Association between Glaucoma and Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Systematic Review

<div><p>Background</p><p>Obstructive sleep apnea syndrome (OSAS) is a common disease that increases the risk of diabetes, heart disease, and stroke. However, studies of an association between OSAS and glaucoma neuropathy have reported controversial findings.</p><p>Objective</p><p>The main purpose of this study was to evaluate whether a significant association exists between OSAS and glaucoma by performing a meta-analysis of previous studies.</p><p>Methods</p><p>A comprehensive literature search using the PubMed and Embase databases was performed to identify cross-sectional, case-control, and cohort studies related to the topic. We estimated a pooled odds ratio (OR) for the association between OSAS and glaucoma, by a fixed- or random-effects model.</p><p>Results</p><p>In total, 16 studies with 2,278,832 participants met the inclusion criteria: one retrospective cohort study reported an adjusted hazard ratio of glaucoma of 1.67 (95% CI = 1.30–2.17). Using a fixed-effects model, the pooled OR of six case-control studies was 1.96 (95% CI = 1.37 2.80). A significant association was also identified in a meta-analysis of nine cross-sectional studies using a random-effects model, which showed a pooled OR of 1.41 (95% CI = 1.11 1.79). However, the reported pooled estimates for case control studies and cross-sectional studies were based on unadjusted ORs.</p><p>Conclusions</p><p>Our results suggest that OSAS is associated with the prevalence of glaucoma. However, this result was based only on unadjusted estimates. Prospective cohort studies designed to take into consideration potential confounders, or examination of data from interventional trials to determine whether a reduction in OSAS status is associated with a reduced incidence of glaucoma, are needed to clarify whether OSAS is an independent risk factor for glaucoma.</p></div

Association between Sleep Duration and Cancer Risk: A Meta-Analysis of Prospective Cohort Studies

<div><p>Background</p><p>Sleep duration has been shown to play an important role in the development of cancer. However, the results have been inconsistent. A meta-analysis with prospective cohort studies was performed to clarify the association between short or long sleep duration and cancer risk.</p> <p>Methods</p><p>PubMed and Embase databases were searched for eligible publications. Pooled relative risk (RR) with 95% confidence interval (CI) was calculated using random- or fixed- model.</p> <p>Results</p><p>A total of 10 prospective studies (8392 incident cases and 555678 participants) were included in the meta-analysis. Neither short nor long sleep duration was statistically associated with increased risk of cancer (short sleep duration: RR=1.05, 95%CI=0.90-1.24, <i>p</i>=0.523; long sleep duration: RR=0.92, 95%CI=0.76-1.12, <i>p</i>=0.415). In the subgroup by cancer type, long sleep duration was positively associated with colorectal cancer (RR=1.29, 95%CI=1.09-1.52, <i>p</i>=0.003).</p> <p>Conclusion</p><p>The present meta-analysis suggested that neither short nor long sleep duration was significantly associated with risk of cancer, although long sleep duration increased risk of with colorectal cancer. Large-scale well-design prospective studies are required to be conducted to further investigate the observed association.</p> </div

Forest plot of cross-sectional studies showing the odds ratios (ORs) with 95% confidence intervals (95% CI) of glaucoma for participants with and without OSAS. <b>The squares and horizontal lines represent the study-specific ORs and 95% CIs.</b>

<p>The sizes of the squares reflect the statistical weights of the studies. The pooled OR is indicated by a diamond (random-effect model).</p

The 23 observational studies investigating associations between obstructive sleep apnea and glaucoma.

<p>OSAS, obstructive sleep apnea syndrome; OAG, open-angle glaucoma; NTG, normal-tension glaucoma; ICD-9, International Classification of Diseases, 9th edition</p><p>PSG, polysomnography; ODI, oxygen desaturation index; AHI, apnea hypopnea index.</p><p>The 23 observational studies investigating associations between obstructive sleep apnea and glaucoma.</p

Meta-analysis of the association between long sleep and risk of cancer.

<p>Meta-analysis of the association between long sleep and risk of cancer.</p

Forest plot of case-control studies showing the odds ratios (ORs) with 95% confidence intervals (95% CI) of OSAS for participants with and without glaucoma.

<p>The squares and horizontal lines represent the study-specific ORs and 95% CIs. The sizes of the squares reflect the statistical weights of the studies. The pooled OR is indicated by a diamond (fixed-effect model).</p

Meta-analysis of the association between short sleep and risk of cancer.

<p>Meta-analysis of the association between short sleep and risk of cancer.</p

Clinical and metabolic characteristics of rs2479106 genotypes(n(%)).

<p>Abbreviations: BMI, body mass index; FSH, follicle-stimulating hormone; LH, luteinizing hormone; T, testosterone; HOMA-IR, the homeostasis model assessment of insulin resistance; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; HDL, high density lipoprotein.</p><p>Clinical and metabolic characteristics of rs2479106 genotypes(n(%)).</p

Flow chart of the procedure for identifying studies and the results thereof.

<p>Flow chart of the procedure for identifying studies and the results thereof.</p

Clinical and metabolic characteristics of rs13429458 genotypes.

<p>Abbreviations: BMI, body mass index; FSH, follicle-stimulating hormone; LH, luteinizing hormone; T, testosterone; HOMA-IR, the homeostasis model assessment of insulin resistance; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; HDL, high density lipoprotein.</p><p>Clinical and metabolic characteristics of rs13429458 genotypes.</p