Glaucoma More Likely in Individuals at Risk For Sleep Apnea

Patients at increased risk for obstructive sleep apnea also face higher odds of eventually developing glaucoma.

Individuals with intermediate/higher risk of obstructive sleep apnea (OSA) have 50% greater odds of having glaucoma, compared with individuals with a low risk of OSA, according to findings published in the Journal of Glaucoma. 

Researchers conducted a cross-sectional study to explore the relationship between OSA and glaucoma and included 3126 adults aged 40 years or older (mean age 63.1±9.6 years) with Indian or Malay ethnicity. Trained ophthalmologists assessed glaucoma and classified it into primary open-angle glaucoma (POAG) and primary angle closure glaucoma (PACG). The researchers employed the Snoring, Tiredness, Observed apnea, High blood pressure, Body mass index, Age, Neck circumference, and male Gender (STOP-Bang) questionnaire to assess OSA risk and categorized it as low risk (<3) or intermediate/higher risk (≥3). Multivariate logistic regression models were used to evaluate the relationship between risk of OSA and glaucoma, adjusted for key variables. Data was further stratified by subtype and ethnicity.

The study identified 134 (4.3%) participants with glaucoma, 86 (2.8%) with POAG, 22 (0.7%) with PACG, 26 (0.8%) with secondary glaucomas, and 1182 (37.8%) with an intermediate/higher risk of OSA. In those with intermediate/higher risk of OSA, a nonsignificant increase in likelihood of having POAG was observed.

The researchers highlight that, to reduce the likelihood of developing glaucoma, particularly POAG, the detection and early treatment of OSA may be important.

Patients at increased risk for obstructive sleep apnea also face higher odds of eventually developing glaucoma.

“Screening for glaucoma in OSA populations may be warranted to aid ophthalmologists and sleep physicians to better understand the OSA-glaucoma relationship, so that relevant ocular disorders, such as glaucoma can be recognized, diagnosed, and treated early,” the researchers explain.

Study limitations include possible confounding due to use of the STOP-Bang questionnaire in place of overnight polysomnography for calculation of spnea-hypopnea index, and possible confounding effects of age, gender, and presence of hypertension in the study population.


Mehta A, Man REK, Gan AT, et al. Association between risk of obstructive sleep apnea and glaucoma: the Singapore epidemiology of eye diseases study. J Glaucoma. 2022; 31(12):935-940. doi:10.1097/IJG.0000000000002105