Sleep disturbance and incident depressive symptoms in patients with glaucoma: a longitudinal study of the LIGHT cohort.

Abstract

To investigate whether baseline sleep disturbance is associated with an increased risk of incident depressive symptoms in patients with glaucoma. In our prospective cohort study, a total of 120 patients with glaucoma who had no depressive symptoms at baseline (mean age 70.1 years) were included. Depressive symptoms, defined as a Geriatric Depression Scale score of 6 or greater, were assessed at baseline and at annual follow-up visits. Sleep disturbance was defined as a Pittsburgh Sleep Quality Index score of 6 or greater. During a median follow-up of 3.94 years, 29 of 120 patients developed depressive symptoms. Kaplan-Meier analysis with the log-rank test showed a higher cumulative incidence of depressive symptoms in the group with baseline sleep disturbance than in the group without sleep disturbance (p=0.021). In Cox proportional hazards models, sleep disturbance was associated with an increased risk of incident depressive symptoms (HR 2.32; 95% CI 1.11 to 4.83). Results remained consistent after adjustment for potential confounders, including visual acuity (HR 3.03; 95% CI 1.25 to 7.33). A significant interaction was observed between sleep disturbance and glaucoma severity in relation to incident depressive symptoms (p=0.021). An association between sleep disturbance and incident depressive symptoms was observed in the non-severe glaucoma group (p<0.001), whereas no significant association was found in the severe glaucoma group. Baseline sleep disturbance was independently associated with a higher risk of incident depressive symptoms in patients with glaucoma, irrespective of visual impairment.