Association between Sleep Parameters and Glaucoma in the United States Population: National Health and Nutrition Examination Survey

Purpose: The main purpose of this study was to investigate the relationship between glaucoma and sleep in United States adults. Patients and Methods: This cross-sectional study included 6784 glaucoma patients from the 2005 to 2008 National Health and Nutrition Examination Survey who were aged 40 years and above, and completed the sleep survey. Predictors included sleep duration, sleep latency, sleep disorders, sleep disturbances, sleep medication use, and daytime dysfunction due to sleepiness. Outcomes included disc defined glaucoma (either right or left disc demonstrating glaucomatous features) and visual field defects (VFDs) assessed by Frequency-Doubling Technology perimetry. Results: The odds of disc defined glaucoma were 3 times higher among subjects who slept for ≥10 hours per night [odds ratio (OR), 3.3; confidence interval (CI), 1.3-8.5; P=0.01] compared with 7 hours per night. The odds of disc defined glaucoma were 2 times higher among subjects who fell asleep in ≤9 minutes (OR, 2.0; CI, 1.2-3.1; P<0.01) and ≥30 minutes (OR, 2.3; CI, 1.4-3.7; P<0.01) compared with 10 to 29 minutes. The odds of VFD were 3 times higher among subjects who slept for ≤3 hours per night (OR, 3.0; CI, 1.1-8.1; P=0.03) and ≥10 hours per night (OR, 3.4; CI, 1.5-7.7; P<0.01), compared with 7 hours per night. The odds of VFD were 2 times higher among subjects who had difficulty remembering things (OR, 2.0; CI, 1.3-2.9; P<0.01) and 3 times higher among subjects who had difficulty working on a hobby (OR, 3.0; CI, 1.5-6.1; P<0.01) due to daytime sleepiness compared with those without difficulty. Conclusions: This study revealed associations between glaucoma and abnormal sleep duration, sleep latency, and daytime dysfunction; poor sleep parameters may be a risk factor for or a consequence of glaucoma.