Sleep issues – including too much or too little shut eye, daytime sleepiness, and snoring – may be linked to a heightened risk of vision loss from glaucoma, investigators said.
Depression and anxiety, which often are associated with insomnia, may also increase the internal eye pressure, possibly because of dysregulated cortisol production.
A large UK Biobank study1 published in the open access journal BMJ Open says the findings underscore the need for sleep therapy in people at high risk of the disease as well as eye checks among those with chronic sleep disorders to check for early signs of glaucoma.
Glaucoma is a leading cause of blindness and will likely affect an estimated 112 million people worldwide by 2040.
Investigators 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 behaviours.
During an average monitoring period of just over 10.5 years, 8,690 cases of glaucoma were identified.
The investigators found 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 observational study relied on self-report rather than objective measurement and reflected one point in time only, the researchers acknowledged. They also said glaucoma might itself influence sleep patterns, rather than the other way round.
But the researchers said there are potentially plausible biological explanations for the associations between sleep disturbance and glaucoma.
The internal pressure of the eye, a key factor in the development of glaucoma, rises when a person is lying down and when sleep hormones are out of kilter, as occurs in insomnia, explained the researchers.
Similarly, repetitive or prolonged episodes of low levels of cellular oxygen, caused by sleep apnoea might cause direct damage to the optic nerve, they suggested.
“As sleep behaviours are modifiable, these findings underscore the necessity of sleep intervention for individuals at high risk of glaucoma and potential ophthalmologic screening among individuals with chronic sleep problems to help prevent glaucoma,” investigators concluded.
Reference
- Huan Song, Huazhen Yang, Yihan Hu, et.al. Association of sleep behaviour and pattern with the risk of glaucoma: a prospective cohort study in the UK Biobank. BMJ. Published 1 Nov 2022. doi: 10.1136/bmjopen-2022-063676
