain, psychiatric medication and glucocorticoid use. Conclusions: In the prospective component of this study, participants with OND had poorer sleep quality and timing than those with normal visual function. In the retrospective component, subjects with autoimmune and demyelinating OND had systemic associations which may contribute to poor sleep. This supports the consideration of sleep quality and timing in the holistic management of patients with OND. E-Thesis Swansea, Wales, UK Optic nerve disorder, neuromyelitis optica spectrum disorder, retinal ganglion cell, sleep wake, sleep quality, sleep timing, circadian rhythm, melatonin, mood, quality of life 5 9 2023 2023-09-05 10.23889/SUthesis.65368 COLLEGE NANME COLLEGE CODE Swansea University John, Ann and Hutchings, Hayley (Swansea University); Downes, Susan M. and Foster, Russell G. (University of Oxford) Doctoral M.D Wellcome Trust, National Institute for Health Research (NIHR); University of Oxford Sleep and Circadian Neuroscience Institute; NIHR Thames Valley and South Midlands Clinical Research Network Fellowship; Eye Research Group Oxford Wellcome Trust, National Institute for Health Research (NIHR); University of Oxford Sleep and Circadian Neuroscience Institute; NIHR Thames Valley and South Midlands Clinical Research Network Fellowship; Eye Research Group Oxford. Wellcome Trust (098461/Z/12/Z; Wellcome Enhancement 090684/Z/09/A); National Institute for Health Research (NIHR) Oxford Biomedical Research Centre of Excellence based at Oxford University Hospitals NHS Trust (A90305 and A92181); OHSRCG Grant (8166 – OHSRC 980); Thames Valley NIHR Clinical Research Network (10558). 2023-12-21T12:49:18.9463593 2023-12-21T12:29:47.8840536 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science SARAH STEVENSON 1 65368__29312__1ff5be09fddc4675b5ee559e9e5b2723.pdf 2023_Stevenson_SR.final.65368.pdf 2023-12-21T12:40:26.3026473 Output 4952955 application/pdf E-Thesis – open access true Copyright: The Author, Sarah R. Stevenson, 2023. Distributed under the terms of a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title The Impact of Optic Nerve Disorders on Sleep Wake
spellingShingle The Impact of Optic Nerve Disorders on Sleep Wake
SARAH STEVENSON
title_short The Impact of Optic Nerve Disorders on Sleep Wake
title_full The Impact of Optic Nerve Disorders on Sleep Wake
title_fullStr The Impact of Optic Nerve Disorders on Sleep Wake
title_full_unstemmed The Impact of Optic Nerve Disorders on Sleep Wake
title_sort The Impact of Optic Nerve Disorders on Sleep Wake
author_id_str_mv fe4a18f05e3b2b6bf75af0d336ea7bf8
author_id_fullname_str_mv fe4a18f05e3b2b6bf75af0d336ea7bf8_***_SARAH STEVENSON
author SARAH STEVENSON
author2 SARAH STEVENSON
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publishDate 2023
institution Swansea University
doi_str_mv 10.23889/SUthesis.65368
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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description Background: Sleep is mediated by photic input from photosensitive retinal ganglion cells via the optic nerves which form part of the retinohypothalamic tract to the suprachiasmatic nuclei, which act as an endogenous circadian pacemaker. Previous studies have shown increased circadian dysfunction in ocular disorders and blindness; however, no large-scale studies demonstrating the impact of optic nerve disorders (OND) on sleep have been performed. Hypothesis: It was hypothesised that individuals with OND would have poorer sleep quality and timing than individuals with normal visual function. Aims: The aim of this research was to investigate the nature of the relationship between OND and sleep quality and timing. Methods: A general literature review of the physiology of normal and abnormal human sleep and OND was undertaken. A systematic review of published research specific to sleep in OND was also carried out. An observational study of sleep quality and timing in OND based on the SOMNUS study was conducted. In the prospective component of this study, participants were recruited from ophthalmology clinics and completed standardised questionnaires including the Pittsburgh Sleep Quality Index (PSQI); the Epworth Sleepiness Scale (ESS); The Morningness-Eveningness Questionnaire (MEQ) to evaluate chronotype; the SF-36 Questionnaire to evaluate quality of life (QOL); and the Hospital Anxiety and Depression Scale (HADS) to assess mood. A pool of normally sighted control subjects was also recruited. In the retrospective component, data from patients with autoimmune and demyelinating optic neuropathies was descriptively analysed. Summary of Findings: In the prospective study, 122 participants with OND were compared to 302 control participants. Poor sleep was present in 65.6% of individuals with OND and in 39.7% of controls (p<0.0001). Sleep timing was worse in OND (p=0.02). Daytime sleepiness (ESS), chronotype and anxiety were comparable between groups, but HADS depression score was worse in OND (p=0.04). QOL scores for all parameters except for emotional wellbeing were worse in OND (p<0.05). Data were retrospectively analysed from 34 participants with neuromyelitis optica spectrum disorder, which revealed prevalence of poor sleep in the presence of depression, sphincter dysfunction, pain, psychiatric medication and glucocorticoid use. Conclusions: In the prospective component of this study, participants with OND had poorer sleep quality and timing than those with normal visual function. In the retrospective component, subjects with autoimmune and demyelinating OND had systemic associations which may contribute to poor sleep. This supports the consideration of sleep quality and timing in the holistic management of patients with OND.
published_date 2023-09-05T12:49:30Z
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score 11.012857

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