Investigating links between glaucoma and sleep apnea

Researchers at the Lions Eye Institute are investigating links between sleep apnea and the development of glaucoma.

As part of the West Australian Apnea and Vascular Endpoints Study (WAVES), and in collaboration with the West Australian Sleep Disorders Research Institute, Lions Eye Institute researchers are testing the eyes of 500 patients with obstructive sleep apnea.

Professor David Mackey AO

The study, led by Professor David Mackey AO, will investigate whether the use of continuous positive airway pressure treatment (CPAP) has any adverse effect on the retinal ganglion cell, or neurons that are located in the retina. Previously, studies have indicated possible links between sleep apnea and glaucoma, however it is not known exactly why.

Glaucoma is a degenerative disease of the optic nerve cause by raised eye pressure, and is the third most common cause of blindness globally. Loss of sight is gradual, and once vision is lost is cannot be restored. More than 300,000 people have glaucoma in Australia, and almost 10 per cent of those will lose their sight to the disease.

It is estimated that around five per cent of Australians have sleep apnea, although this number could be higher as many people with sleep apnea are undiagnosed.

Dr Samantha Sze-Yee Lee

According to Dr Samantha Sze-Yee Lee, a postdoctoral researcher at the Lions Eye Institute, experiencing obstructive sleep apnea as a young adult may accelerate the risk of developing glaucoma later in life.

“With obstructive sleep apnea, the body receives less oxygen and blood flow. Not only does this affect the brain, we believe it also affects the eyes,” said Dr Lee.

“In research published by my team in 2019, we found that 20 percent of young adults, around 20 years of age, had obstructive sleep apnea. That same group were also found to have thinner nerves at the back of the eye, which can lead to glaucoma.

“This was quite a shocking find in people so young. It raises the possibility that sleep apnea may cause an accelerated rate of nerve thinning in the back of the eye.”

In the WAVES study, Dr Lee’s team are comparing eye measurements of people with obstructive sleep apnea who are on long-term CPAP, against those with obstructive sleep apnea who are not undergoing CPAP.

“We are looking at whether obstructive sleep apnea results in an increased risk of glaucoma, and if so, why. Is there a genetic link between the two? Does treatment for obstructive sleep apnea help reduce the risk of glaucoma? We hope to uncover the answers to these questions and more with our research, which in turn could help save the sight of countless people in the future.”

Further reading

Sleep and eye disease: A review https://onlinelibrary.wiley.com/doi/10.1111/ceo.14071

Is Genetic Risk for Sleep Apnea Causally Linked With Glaucoma Susceptibility https://iovs.arvojournals.org/article.aspx?articleid=2778289

Associations of sleep apnoea with glaucoma and age-related macular degeneration: an analysis in the United Kingdom Biobank and the Canadian Longitudinal Study on Aging https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111909/

Optic Disc Measures in Obstructive Sleep Apnea: A Community-based Study of Middle-aged and Older Adults https://pubmed.ncbi.nlm.nih.gov/32134828/

Associations between Optic Disc Measures and Obstructive Sleep Apnea in Young Adults https://pubmed.ncbi.nlm.nih.gov/31196726/

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