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Association between normal tension glaucoma and the risk of obstructive sleep apnoea using the STOP-Bang questionnaire

Eye volume 39, pages 1420–1425 (2025)Cite this article

Subjects

Abstract

Background

To assess the association between patients with normal tension glaucoma (NTG) and the risk of obstructive sleep apnoea (OSA) using the STOP-Bang questionnaire.

Methods

A population-based cross-sectional analysis was performed using data from the Korean National Health and Nutrition Examination Survey from 2019 to 2021. An overall of 8832 subjects ≥ 40 years of age were investigated. Patients with NTG and controls completed the STOP-Bang questionnaire, a validated tool for identifying high-risk patients for OSA. The patients were divided into low-, intermediate-, and high-risk groups based on their scores.

Results

The mean STOP-Bang scores were 2.04 ± 0.02 in the control group and 2.42 ± 0.10 in the NTG group, with significant differences between groups (p < 0.001). In univariate logistic regression models, both intermediate-risk (Odds ratio (OR), 1.42; 95% Confidence intervals (CI), 1.05–1.91) and high-risk (OR, 1.71; 95% CI, 1.22–2.40) for OSA groups revealed a significant relationship regarding NTG compared to low-risk for OSA group. When adjusted for all confounding factors, the high risk for the OSA group was significantly associated with NTG (OR, 1.54; 95% CI, 1.06–2.24).

Conclusions

Our results indicate that high-risk OSA, as measured using the STOP-Bang questionnaire, correlates with NTG. Therefore, patients who scored two or more on the STOP-Bang questionnaire and were male, had a BMI > 35 or a neck circumference > 40 cm, or those who scored five or more and were classified as high risk should be carefully monitored because of the significantly higher likelihood of an association with NTG.

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Fig. 1: STOP-Bang questionnaire.
Fig. 2: A flowchart illustrating the inclusion of subjects in the study.

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Data availability

The data used in this study are accessible to the public through the KNHANES website. (https://knhanes.kdca.go.kr/knhanes/eng/main.do, accessed on 15 June 2024).

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Acknowledgements

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2022R1F1A107625911).

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Authors and Affiliations

  1. Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50 Yonsei‑ro, Seodaemun‑gu, Seoul, South Korea

    Eun Jin Koh, Jihei Sara Lee, Chan Yun Kim & Hyoung Won Bae

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  1. Eun Jin Koh
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  2. Jihei Sara Lee
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Contributions

EJK performed the study design, data interpretation, and analysis and wrote the manuscript. JSL and CYK contributed to the data interpretation. HWB was responsible for the supervision, study design, analysis, and manuscript writing.

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Correspondence to Hyoung Won Bae.

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Koh, E.J., Lee, J.S., Kim, C.Y. et al. Association between normal tension glaucoma and the risk of obstructive sleep apnoea using the STOP-Bang questionnaire. Eye 39, 1420–1425 (2025). https://doi.org/10.1038/s41433-025-03638-z

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