A recent study has found that individuals with obstructive sleep apnea (OSA) have a 30% higher likelihood of developing glaucoma. Researchers from UC San Diego conducted this analysis using data from over 12.5 million adults aged 40 and older who were either evaluated for OSA or underwent sleep testing between 2010 and 2025, with no prior glaucoma diagnosis and a minimum of 180 days of follow-up. The findings were published in the journal Ophthalmology Glaucoma.
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The study categorized participants into three groups: sleep-tested controls without OSA, OSA patients without a recorded use of continuous positive airway pressure (CPAP) devices, and OSA patients with CPAP usage records. Both groups of OSA patients experienced higher rates of glaucoma when compared to controls, with untreated OSA patients showing an approximate 30% higher hazard ratio. Additionally, OSA patients using CPAP had a hazard of developing glaucoma that was twofold higher than that of controls. Despite these findings, the overall incidence of glaucoma among OSA patients, both treated and untreated, remained low over a five- to ten-year period.
Researchers cautioned against interpreting the increased hazard in the CPAP-treated group as evidence that the therapy itself raises glaucoma risk. They noted that CPAP use is often initiated in those with more severe OSA, which may explain the elevated risk seen in that group. This suggests that the correlation is likely due to the severity and symptomatology of OSA rather than a direct adverse effect of CPAP treatment.
The study indicates that both treated and untreated OSA patients may require more vigilant ophthalmic monitoring. The persistence of elevated risk among individuals using CPAP adds to the understanding that OSA might influence glaucoma through mechanisms beyond intraocular pressure increases. Potential pathways include vascular dysregulation due to intermittent hypoxia, which may heighten the vulnerability of the optic nerve.
The authors emphasized that effective treatment of OSA could potentially mitigate risk through reductions in hypoxia and endothelial dysfunction. This aligns with earlier studies suggesting a link between OSA and normal-tension glaucoma, highlighting the relevance of non-intraocular pressure mechanisms in some patients.
The study is titled "Positive Airway Pressure and Long-term Glaucoma Risk in Obstructive Sleep Apnea: A Real-World Cohort Study" and was published online ahead of print on May 26, 2026.