{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T15:36:05Z","timestamp":1778945765650,"version":"3.51.4"},"reference-count":45,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korean government (MSIT)","award":["NRF-2021R1C1C1005746"],"award-info":[{"award-number":["NRF-2021R1C1C1005746"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The association between glaucoma and the risk of obstructive sleep apnea (OSA) has not been fully evaluated. Therefore, this study aimed to investigate the prospective association between glaucoma and OSA. In total, 1437 patients with glaucoma and 5748 patients without glaucoma were enrolled after 1:4 propensity score matching using a nationwide cohort sample. We investigated OSA events during a 10-year follow-up period. Survival analysis, the log-rank test, and Cox proportional hazards regression models were used to calculate the incidence, disease-free survival rate, and hazard ratio (HR). The incidence of OSA was 12,509.0 person-years among those with glaucoma. The adjusted HR for patients with glaucoma developing OSA events during the follow-up period was 1.52 (95% confidence interval [CI]: 0.64\u20133.621) after other covariates. In a subgroup analysis, primary angle-closure glaucoma (PACG) showed a significantly increased adjusted HR for OSA events (5.65, 95% CI: 1.65\u201319.41), whereas we could not find any significant association between primary open-angle glaucoma (POAG) and OSA. The adjusted HR of OSA events in POAG was considerably increased 4 years after POAG diagnosis. PACG may be associated with an increased incidence of OSA. Clinicians should pay attention to early detection of OSA in patients with PACG.<\/jats:p>","DOI":"10.3390\/diagnostics12122992","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T03:49:13Z","timestamp":1669780153000},"page":"2992","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Glaucoma Is Associated with the Risk of Obstructive Sleep Apnea: A Population-Based Nationwide Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"given":"So Yeon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Nune Eye Hospital, Seoul 06198, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3213-2353","authenticated-orcid":false,"given":"Hyunjae","family":"Yu","sequence":"additional","affiliation":[{"name":"Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4917-0177","authenticated-orcid":false,"given":"Dong-Kyu","family":"Kim","sequence":"additional","affiliation":[{"name":"Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea"},{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis","volume":"121","author":"Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0079-6123(08)01101-1","article-title":"Epidemiology of primary glaucoma: Prevalence, incidence, and blinding effects","volume":"173","author":"Cedrone","year":"2008","journal-title":"Prog. Brain Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ogla.2021.07.010","article-title":"Differentiating diagnosed and undiagnosed primary angle-closure glaucoma and open-angle glaucoma: A population-based study","volume":"5","author":"Iwase","year":"2022","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1136\/bjophthalmol-2011-301189","article-title":"The prevalence of primary angle closure glaucoma in European derived populations: A systematic review","volume":"96","author":"Day","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Cheng, J.W., Zong, Y., Zeng, Y.Y., and Wei, R.L. (2014). The prevalence of primary angle closure glaucoma in adult Asians: A systematic review and meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0103222"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.ophtha.2010.10.024","article-title":"Differences in rates of glaucoma among Asian Americans and other racial groups, and among various Asian ethnic groups","volume":"118","author":"Stein","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.survophthal.2013.09.003","article-title":"Population-based glaucoma prevalence studies in Asians","volume":"59","author":"Cho","year":"2014","journal-title":"Surv. