Sleep-disordered breathing in patients with total bilateral blindness: A 10-year prospective study

Obstructive sleep apnea (OSA) is common in the general population and is associated with major cardiovascular consequences and impaired quality of life. The absence of light perception in patients with total bilateral blindness (TBB) promotes circadian desynchronization, which may increase the risk of OSA. The aim of this study was to assess the prevalence of OSA and other sleep-disordered breathing conditions in patients with TBB.

This was a prospective observational study conducted over a 10-year period, including 19 patients with TBB of various etiologies. Clinical interviews, validated questionnaires (STOP-BANG, ESS), and in-laboratory overnight polysomnography were performed.

Moderate to severe OSA was present in 63.2% (12/19) of patients, with a predominance among males. Significant alterations in sleep architecture were observed, along with a high frequency of circadian desynchronization (non-24-h sleep-wake disorder).

Patients with TBB show a significantly higher prevalence of OSA compared with the general population, probably related to circadian desynchronization secondary to the absence of light perception. These findings support the need for systematic screening for sleep-disordered breathing in this population, given its impact on quality of life and cardiovascular risk.