Researchers have performed a prospective cohort study to understand the association between different sleep behaviors and glaucoma. Insomnia, snoring, daytime sleepiness, and short/long duration, individually or jointly, were all associated with the risk of glaucoma. The findings underscore the need for sleep intervention for individuals at high risk of glaucoma as well as potential ophthalmologic screening among individuals with chronic sleep problems for glaucoma prevention.
Sun et al. assessed the association of sleep behaviors and patterns with glaucoma. Image credit: National Eye Institute.
Glaucoma is a leading cause of irreversible vision loss that currently affects more than 70 million people worldwide and will affect 111.8 million people by 2040.
It is characterized by progressive loss of retinal ganglion cells, especially intrinsically photosensitive retinal ganglion cells, and changes in neuro-retinal rim tissue in the optic nerve head and visual field constriction.
The underlying mechanisms of glaucoma are still poorly understood and the factors contributing to its progression have not been fully characterized.
When left undetected and untreated, glaucoma can lead to blindness as the changes are irreversible.
Therefore, glaucoma screening is pertinent to aid early detection. However, screening the general population may not be cost-effective.
Instead, identifying high-risk groups to guide screening efforts for early detection may be an effective solution.
Dr. Huan Song, a researcher with Sichuan University and the University of Iceland, and colleagues set out to ascertain the risk of glaucoma among people with different sleep behaviors: insomnia; too much or too little sleep; night or morning chronotypes (‘owls’ or ‘larks’); daytime sleepiness; and snoring.
They drew on 409,053 participants in the UK Biobank, all of whom were aged between 40 and 69 in 2006-10 when recruited, and who had provided details of their sleep behaviors.
Sleep duration was defined as normal (7 to less than 9 hours/day) and as too little or too much, outside this range. Chronotype was defined according to whether the person described themselves as more of a morning lark or night owl.
Insomnia severity was classified as never/sometimes or usually, whereas subjective daytime sleepiness was categorized as never/rarely, sometimes, or frequent.
During an average monitoring period of just over 10.5 years, 8,690 cases of glaucoma were identified.
Those with glaucoma tended to be older and more likely to be male, an ever smoker, and to have high blood pressure or diabetes than those who weren’t diagnosed with the disease.
With the exception of chronotype, the other four sleep patterns/behaviors were all associated with varying degrees of heightened glaucoma risk.
Short or long sleep duration was associated with an 8% heightened risk; insomnia 12%; snoring 4%; and frequent daytime sleepiness (20%).
And compared with those with a healthy sleep pattern, snorers and those who experienced daytime sleepiness were 10% more likely to have glaucoma, while insomniacs and those with a short/long sleep duration pattern were 13% more likely to have it.
The results were similar when categorized by different types of glaucoma.
“This is an observational study, and as such, can’t establish cause,” the authors said.
“The study relied on self report rather than objective measurement and reflected one point in time only.”
“Glaucoma might itself influence sleep patterns, rather than the other way round.”
The study was published in the journal BMJ Open.
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C. Sun et al. 2022. Association of sleep behaviour and pattern with the risk of glaucoma: a prospective cohort study in the UK Biobank. BMJ Open 12: e063676; doi: 10.1136/bmjopen-2022-063676
