Colin Snow
Sleep problems and glaucoma are linked, and people with glaucoma are more likely to experience sleep disturbances. While the relationship between the two is not fully understood, researchers suspect that intraocular pressure (IOP) levels, which are known to rise when a person is lying down, may play a role. Studies have found that people with glaucoma are more likely to fall asleep quickly (in nine minutes or fewer) or take longer (30 minutes or more) to fall asleep. Certain sleep aids, such as zolpidem, may increase the risk of glaucoma, while melatonin may help lower IOP and improve sleep in people with glaucoma.
| Characteristics | Values |
|---|---|
| Sleep aid that can be taken for glaucoma | Melatonin |
| How does melatonin help? | Melatonin is a hormone naturally produced in the brain and retina that regulates sleep. It can lower intraocular pressure (IOP) and has other potential benefits for those with glaucoma. |
| Dosage | 500mcg (0.5mg) to 5mg per night |
| Precautions | Care should be taken when used with other blood-pressure-lowering medications. |
| Other sleep aids | Zolpidem is a non-benzodiazepine hypnotic drug that improves total sleep duration but may increase the risk of glaucoma. |
| Sleep and glaucoma | Sleep problems can be a contributing factor to glaucoma progression. Poor sleep duration, sleep disorders, disturbances, and daytime drowsiness could be either a risk factor or a result of glaucoma. |
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What You'll Learn
Melatonin may help with glaucoma and sleep
Glaucoma is a progressive eye disease that can lead to vision loss. It is often associated with an increase in intraocular pressure (IOP). Sleep problems and glaucoma are not always related, but studies have confirmed that eye pressure is higher when people are lying flat than when seated, and this difference is more significant in glaucoma patients.
Sleep disorders and chronic short sleep are associated with an increased risk of heart disease, obesity, high blood pressure, and diabetes. Untreated obstructive sleep apnea (OSA) can lead to serious health problems, including vision loss from glaucoma. People who suffer from sleep apnea may be up to 10 times more likely to develop glaucoma.
Melatonin is a hormone naturally produced in the brain and retina. It is also found in plant-based foods such as cherries, walnuts, tomatoes, and strawberries. Its best-known function is to regulate sleep. Melatonin has been shown to lower IOP in healthy men. A larger dose of 10mg was demonstrated to lower IOP when taken before cataract surgery. This effect is due to melatonin's actions on alpha and beta adrenergic receptors, as well as carbonic anhydrase. Melatonin acts on three of the four IOP-lowering pathways targeted by modern prescription ocular therapy.
In addition to its potential benefits for glaucoma, melatonin may also improve sleep. It can be effective in restoring disrupted circadian rhythms, which are often altered in glaucoma patients. Melatonin may also lower blood pressure, which could be beneficial for those whose blood pressure is not well-controlled. However, care should be taken when using melatonin with other blood pressure-lowering medications.
Overall, melatonin provides a dual benefit for glaucoma patients by potentially improving both their eye health and sleep quality.
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Zolpidem may increase glaucoma risk
Sleep and its duration have been found to affect several endocrine, metabolic, and neurological functions that are critical to the maintenance of individual health. Untreated sleep disorders and chronic short sleep are associated with an increased risk of heart disease, obesity, high blood pressure, and diabetes. Research has indicated that sleep problems may also contribute to worsening glaucoma.
Zolpidem is a medication often prescribed for insomnia and other sleep disorders. It is a sedative-hypnotic drug that works by slowing down brain activity to allow sleep. However, several studies have suggested a link between zolpidem use and an increased risk of glaucoma. A Taiwanese population-based case-control study found that zolpidem exposure was positively correlated with glaucoma risk. The study took into account the total amount of zolpidem used as well as the exposure period.
The exact mechanism behind the association is not yet fully understood, and further research is needed to confirm the relationship. However, it is important for clinicians and patients to be aware of the potential risk, especially in individuals with other risk factors for glaucoma. It is worth noting that Taiwan's healthcare community has implemented a strict monitoring system for zolpidem prescription to address the increasing usage and reported side effects of the drug.
While zolpidem may increase the risk of glaucoma, it is important to consult a doctor before starting or stopping any medication. Discontinuing zolpidem without medical supervision can lead to withdrawal symptoms and sleep rebound effects. Alternative sleep aids, such as melatonin, may be considered, as they have been found to have benefits for both sleep and glaucoma. Melatonin is a naturally occurring hormone in the brain and retina, and it has been shown to lower intraocular pressure (IOP), which is a key factor in glaucoma. However, it should be used with caution in individuals with blood pressure issues, as it can also lower blood pressure.
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Sleep apnea and glaucoma are linked
Sleep apnea is characterised by recurrent interruptions of normal breathing during sleep, resulting in decreased arterial oxygen saturation and increased carbon dioxide levels. This causes transient hypoxia and increased vascular resistance in body tissues. In the case of ocular tissues, this results in a reduction of ocular perfusion pressure and decreased oxygenation to the optic nerve, which can lead to glaucomatous optic neuropathy.