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S0140-6736(08)61622-0","article-title":"Obstructive sleep apnoea and its cardiovascular consequences","volume":"373","author":"Bradley","year":"2009","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Drager, L.F., and Martinez-Garcia, M.A. (2021). Thoracic aortic aneurysms: Expanding the potential cardiovascular consequences of obstructive sleep apnoea. Eur. Respir. J., 57.","DOI":"10.1183\/13993003.04440-2020"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.sleep.2013.08.789","article-title":"Obstructive sleep apnea and neurocognitive performance: The role of cortisol","volume":"15","author":"Edwards","year":"2014","journal-title":"Sleep Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jsmc.2019.10.001","article-title":"Effect of obstructive sleep apnea on neurocognitive performance","volume":"15","author":"Seda","year":"2020","journal-title":"Sleep Med. Clin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.oooo.2018.01.021","article-title":"Prevalence of primary open-angle glaucoma among patients with obstructive sleep apnea","volume":"126","author":"Friedlander","year":"2018","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_13","first-page":"297","article-title":"Obstructive sleep apnea\/hypopnea syndrome increases glaucoma risk: Evidence from a meta-analysis","volume":"8","author":"Wu","year":"2015","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_14","first-page":"198","article-title":"Prevalence of glaucoma in patients with obstructive sleep apnea","volume":"9","author":"Bagabas","year":"2019","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Leggewie, B., Gouveris, H., and Bahr, K. (2022). A narrative review of the association between obstructive sleep apnea and glaucoma in adults. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231710080"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chuang, L.H., Koh, Y.Y., Chen, H.S.L., Lo, Y.L., Yu, C.C., Yeung, L., and Lai, C.C. (2020). Normal tension glaucoma in obstructive sleep apnea syndrome: A structural and functional study. Medicine, 99.","DOI":"10.1097\/MD.0000000000019468"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1097\/IJG.0000000000001485","article-title":"Optic disc measures in obstructive sleep apnea: A community-based study of middle-aged and older adults","volume":"29","author":"Lee","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2174\/1874306401913010019","article-title":"Prevalence and predictors of ocular complications in obstructive sleep apnea patients: A cross-sectional case-control study","volume":"13","author":"Morsy","year":"2019","journal-title":"Open Respir. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/j.ophtha.2019.04.041","article-title":"Associations between optic disc measures and obstructive sleep apnea in young adults","volume":"126","author":"Lee","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1038\/s41433-019-0430-2","article-title":"Correlation between structural progression in glaucoma and obstructive sleep apnea","volume":"33","author":"Fan","year":"2019","journal-title":"Eye"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1177\/1120672120926859","article-title":"Structural assessment of the optic nerve in patients with obstructive sleep apnea syndrome: Case-control study","volume":"31","author":"Uslu","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.5664\/jcsm.10054","article-title":"Optical coherence tomography angiography and Humphrey visual field in patients with obstructive sleep apnea","volume":"18","author":"Davanian","year":"2022","journal-title":"J. Clin. Sleep Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/IJG.0000000000000837","article-title":"Is obstructive sleep apnea associated with progressive glaucomatous optic neuropathy?","volume":"27","author":"Swaminathan","year":"2018","journal-title":"J. Glaucoma"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1097\/IJG.0000000000001296","article-title":"Obstructive sleep apnea in patients with primary-open angle glaucoma: No role for a screening program","volume":"28","author":"Wozniak","year":"2019","journal-title":"J. Glaucoma"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1136\/bjo.54.3.161","article-title":"Aetiology of the anatomical basis for primary angle-closure glaucoma. Biometrical comparisons between normal eyes and eyes with primary angle-closure glaucoma","volume":"54","author":"Lowe","year":"1970","journal-title":"Br. J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1038\/sj.eye.6702687","article-title":"Study of biometric parameters in family members of primary angle closure glaucoma patients","volume":"22","author":"Sihota","year":"2008","journal-title":"Eye"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1016\/S0161-6420(98)91132-0","article-title":"Ultrasound biomicroscopic and conventional ultrasonographic study of ocular dimensions in primary angle-closure glaucoma","volume":"105","author":"Marchini","year":"1998","journal-title":"Ophthalmology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/S0161-6420(00)00022-1","article-title":"Epidemiology of angle-closure glaucoma: Prevalence, clinical types, and association with peripheral anterior chamber depth in the Egna-Neumarket Glaucoma Study","volume":"107","author":"Bonomi","year":"2000","journal-title":"Ophthalmology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1076\/soph.17.2.50.14718","article-title":"The epidemiology of primary angle closure and associated glaucomatous optic neuropathy","volume":"17","author":"Foster","year":"2002","journal-title":"Semin. