The association between cataract and sleep apnea: a nationwide population-based cohort study

STUDY OBJECTIVES: The association between sleep apnea (SA) and cataract was confirmed in a comprehensive large-scale study. This study aimed to investigate whether SA was associated with increased risk of cataract. METHODS: The 18-year nationwide retrospective population-based cohort study used data retrieved from the Taiwan National Health Insurance Database. We selected adult patients with a diagnosis of SA, based on diagnostic codes (suspected SA cohort) or on presence of diagnosis after polysomnography (SA cohort), and matched each of them to 5 randomly selected, and age- and sex-matched control participants. The incidence rate of cataract was compared between patients with SA and the controls. The effect of SA on incident cataract was assessed using multivariable Poisson regression and Cox regression analyses. RESULTS: A total of 6,438 patients in the suspected SA cohort were matched with 32,190 controls (control A cohort), including 3,616 patients in the SA cohort matched with 18,080 controls (control B cohort). After adjusting for age, sex, residency, income level, and comorbidities, the incidence rates of cataract were significantly higher in the SA cohorts than in the corresponding control cohorts. SA was an independent risk factor for incident cataract (adjusted hazard ratio [95% confidence interval]: 1.4 [1.2–1.6]). In patients with SA, elder age, heart disease, chronic pulmonary disease, and diabetes mellitus were independent risk factors for incident cataract. CONCLUSIONS: Our study revealed a significantly higher risk for developing cataract in patients with SA. Physicians caring for patients with SA should be aware of this ophthalmic complication. CITATION: Liu P-K, Chang Y-C, Wang N-K, et al. The association between cataract and sleep apnea: a nationwide population-based cohort study. J Clin Sleep Med. 2022;18(3):769–777.