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    This cross-sectional study investigated the relationship between glaucoma and sleep-related parameters among adults in the United States.

    Study design

    Using data obtained from the National Health and Nutrition Examination Survey (NHANES), the authors included 6,784 patients aged 40 years or older who completed the sleep survey. Examined predictors included sleep duration, sleep latency, previously diagnosed sleep disorder, sleep disturbance, sleep medication use and daytime dysfunction due to sleepiness. Participants underwent fundus photography and automated visual field testing using frequency doubling technology.


    The study found associations between a number of abnormal sleep parameters with both disc and visual field defined glaucoma. Three parameters were associated with increased risk of disc defined glaucoma: sleeping 10 hours or more per night, falling asleep in 9 minutes or less and falling asleep in 30 minutes or more. Four parameters were associated with an increased risk of visual field associated glaucoma: sleeping 3 hours or less per night, sleeping 10 hours or more per night, difficulty with memory and difficulty with performance of hobbies due to fatigue.


    This was a cross-sectional study that involved mining a large dataset for possible associations between parameters and glaucoma. Prospectively gathered data would allow for stronger evidence in support of these possible relationships. Glaucoma was defined either structurally or functionally; greater specificity for glaucoma diagnosis could be obtained by using both measures together. Abnormalities in sleep parameters were based on responses to survey questions rather than validated sleep studies.

    Clinical significance

    This study adds to the existing literature supporting an association between sleep disorders and poor sleep habits with glaucoma risk. Clinicians should promote healthy sleep habits for overall health as well as to possibly decrease the risk of glaucomatous optic neuropathy.