Glaucoma Is Associated with the Risk of Obstructive Sleep Apnea: A Population-Based Nationwide Cohort Study

The association between glaucoma and the risk of obstructive sleep apnea (OSA) has not been fully evaluated. Therefore, this study aimed to investigate the prospective association between glaucoma and OSA. In total, 1437 patients with glaucoma and 5748 patients without glaucoma were enrolled after 1:4 propensity score matching using a nationwide cohort sample. We investigated OSA events during a 10-year follow-up period. Survival analysis, the log-rank test, and Cox proportional hazards regression models were used to calculate the incidence, disease-free survival rate, and hazard ratio (HR). The incidence of OSA was 12,509.0 person-years among those with glaucoma. The adjusted HR for patients with glaucoma developing OSA events during the follow-up period was 1.52 (95% confidence interval [CI]: 0.64-3.621) after other covariates. In a subgroup analysis, primary angle-closure glaucoma (PACG) showed a significantly increased adjusted HR for OSA events (5.65, 95% CI: 1.65-19.41), whereas we could not find any significant association between primary open-angle glaucoma (POAG) and OSA. The adjusted HR of OSA events in POAG was considerably increased 4 years after POAG diagnosis. PACG may be associated with an increased incidence of OSA. Clinicians should pay attention to early detection of OSA in patients with PACG.