Sleep Apnea Associated with Threefold Higher Risk of DED

Due to the strong condition between DED and sleep apnea, researchers of a recent study suggest that eye checks should be included in the routine care of sleep apnea patients. Photo: Mayo Clinic. Click image to enlarge. It's been shown that obstructive sleep apnea doesn’t just affect sleep—the condition may also affect ocular health, including dry eye disease (DED). In a recent study presented at ARVO 2025 in Salt Lake City, researchers examined whether people with sleep apnea are more likely to have DED; they found that dry eye was indeed significantly more common in people with the condition, even after accounting for other health issues like diabetes and obesity—suggesting a strong connection between the two conditions.This cross-sectional matched case-control study used data from the All-of-Us Research Program, which collects diverse health information from participants across the United States. Included were 40,083 patients with obstructive sleep apnea and 120,249 controls. The prevalence of DED was compared between cases and controls, using univariate and multivariable logistic regression models, adjusted by smoking status, obesity, diabetes, hypertension, hyperlipidemia, hypothyroidism and cardiovascular disease.Obstructive sleep apnea was found to be significantly associated with a higher risk of DED. Those with obstructive sleep apnea and matched controls were similar in age (mean age of 62). Obstructive sleep apnea patients were more likely to have obesity, diabetes, hypertension, hyperlipidemia, hypothyroidism and cardiovascular disease. A total of 17.9% of OSA subjects showed evidence of dry eye, compared with  6.1% in matched controls.“Given the chronic nature of both conditions, integrating DED evaluation into routine care for obstructive sleep apnea patients may help address an unmet need in this population,” the authors concluded in their paper. “Future research should explore mechanistic pathways linking these conditions and assess the potential benefits of obstructive sleep apnea treatment in improving ocular and systemic health outcomes for individuals with obstructive sleep apnea.”Original abstract content ©2025 Association for Research in Vision and Ophthalmology. Zhang A, He J, Ying G-S. Association of sleep apnea with dry eye disease in the All-of-Us Program. ARVO 2025 annual meeting.