Association between circadian rhythm sleep disorder and open-angle glaucoma: The modifying role of melatonin
Abstract
Abstract Background: Circadian rhythm sleep disorders (CRSD) may disrupt neurovascular regulation and increase open-angle glaucoma (OAG) and ocular hypertension (OHT) risk. This study assessed associations with OAG, primary open-angle glaucoma (POAG), and OHT and examined melatonin’s modifying effect.
Methods:: A retrospective cohort study using TriNetX data included adults (≥ 18 years) with CRSD matched 1:1 to polysomnography-tested controls without sleep disorders. Melatonin subgroups were analyzed. Among 24,730 matched pairs, ICD-10–defined OAG, POAG, and OHT at 1, 3, and 5 years were assessed using adjusted hazard ratios (aHRs) and Kaplan–Meier analyses.
Results:: After matching, 24,730 patients were included in each group. The CRSD group had a significantly higher risk of OAG at 1 year (0.14% vs. 0.04%; P=.0005; aHR 2.67, 95% CI 1.42–5.02), 3 years (0.25% vs. 0.07%; P < .0001; aHR 3.02, 95% CI 1.81–5.05), and 5 years (0.27% vs. 0.08%; P < .0001; aHR 2.88, 95% CI 1.78–4.66). Similar trends were observed for POAG, while no significant differences were seen for OHT. Among CRSD patients not using melatonin (n = 24,150 pairs), OAG risk remained significantly elevated at all time points. In contrast, among melatonin users (n = 4,081 pairs), the risks of OAG, and OHT were not significantly different from controls (5-year OAG: 0.52% vs. 0.32%; P = .23; aHR 2.07, 95% CI 0.88–4.84).
Conclusions:: CRSD is associated with an increased risk of OAG and POAG, in patients not using…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 24,730 participants or records.
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