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Professor David Mackey & Dr Samantha Sze-Yee Lee
August 2021

Disturbed sleep, including snoring, is a common problem. However, snoring may be a symptom of a more severe condition, obstructive sleep apnoea (OSA). In OSA, airflow is completely or partially obstructed for a period of time. People affected by OSA may experience tiredness, excessive daytime sleepiness, heavy snoring, poor concentration, poor memory, low energy, waking up unrefreshed, gasping or interrupted breathing while asleep, and morning headaches.

Blurred image of person waking up in middle of night


OSA is known to be associated with an increased risk of high blood pressure, heart attacks, and strokes. In addition, floppy eyelid syndrome and increased risk of age-related macular degeneration have also been linked with OSA. However, there has also been some debate as to whether OSA increases glaucoma risk or worsens any existing glaucoma.

We studied two cohorts in WA: over 800 young adults of the Raine Study Gen2 (21% had OSA measured in a sleep laboratory) and another 800 adults of the Baby Boomer generation from the Busselton study (48% had OSA measured with a home monitor). We found that the retinal nerve fibre layers were thinner in some regions in individuals with OSA.

We then looked at participants in two large international cohorts of over 500,000 participants – the UK Biobank Study and the Canadian Longitudinal Study of Aging – where 2% of participants said they had been diagnosed with OSA. These participants were monitored over several years. We found that people who had OSA were 50% more likely to later be diagnosed with glaucoma compared to those without OSA.

From these studies, it seems that OSA is associated with a slight increased risk of glaucoma. Although OSA treatment, for example by using a continuous positive airway pressure machine (CPAP), may lessen glaucoma risk or progression, we are not yet sure how OSA treatment may affect glaucoma. This is part of one of our ongoing research studies. 

Regardless, it is important to let your glaucoma specialist know if you have OSA and continue any treatment for sleep apnoea as recommended by the doctor.

Article by Professor David Mackey
Ophthalmologist
Genetics and Epidemiology Group at the Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia.
Article by Dr Samantha Sze-Yee Lee
Postdoctoral Research Fellow
Genetics and Epidemiology Group at the Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia.