Authors
Taher Eleiwa, Muhammad Chauhan, Krishna Kishor, Subhi Al Aref, Mohamed Khodeiry, Ibrahim Abboud, Sanjoy Bhattacharya, Richard Lee, Abdelrahman Elhusseiny
Published in
Research square. Jun 28, 2026. Epub Jun 28, 2026.
Abstract
Circadian rhythm sleep disorders (CRSD) may disrupt neurovascular regulation and increase open-angle glaucoma (OAG) and ocular hypertension (OHT) risk. This study assessed associations with OAG, primary open-angle glaucoma (POAG), and OHT and examined melatonin's modifying effect.
A retrospective cohort study using TriNetX data included adults (≥ 18 years) with CRSD matched 1:1 to polysomnography-tested controls without sleep disorders. Melatonin subgroups were analyzed. Among 24,730 matched pairs, ICD-10-defined OAG, POAG, and OHT at 1, 3, and 5 years were assessed using adjusted hazard ratios (aHRs) and Kaplan-Meier analyses.
After matching, 24,730 patients were included in each group. The CRSD group had a significantly higher risk of OAG at 1 year (0.14% vs. 0.04%; P=.0005; aHR 2.67, 95% CI 1.42-5.02), 3 years (0.25% vs. 0.07%; P < .0001; aHR 3.02, 95% CI 1.81-5.05), and 5 years (0.27% vs. 0.08%; P < .0001; aHR 2.88, 95% CI 1.78-4.66). Similar trends were observed for POAG, while no significant differences were seen for OHT. Among CRSD patients not using melatonin (n = 24,150 pairs), OAG risk remained significantly elevated at all time points. In contrast, among melatonin users (n = 4,081 pairs), the risks of OAG, and OHT were not significantly different from controls (5-year OAG: 0.52% vs. 0.32%; P = .23; aHR 2.07, 95% CI 0.88-4.84).
CRSD is associated with an increased risk of OAG and POAG, in patients not using melatonin. Melatonin use appears to decrease this risk, suggesting a potential protective effect.
PMID:
42396504
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.
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