Association Between Sleep Apnea and Dry Eye Disease in the All-of-Us Program

Area of Science:

• Ophthalmology
• Sleep Medicine
• Epidemiology

Background:

• Obstructive sleep apnea (OSA) is a common condition affecting millions.
• Dry eye disease (DED) and meibomian gland dysfunction (MGD) are prevalent ocular surface conditions.
• The association between OSA and DED/MGD in a large, diverse U.S. population remains under-investigated.

Purpose of the Study:

• To investigate the association between obstructive sleep apnea (OSA) and the prevalence of dry eye disease (DED) and meibomian gland dysfunction (MGD).
• To utilize the All-of-Us Research Program (AoURP) dataset for a large-scale, demographically diverse U.S. population analysis.

Main Methods:

• A cross-sectional, matched case-control study design.
• Participants with OSA were matched 1:3 to controls without OSA based on age, gender, race, and ethnicity.
• Logistic regression models were used to assess associations, adjusting for comorbidities like obesity, diabetes, and hypertension.

Main Results:

• The study included over 628,000 participants, with nearly 60,000 diagnosed with OSA.
• OSA patients exhibited significantly higher rates of DED (19.4% vs. 5.8%) and MGD (2.6% vs. 1.0%) compared to controls.
• Adjusted odds ratios indicated a 1.76-fold increased likelihood of DED and a 1.43-fold increased likelihood of MGD in individuals with OSA.

Conclusions:

• Obstructive sleep apnea is independently associated with a higher prevalence of both dry eye disease and meibomian gland dysfunction.
• These findings underscore a significant link between OSA and ocular surface disease in a large U.S. population.
• Screening for DED and MGD in patients with OSA may enhance early detection and management of these conditions.