Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.
How does Poor Sleep Affect Glaucoma? | Do Sleep Problems Lead to Glaucoma?
Overview
Glaucoma is a leading cause of blindness, especially in the elderly. While this statistic has been known for years, we still know little about its etiology.
Glaucoma sets in when the optic nerve is damaged. It begins to manifest as a gradual process until complete vision loss happens. Because it is a slowly progressing disease, early detection can effectively halt the disease and prolong eye function.
A comprehensive dilated eye exam, performed by an ophthalmologist, is the most appropriate approach for spotting this damage at an early stage.[4]
Studies now reveal that people with unhealthy sleeping patterns have a higher risk of developing eye diseases.
Sleeping problems such as irregular sleeping and insomnia often cause a depletion in a person’s ability to concentrate. A decade-long study reveals that such sleep-related imbalances can precipitate total blindness in humans.
In this study, 409,053 subjects were considered and characterized based on their sleep habits, and 8,630 cases of glaucoma were identified.[3] Rather than uncover the cause of glaucoma, the study aimed to investigate the progression of the disease through observation.
In the mentioned study, it was discovered that among people with a preexisting risk of developing glaucoma, those with healthy sleep patterns had a lower risk percentage at 11 percent. In contrast, people with abnormal sleep behaviors had an increased risk of 13 percent.
While there is no cure for glaucoma, sleep therapy is also proposed to be a good way of managing the disease. Cognitive behavioral therapy for insomnia remains the most reliable evidence-based sleep disorder treatment.
How Does Poor Sleep Affect Glaucoma?
There are many benefits to establishing and maintaining a healthy sleep pattern. Regular sleep can lower your risk for serious health problems like diabetes and heart disease. On the flip side, poor sleeping habits lead to developing eye defects like glaucoma and a host of other health challenges.[1]
Studies have shown that glaucoma was three times more prevalent in participants who slept ten or more hours per night than participants who slept seven hours per night. It was also noted that people with glaucoma were more likely to fall asleep quickly (in nine or fewer minutes) or take longer (30 minutes or more) to fall asleep.[2]
Do Sleep Problems Lead to Glaucoma?
Sleep is a necessary process and not just a luxury for a select few. Sleep time allows homeostatic recoveries to occur physiologically and mentally throughout the body.
The relationship between glaucoma and sleep is precariously balanced. Too little sleep can worsen glaucoma, but too much sleep will also have similar effects.
The influence of sleep patterns on glaucoma may depend on comorbidities, such as hypertension, depression, or anxiety.
The following are different ways several biological events in the eye are related to Glaucoma.
1) Intraocular Pressure
Aqueous humor is a fluid produced by the eye. The aqueous humor fluid’s primary purpose is to provide the eye’s nutrition and maintain a pressurized state in the eye. The rate of production and drainage of this fluid largely determine intraocular pressure.
Most, but not all, forms of glaucoma are characterized by abnormal eye (intraocular) pressure. Physiologically, this is due to the position of the drainage system when the head is in a tilted position, usually 30°. When one sleeps or lies down, the eye produces less aqueous humor, and the intraocular pressure goes low, usually within 10-20 percent.
2) Blood Flow to the Optic Nerve During Sleep
During sleep, blood pressure decreases and stays low all through the night. The state of low eye pressure is referred to as hypotension, and the occurrence over an extended period also damages the eyes and worsens glaucoma.
Sleeping for an extended period is helpful in some cases, e.g., it’s beneficial for patients who suffer from hypertension and other cardiovascular diseases. However, certain antihypertensives, especially those taken at night, can cause nighttime hypotension.
Hypertensive glaucoma patients or their ophthalmologists should have a discussion with the primary care doctor to consider the safety of nighttime blood pressure medicines taken by the patient.
3) Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea (OSA) is a breathing-related sleep disorder and often happens to affect glaucoma negatively.
Individuals with OSA, particularly those who are overweight, experience moments where breathing partially or completely ceases when they are asleep. The patient may be unaware of these events except for moments of gasping or choking when the body is fighting for air.
What happens in the eye during these times of absent or reduced breathing is a reduction in the amount of oxygen in circulation in the optic nerve. This occurrence could lead to further progression of glaucoma in patients.
There’s a bidirectional relationship between glaucoma and OSA, meaning patients with OSA are more likely to develop glaucoma, and patients with glaucoma are more likely than the general population to have OSA.
People with OSA experience fatigue during the day and sleepiness during routine activities. Treating OSA early on would play a huge role in managing glaucoma effectively.
4) Imbalanced Sleep Periods
The amount of sleep a glaucoma patient gets has been linked to worsening the effects of glaucoma in patients. There is no ideal amount of sleep for individuals as it differs for everyone, varying from five to nine hours. Based on this, getting too much or too little sleep as a glaucoma patient plays a huge factor in managing the situation.
Glaucoma often happens to people in their 40s, with many health conditions manifesting during this time. Conditions that glaucoma patients may also be experiencing include Alzheimer’s disease, heart disease, kidney disease, high blood pressure, diabetes, stroke, and obesity.
Getting adequate sleep helps in managing these situations despite conflicting pointers that may occur.
Conclusion
Quality sleep is beneficial in preventing and managing glaucoma. It’s important to emphasize that there may be no cure for glaucoma, but it can be managed with proper education and treatment.
The American Academy of Ophthalmology recommends that individuals over 40 schedule an appointment with an ophthalmologist, as it is the peak age for eye diseases to appear.
References:
- Brown, M. (2021, August 1). Get Enough Sleep – MyHealthfinder | health.gov. Office of Disease Prevention and Health Promotion. Retrieved December 14, 2022, from https://health.gov/myhealthfinder/healthy-living/mental-health-and-relationships/get-enough-sleep
- Glaucoma Research Foundation. (2021, July 12). Sweet Dreams: The Relationship Between Sleep and Glaucoma | glaucoma.org. Glaucoma Research Foundation. Retrieved December 14, 2022, from https://glaucoma.org/sweet-dreams-the-relationship-between-sleep-and-glaucoma/
- Gregory, A. (2022, November 2). Study reveals link between sleep problems and glaucoma. The Guardian. Retrieved December 14, 2022, from https://www.theguardian.com/society/2022/nov/01/study-reveals-link-between-sleep-problems-and-glaucoma
- National Eye Institute. (2022, April 21). Glaucoma. National Eye Institute. Retrieved December 14, 2022, from https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma