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.ophtha.2022.03.009","article-title":"Six-year incidence and risk factors for primary angle-closure disease: The Singapore epidemiology of eye diseases study","volume":"129","author":"Teo","year":"2022","journal-title":"Ophthalmology"},{"key":"ref_31","first-page":"1706","article-title":"Primary angle closure glaucoma in Chinese and Western populations","volume":"115","author":"Wang","year":"2002","journal-title":"Chin. Med. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.mrfmmm.2008.11.002","article-title":"Gene-environment interactions in ocular diseases","volume":"667","author":"Sacca","year":"2009","journal-title":"Mutat. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/13816810802324532","article-title":"Genetic heritability of a shallow anterior chamber in Chinese families with primary angle closure glaucoma","volume":"29","author":"Tu","year":"2008","journal-title":"Ophthalmic Genet."},{"key":"ref_34","first-page":"1412","article-title":"Association of the single nucleotide polymorphisms in the extracellular matrix metalloprotease-9 gene with PACG in southern China","volume":"15","author":"Cong","year":"2009","journal-title":"Mol. Vis."},{"key":"ref_35","first-page":"1223","article-title":"The association of single nucleotide polymorphisms in the MMP-9 genes with susceptibility to acute primary angle closure glaucoma in Taiwanese patients","volume":"12","author":"Wang","year":"2006","journal-title":"Mol. Vis."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Chen, X., Chen, Y., Wiggs, J.L., Pasquale, L.R., Sun, X., and Fan, B.J. (2016). Association of matrix metalloproteinase-9 (MMP9) variants with primary angle closure and primary angle closure glaucoma. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157093"},{"key":"ref_37","first-page":"2052","article-title":"Association of MYOC and APOE promoter polymorphisms and primary open-angle glaucoma: A meta-analysis","volume":"15","author":"Guo","year":"2015","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Nowak, A., Majsterek, I., Przyby\u0142owska-Sygut, K., Pytel, D., Szymanek, K., Szaflik, J., and Szaflik, J.P. (2015). Analysis of the expression and polymorphism of APOE, HSP, BDNF, and GRIN2B genes associated with the neurodegeneration process in the pathogenesis of primary open angle glaucoma. Biomed. Res. Int., 2015.","DOI":"10.1155\/2015\/258281"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1212\/01.wnl.0000265818.88703.83","article-title":"APOE epsilon 4 allele, cognitive dysfunction, and obstructive sleep apnea in children","volume":"17","author":"Gozal","year":"2007","journal-title":"Neurology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.ophtha.2015.01.020","article-title":"Retinal vein occlusion and the risk of stroke development: A 9-year nationwide population-based study","volume":"122","author":"Rim","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1001\/jamaoto.2018.0658","article-title":"Association of Idiopathic Sudden Sensorineural Hearing Loss with Affective Disorders","volume":"144","author":"Kim","year":"2018","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1001\/jamaoto.2019.2435","article-title":"Association of Obstructive Sleep Apnea with the Risk of Affective Disorders","volume":"145","author":"Kim","year":"2019","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.5664\/jcsm.7922","article-title":"Association of Obstructive Sleep Apnea With the Risk of M\u00e9ni\u00e8re\u2019s Disease and Sudden Sensorineural Hearing Loss: A Study Using Data From the Korean National Health Insurance Service","volume":"15","author":"Kim","year":"2019","journal-title":"J. Clin. Sleep Med."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Lee, I.H., Yu, H., Ha, S.-S., Son, G.M., Park, K.J., Lee, J.J., and Kim, D.-K. (2021). Association between Late-Onset M\u00e9ni\u00e8re\u2019s Disease and the Risk of Incident All-Cause Dementia. J. Pers Med., 31.","DOI":"10.3390\/jpm12010019"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.jaip.2019.09.001","article-title":"Relationship of Chronic Rhinosinusitis with Asthma, Myocardial Infarction, Stroke, Anxiety, and Depression","volume":"8","author":"Kim","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/12\/2992\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:29:39Z","timestamp":1760146179000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/12\/2992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":45,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["diagnostics12122992"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12122992","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,29]]}}}