August 14, 2019
2 min read

Quality of sleep associated with glaucoma

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Michael V. Boland

Poor sleep parameters, including sleep duration, latency and daytime dysfunction, are associated with glaucoma, either as a risk factor or as a consequence, according to a study.

“Experimental models of glaucoma have shown that chronic ocular hypertension damages photosensitive retinal ganglion cells, which are hypothesized to mediate non-vision forming pathways, including circadian rhythm and sleep,” study co-author Michael V. Boland, MD, PhD, told Ocular Surgery News. “This cross-sectional study of a representative sample of the United States population sought to explore the hypothesis that ganglion cell loss due to glaucoma may be associated with poor sleep.”

Subjects were culled from the 2005-2008 National Health and Nutrition Examination Survey and included 175 participants with disc defined glaucoma, 575 with visual field defects and 3,742 without evidence of glaucoma. Mean age was 57.1 years, and compared with the non-glaucoma group, subjects in the two glaucoma groups tended to be older and black.

Subjects who completed the sleep survey responded to questions about sleep duration, sleep latency, sleep disorders, sleep disturbances, sleep medication use and daytime dysfunction caused by drowsiness.

“This analysis identified an association between glaucoma and short and long sleep duration and latency, as well as an association between visual field defects and daytime dysfunction due to excessive sleepiness,” Boland said.

Disc defined glaucoma was three times more prevalent in participants who slept 10 or more hours per night vs. those who slept 7 hours (P = .01) and was twice as prevalent in those who fell asleep in 9 minutes or less or in half an hour or more (both P < .01 ) compared with those who fell asleep in 10 to 29 minutes.

“Ophthalmologists may want to consider asking their glaucoma patients about their sleep quality,” Boland said.

Visual field defects were three times as likely in those who slept 3 hours or less (P < .03) or 10 hours or more (P < .01) than in those who slept 7 hours.

As well, memory difficulty was more likely in those with visual field defects and was attributed to excessive daytime sleepiness. However, no association was found between sleep-disordered breathing and glaucoma.

“The results of this analysis raise thought-provoking questions that warrant further study,” Boland said. “The relationship between visual field severity and sleep dysfunction should be investigated in order to explore whether there might be a threshold effect in the relationship between visual field defects and disturbed sleep. In order to further test the underlying hypothesis, sleep parameters of patients with glaucoma should be compared with that of patients with vision loss due to other etiologies that do not cause retinal ganglion cell injury, such as diabetic retinopathy and macular degeneration.” – by Scott Buzby


Qiu M, et al. J Glaucoma. 2019;doi:10.1097/IJG.0000000000001169.

For more information:

Michael V. Boland, MD, PhD, can be reached at Wilmer Eye Institute, 600 N. Wolfe St., Baltimore, MD 21287; email:

Disclosure: Boland reports he receives honoraria from Heidelberg Engineering.