Sleep Disturbance as a Risk Factor for Retinal Neurodegeneration and Subsequent Glaucoma

作者：Masahiro Akada, Yuta Y. Nakanishi, Midori Ideyama, Yuki Mori, Kazuya Morino, Eri Nakano, Shogo Numa, Tadao Nagasaki, Takeshi Matsumoto, Hironobu Sunadome, Satoshi Hamada, Naomi Takahashi, Toyohiro Hirai, Naoko Komenami, Kazuo Chin, Kimihiko Murase, Susumu Satô, Yasuharu Tabara, Fumihiko Matsuda, Hiroshi Tamura, Masahiro Miyake, Akitaka Tsujikawa, Masayuki Hata · 发表于：American Journal of Ophthalmology · 年份：2025 · DOI：10.1016/j.ajo.2025.08.019 · 被引用次数：11 · 研究领域：Sleep and related disorders、Obstructive Sleep Apnea Research、Glaucoma and retinal disorders

PURPOSE: To determine whether insufficient sleep, insomnia, and sleep-apnea syndrome (SAS) are associated with retinal nerve fiber layer (RNFL) thinning and incident glaucoma in adults. DESIGN: Community-based cross-sectional analysis and nationwide population-based retrospective cohort study. PARTICIPANTS: The regional cohort included 5958 adults aged 40-80 years who underwent wrist actigraphy and optical coherence tomography. The nationwide cohort, comprised adults aged ≥40 years, totaling 985,136 patients with insomnia and 72,075 with sleep apnea syndrome, along with respective control groups without these disorders. METHODS: In the regional cohort, we conducted a cross-sectional analysis to assess the association between objectively measured sleep parameters and retinal nerve fiber layer (RNFL) thickness, using multivariable linear models. In the nationwide cohort, we performed a longitudinal analysis with up to 7.5 years of follow-up, estimating adjusted hazard ratios (aHR) for incident glaucoma using Cox proportional hazards models. RESULTS: In the regional cohort, RNFL thickness peaked at 6-7 h of actual sleep and declined with shorter duration; sleeping <6 h remained independently associated with thinner RNFL after adjustment for age, sex, intraocular pressure, and systemic factors. In the nationwide cohort, glaucoma risk was higher in patients with insomnia (aHR 1.30, 95% CI 1.28-1.32) and SAS (aHR 1.43, 95% CI 1.35-1.51) compared with controls. CONCLUSIONS: Objectiv...