Sleep disturbances are related to decreased transmission of blue light to the retina caused by lens yellowing

Abstract

Study Objectives: Sleep pattern and circadian rhythms are regulated via the retinohypothalamic tract in response to stimulation of a subset of retinal ganglion cells, predominantly by blue light (450-490 nm). With age, the transmission of blue light to the retina is reduced because of the aging process of the human lens, and this may impair the photoentrainment of circadian rhythm leading to sleep disorders. The aim of the study was to examine the association between lens aging and sleep disorders. Design: Cross-sectional population based study. Setting: The study was performed at the Research Center for Prevention and Health, Glostrup Hospital, Denmark and at the Department of Ophthalmology, Herlev Hospital, Denmark. Participants: An age- and sex-stratified sample of 970 persons aged 30 to 60 years of age drawn from a sample randomly selected from the background population. Interventions: Not applicable. Measurements and Results: Sleep disturbances were evaluated by a combination of questionnaire and the use of prescription sleeping medication. Lens aging (transmission and yellowing) was measured objectively by lens autofluorometry. The risk of sleep disturbances was significantly increased when the transmission of blue light to the retina was low, even after correction for the effect of age and other confounding factors such as smoking habits, diabetes mellitus, gender, and the risk of ischemic heart disease (P < 0.0001). Conclusions: Filtration of blue light by the aging lens was significantly associated with an increased risk of sleep disturbances. We propose that this is a result of disturbance of photoentrainment of circadian rhythms.