There is a gap in current research on melatonin use to enhance sleep in blind patients. Photo: Getty Images.

One group of researchers found the interrelationship of ocular health and sleep quality particularly important and deserving of further study, noting a global aging population and increasing visual impairment prevalence across all age groups. As such, the  study authors conducted a scoping review to investigate the current state of research on sleep health in visually impaired populations.

Included after investigation were 83 total peer-reviewed articles published from 1977 to 2023. Upon analysis, 11 ocular conditions were identified, including blindness, glaucoma, diabetic retinopathy, low vision, cataract, retinitis pigmentosa, macular degeneration, optic neuropathy, visual field defects, ocular hypertension and retinal vein occlusion. Along with this, eight major sleep problems were also identified, including abnormal sleep duration, daytime sleepiness, insomnia, Non-24-Hour Sleep Wake Disorder, sleep apnea, sleep disorders, sleep disturbances and sleep disordered breathing.

Four prominent themes emerged across these studies: poor sleep quality in those with visual impairments and ophthalmic diseases, a high prevalence of sleep issues in those with ophthalmic diseases, sleep apnea in those with ophthalmic conditions and circadian rhythm disruptions in those who are blind.

Within their discussion, the authors make note that most of the conducted studies took place in the US or UK, with India emerging as a country with notably high prevalence of visual impairment—this included blindness mainly attributed to cataract. Although India had a high prevalence, no sleep studies could be located by the authors from there. While research efforts in the US and UK mainly focus on preventing blindness and visual impairment, studies done in Saudi Arabia and India focus more on the unmet vision care needs in rural areas, highlighting how more is needed to be done for accessibility in these regions to eye care services.

The authors continue by relaying that there is a noticeable lack of research on non-pharmacological intervention aimed at improving sleep quality for the blind population, who experience circadian rhythm disorders and changes in sleep duration and pattern. Similarly, there is lack of research on non-pharmacological agents to improve sleep disturbances in visually impaired individuals, despite numerous studies demonstrating efficacy to improve sleep quality in hospitalized patients, the elderly and those with mental health problems.

From these observations, the investigators speculate “that a holistic approach to patient care, which includes the assessment and management of sleep health, is vital for improving overall health outcomes. The high prevalence of sleep-related problems in individuals with visual impairments calls for routine screening and tailored interventions.”

However, they are hopeful that “the evolving landscape of digital health technologies offers promising avenues for developing effective sleep health interventions.”

Choi S, Kim G, Pionke JJ. The sleep health of individuals with visual impairments: a scoping review. Ophthalmic Epidemiol. 2024:1-19.