Obstructive sleep apnea (OSA) is a systemic risk factor for glaucoma, causing irreversible visual field (VF) damage. Studies have found that the prevalence of glaucoma is higher in OSA patients, independent of intraocular pressure (IOP). OSA patients have been found to be up to 1.67 times more likely to develop glaucoma within the first five years of diagnosis.
People with OSA are approximately ten times more likely to develop glaucoma, although the underlying cause of this correlation is not yet fully understood. One theory suggests that there may be an increase in IOP during episodes of paused breathing. However, researchers have also found that OSA patients with glaucoma do not always show an increase in IOP, indicating that other factors may be at play.
Another theory suggests that the correlation between OSA and glaucoma may be due to a drop in oxygen levels in the blood during apnea episodes. This routine low oxygen concentration in the blood may contribute to the degradation of the optic nerve, potentially leading to glaucoma. This theory is supported by the fact that OSA is also associated with other disorders characterised by oxygen deprivation, such as heart attacks and strokes.
The link between sleep apnea and glaucoma has important implications for the management of both conditions. Researchers are developing innovative technologies, such as contact lens sensors (CLS), to continuously monitor IOP during sleep and gain a better understanding of the correlation between the two conditions.
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Sleep position may affect glaucoma
Sleep is critical for a person's overall health and wellbeing. Sleep time and duration affect several endocrine, metabolic, and neurological functions that are vital for maintaining individual health. Untreated sleep disorders and chronic short sleep are associated with an increased risk of heart disease, obesity, high blood pressure, and diabetes.
Research has indicated that sleep problems may also contribute to worsening glaucoma. Sleep apnea, for instance, may lead to vision loss from glaucoma. People who suffer from sleep apnea are up to ten times more likely to develop glaucoma, although the reason is not yet known.
Additionally, sleep position may affect glaucoma. A study from South Korea found that people with worsening glaucoma on one side were more likely to sleep with the affected eye facing downward. This is attributed to the eye's internal pressure being raised, accelerating the deterioration of the optic nerve. However, it is important to note that sleeping position is not considered the sole reason for worsening glaucoma on one side.
Another study found that the lateral decubitus position (LDP) in the right eye's dependent position resulted in a mean positional increase of less than 2 mmHg, which could lead to worse glaucomatous progression in that eye. However, multiple studies have failed to find a strong association between sleep position and glaucoma progression.
To mitigate the effect on patients with more advanced stages of glaucoma, some eye care providers recommend sleeping slightly upright. Protective shielding in the form of glasses that sit on the orbital rim can also help reduce intraocular pressure (IOP) elevation while sleeping.
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Sleep disorders and glaucoma
The relationship between sleep and glaucoma involves various factors, including sleep duration, sleep positions, sleep apnea, and even pillow choice. Glaucoma is more prevalent in those who sleep for longer durations, with a higher risk associated with sleeping ten or more hours per night compared to seven hours.
Furthermore, sleeping positions can influence eye pressure, which is a critical factor in glaucoma. Eye pressure, or intraocular pressure (IOP), is known to increase when individuals are lying flat compared to when they are seated, and this difference is more pronounced in glaucoma patients. This has led some doctors to recommend sleeping in an upright position to mitigate the rise in IOP.
Untreated obstructive sleep apnea (OSA) has been linked to an increased risk of glaucoma, with people suffering from sleep apnea up to ten times more likely to develop the condition. The exact mechanism behind this link is not fully understood, but it highlights the importance of addressing sleep disorders to maintain eye health.
In terms of sleep aids, melatonin has been suggested as a potential treatment for glaucoma and sleep disturbances. Melatonin is a naturally occurring hormone that regulates sleep and has been found to lower IOP, which is a key factor in glaucoma management. However, it is important to consult a doctor before taking any sleep aids or supplements, especially if there are existing eye conditions or other medications in use.
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Frequently asked questions
Melatonin is a natural hormone produced in the brain and retina that regulates sleep. It has been shown to lower intraocular pressure (IOP) in healthy men. As glaucoma and sleep disturbances are more common with age, melatonin provides a dual benefit. However, it is important to consult a doctor before taking any new medication.
Research has indicated that both long and short sleep durations could be a risk factor for glaucoma. Glaucoma was found to be three times more prevalent in those who slept ten or more hours per night compared to those who slept seven hours.
People with untreated sleep apnea may be up to ten times more likely to develop glaucoma. This is possibly due to the increase in intraocular pressure (IOP) when lying down, which is already higher in glaucoma patients.
Studies have found that sleeping positions may contribute to asymmetric visual field loss between the eyes. It is recommended that glaucoma patients consider sleeping in an upright position to reduce intraocular pressure (IOP).
Insomnia has been associated with glaucoma, with NTG patients experiencing prolonged sleep-onset latency. Additionally, the use of zolpidem, a drug commonly prescribed for insomnia, has been suggested to increase the risk of glaucoma.
