Sleep disorders: A risk factor for normal-tension glaucoma?

Dennis M. Marcus, Anastasios P. Costarides, Parag Gokhale, Georgios Papastergiou, John J. Miller, Maribeth H Johnson, Bashir A. Chaudhary

Research output: Contribution to journalArticlepeer-review

89 Scopus citations


Purpose: To determine the prevalence of sleep-related symptoms and sleep-related breathing disorders by polysomnography in patients with normal-tension glaucoma (NTG). Patients and Methods: This comparative case series included 23 patients with NTG, 14 NTG suspects, and 30 comparison patients without NTG. A sleep history was obtained and determined to be positive or negative. Polysomnography was offered for patients with a positive sleep history. Prevalence of a positive sleep history and prevalence of sleep disorders were the main outcome measures. Results: The NTG, NTG suspect, and comparison groups did not differ with respect to age, body mass index, systemic disease, gender, or race. Thirteen (57%) of 23 patients with NTG, 6 (43%) of 14 NTG suspects, and 1 (3%) of 30 comparison patients had a positive sleep history (P = 0.001). Nine of 13 patients with NTG and four of six NTG suspects with a positive sleep history chose to undergo polysomnography. Seven (78%) of nine patients with NTG and all four NTG suspects undergoing polysomnography were diagnosed with a sleep disorder. Five patients with NTG had sleep apnea and two had sleep hypopnea. Two NTG suspects had sleep apnea; one had sleep hypopnea; and one had upper airway resistance syndrome. The one comparison patient with a positive sleep history had upper airway resistance syndrome by polysomnography. Conclusions: Sleep-disturbed breathing may be a risk factor for NTG. Although we do not provide evidence for a cause-and-effect relationship, various physiologic factors produced by sleep-disturbed breathing may play a significant role in the pathogenesis of this optic neuropathy. We recommend obtaining a sleep history from patients with NTG and performing polysomnography in those patients with sleep disturbance symptoms.

Original languageEnglish (US)
Pages (from-to)177-183
Number of pages7
JournalJournal of Glaucoma
Issue number3
StatePublished - 2001


  • Low-tension glaucoma
  • Normal-tension glaucoma
  • Sleep apnea
  • Sleep disorders

ASJC Scopus subject areas

  • Ophthalmology


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