Meta-Analysis of Relationship of Sleep Quality and Duration With Risk of Diabetic Retinopathy

Zhenzhen Zheng; Chaoyu Wang; Chunhe Li; Qinglan Wu; Xiaojuan Chen; Huimin Chen; Huizhao Liao; Jinru Zhu; Junyan Lin; Xudong Ou; Zhihong Zou; Jinhua Liang; Riken Chen

doi:10.3389/fendo.2022.922886

Meta-Analysis of Relationship of Sleep Quality and Duration With Risk of Diabetic Retinopathy

Front Endocrinol (Lausanne). 2022 Jun 22:13:922886. doi: 10.3389/fendo.2022.922886. eCollection 2022.

Authors

Zhenzhen Zheng¹, Chaoyu Wang², Chunhe Li³, Qinglan Wu⁴, Xiaojuan Chen⁵, Huimin Chen¹, Huizhao Liao⁶, Jinru Zhu¹, Junyan Lin⁶, Xudong Ou⁶, Zhihong Zou⁶, Jinhua Liang¹, Riken Chen⁶

Affiliations

¹ Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
² Department of Respiratory and Critical Care Medicine, Taishan Hospital of Traditional Chinese Medicine, Jiangmen, China.
³ Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁴ Department of Respiratory and Critical Care Medicine, Central People's Hospital of Zhanjiang, Zhanjiang, China.
⁵ Medical College, Jiaying Uiversity, Meizhou, China.
⁶ Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Abstract

Objective: A meta-analysis is used to explore the relationship of sleep quality and duration with the risk of diabetic retinopathy (DR).

Method: Cochrane Library, PubMed, Embase, and other databases are searched from their establishment to April 2022. Literature on the relationship of sleep quality and duration with DR risk published in various databases is collected, and two researchers independently screen the literature, extract data, and evaluate the quality of the included articles. The meta-analysis is performed with Review Manage 5.4.1 software.

Results: A total of 7 articles are selected, including 4,626 subjects. The results show a strong correlation between sleep quality and DR risk. When comparing the sleep quality scores of "DR" (experimental group) and "NO DR" (control group), the Pittsburgh sleep quality index(PSQI) score of the DR group is significantly higher than that of the NO DR group (MD = 2.85; 95% confidence interval [CI] 1.92, 3.78, P<0.001), while the ESS score of the DR group is also significantly higher than that of the NO DR group (MD = 1.17; 95% confidence interval [CI] 0.14 to 2.30, P=0.04), so the sleep quality score of the DR group is higher than that of the NO DR group in both the PSQI and ESS scores, which confirms that low sleep quality is a risk factor for DR. Long sleep duration is also associated with the risk of developing DR; the number of adverse events (DR prevalence) is higher for "long sleep duration" than "normal sleep duration" [OR = 1.83, 95%CI 1.36-2.47, P < 0.001], suggesting that long sleep duration can cause increased DR risk. Short sleep duration is also associated with the occurrence of DR [OR = 1.49, 95%CI 1.15-1.94), P = 0.003] and can increase DR risk.

Conclusion: Sleep quality and duration (including long and short sleep duration) are significantly associated with DR. To reduce DR risk, sleep intervention should be actively carried out, lifestyle changes should be made, and attention should be paid to the role of DR management.

Keywords: Epworth sleepiness scale; Pittsburgh sleep quality index; diabetic retinopathy; meta-analysis; sleep duration; sleep quality.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus*
Diabetic Retinopathy* / epidemiology
Diabetic Retinopathy* / etiology
Humans
Risk Factors
Sleep
Sleep Quality
Sleep Wake Disorders*