Obstructive Sleep Apnea Associated with Greater AMD Risk

While this study reports that people with OSA have a 43% higher risk of developing AMD, the authors found little to no association between insomnia or sleep duration and macular degeneration. They concluded that more research is needed to clarify causality and whether treating sleep disorders can influence AMD outcomes. Photo: Mayo Clinic. Click image to enlarge. Sleep disorders, especially obstructive sleep apnea (OSA), can trigger intermittent hypoxia and blood pressure swings that promote oxidative stress and endothelial dysfunction, potentially reducing blood flow to ocular tissues. That has made sleep-disordered breathing an increasing focus in eye research, having already been linked to conditions such as glaucoma, nonarteritic anterior ischemic optic neuropathy and, more recently, age-related macular degeneration (AMD). A new systematic review and meta-analysis published in the journal Retina aimed to clarify this relationship, and the overall conclusion was that OSA is associated with a higher risk of AMD, while insomnia and sleep duration showed little to no consistent association.Researchers systematically searched PubMed, Embase and Web of Science databases for studies published through August 2025. Eligible studies included randomized trials, cohort studies and case-control studies that evaluated sleep dysfunction—such as sleep duration, quality or disordered breathing—in relation to AMD diagnosis. The final review included 22 studies and 14 datasets, mostly including middle-aged and older adults, with mean ages ranging from 56 to 84 years.The analysis of OSA included seven studies and found a pooled hazard ratio of 1.43, indicating a 43% higher risk of AMD among patients with OSA. However, the authors pointed out that these studies exhibited high heterogeneity, likely attributable to differences in diagnostic criteria for OSA. They noted in their paper, “Some studies used polysomnography as the gold standard, while others relied on clinical diagnosis or medical records.”For sleep duration, four studies assessed short sleep (defined as <7 hours per night) and found no significant association with AMD (odds ratio: 1.23). An additional four studies evaluated long sleep, defined as >8 hours, and again found no effect on AMD risk (OR: 0.99).Interestingly, the one sleep-related trait that did show a significant link was chronotype. Individuals described as having a morning person chronotype (i.e., those who prefer waking up early) showed an increased risk of AMD (odds ratio: 1.19). “If definitively confirmed,” the authors explained, “this association could have clinical implications for AMD prevention, potentially paving the way for sleep modulation and light exposure strategies, reducing disease treatment costs.”Overall, these findings suggest “that the physiopathological events related to OSA may contribute to AMD pathogenesis,” the authors stated in their paper. They added, “Future research should investigate the role of sleep disorders in the progression to early and late-stage AMD, clarifying underlying mechanisms and identifying intervention opportunities.”Click here for the journal source. Nascimento LM, Louzada R, Amaral DC, et al. Associations between sleep disorders and age-related macular degeneration: a systematic review and meta-analysis. Retina. 2026;46(7):1147-59. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.