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Sleep disorders in practice

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1R. H. Mason, 2S. D. West, 3V. Chong, 1J. R. Stradling. 1The Churchill Hospital, Oxford, UK, 2Freeman Hospital, Newcastle upon Tyne, UK, 3The Eye Hospital, Oxford, UK

Introduction and Objectives Diabetic retinopathy is an important cause of visual loss worldwide. We and others recently showed that retinopathy was more common in a group of patients with diabetes if they also had obstructive sleep apnoea (OSA).1 2 Although the numbers were small, maculopathy was also related to the presence of OSA.2 This study was designed to see if OSA was also related to the presence of diabetic macular oedema (DME), which is at the more severe end of the diabetic retinopathy spectrum, poorly responsive to treatment and the most common cause of blindness in patients with diabetes.

Methods 62 patients who had received laser therapy for DME provided anthropometric data, filled in the Epworth Sleepiness Score (ESS) and were screened with a home sleep study (ApnoeaLink, ResMed) to identify the presence of OSA (oxygen desaturation index (ODI), apnoea–hypopnoea index (AHI) and snoring). These results were compared with available prevalence figures from relevant control populations.

Results 58 patients (27 males) had >2 h of valid overnight data. Average (SD) age 62.9 (10.6), neck circumference 40.6 cm (5.3), body mass index (BMI) 30.9 (6.2), HbA1c 7.7% (1.4), ESS 7.5 (4.7). The prevalence of an ODI ⩾10 was 53%, that of AHI ⩾15 was 47%, and 57% had either or both. These prevalences are considerably higher than in any of the control data, 6% in a randomly selected population,3 and 17% in randomly selected patients with type 2 diabetes.4 Those with OSA were not significantly sleepier than those without, but they were older and more obese.

Conclusions Individuals with DME show a …

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