Associations of sleep duration and nocturnal oxygenation with OCT-derived retinal arterial structure

To examine the associations of objectively measured sleep parameters (sleep duration, efficiency, and nocturnal oxygen desaturation) with retinal arterial structure assessed using optical coherence tomography (OCT).

This cross-sectional study included 5991 adults from the community-based Nagahama Study in Japan (2012-2016). All participants underwent OCT and wrist actigraphy. Retinal arterial outer diameter (OD), inner diameter (ID), and wall thickness were measured from peripapillary OCT B-scans. Sleep period time (SPT) and sleep efficiency (defined as total sleep time divided by SPT) were derived from actigraphy. Nocturnal oxygen desaturation was evaluated using the 3% oxygen desaturation index (3%ODI) obtained from synchronized actigraphy and oximetry recordings. Associations between retinal arterial parameters and sleep/oxygenation metrics were evaluated using multivariable linear regression models adjusted for demographic, ocular, and systemic covariates.

Among 5991 participants (mean age 57.6 years; 30.6% male), shorter sleep duration was associated with narrower retinal arterial diameters (OD: β = 0.399; 95% confidence interval [CI], 0.165-0.632; ID: β = 0.402; 95% CI, 0.188-0.616). Higher 3%ODI were associated with thicker arterial walls (β = 0.121; 95% CI, 0.050-0.192) and wider OD (β = 0.431; 95% CI, 0.003-0.859). Sleep efficiency showed no significant associations with any vascular parameter.

Sleep duration and nocturnal oxygen desaturation showed distinct associations with retinal arterial characteristics. OCT-based vascular metrics may serve as noninvasive indicators of sleep-related microvascular alterations.