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Association Between Sleep Apnea and Dry Eye Disease in the All-of-Us Program
Journal article   Open access   Peer reviewed

Association Between Sleep Apnea and Dry Eye Disease in the All-of-Us Program

Annie Zhang, Jocelyn He and Gui-Shuang Ying
Biomedicines, v 14(1), 24
22 Dec 2025
DOI: https://doi.org/10.3390/biomedicines14010024
PMID: 41595560
Featured in Collection :   Research Supported by Drexel Libraries' OA Programs
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https://doi.org/10.3390/biomedicines14010024View
Published, Version of Record (VoR) Open Access Discount via Drexel Libraries Read and Publish Program 2025 Open CC BY V4.0

Abstract

obstructive sleep apnea dry eye disease All-of-Us cross-sectional Epidemiology
Purpose: The aim of this study was to investigate the association between obstructive sleep apnea (OSA) and the prevalence of dry eye disease (DED) and meibomian gland dysfunction (MGD) using the All-of-Us Research Program (AoURP) dataset from a large, demographically diverse U.S. population. Methods: In this cross-sectional, matched case–control study, participants with documented OSA were exactly matched 1:3 by age, gender, race, and ethnicity to controls without OSA. Associations between OSA and DED and MGD were evaluated using univariate and multivariate logistic regression models adjusted for obesity, diabetes, smoking, hypertension, hyperlipidemia, hypothyroidism, and cardiovascular disease at the time of enrollment. Results: Among the 628,649 AoURP participants, 59,804 individuals had OSA and 179,412 matched controls were identified with the same demographics (mean age 61.95 years; 54.0% female; 12.5% Hispanic; 62.3% non-Hispanic White; 15.5% non-Hispanic Black). Compared to controls, OSA participants had significantly higher rates of smoking (13.7% vs. 10.9%), obesity (68.4% vs. 13.2%), diabetes (43.3% vs. 11.7%), hypertension (76.4% vs. 28.2%), hyperlipidemia (74.5% vs. 27.5%), hypothyroidism (24.7% vs. 8.1%), and cardiovascular disease (43.1% vs. 12.8%) (all p < 0.001). Compared to matched controls, the prevalence of DED was significantly higher in the OSA group (19.4% vs. 5.8%), with an adjusted odds ratio (OR) of 1.76 (95% confidence interval (95% CI), 1.70–1.82; p < 0.001). MGD prevalence was also higher in the OSA group (2.6% vs. 1.0%), with an adjusted OR of 1.43 (95% CI, 1.32–1.55; p < 0.001). Conclusions: In this large, demographically diverse U.S. population, obstructive sleep apnea was independently associated with a higher prevalence of both dry eye disease and meibomian gland dysfunction. These findings provide large-scale U.S. evidence and suggest that screening for ocular surface disease may be warranted in patients with OSA to improve detection and management.

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Biochemistry & Molecular Biology
Medicine, Research & Experimental
Pharmacology & Pharmacy
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