Association Between Sleep Disorders and Intraocular Pressure in Adults with Glaucoma in Plateau State

Sleep disorders, including obstructive sleep apnoea, are increasingly recognised as risk factors for glaucoma progression through mechanisms involving nocturnal IOP elevation, hypoxia, and vascular dysregulation. The relationship between sleep disorders and intraocular pressure in Nigerian glaucoma patients has not been studied. This study investigates the association between sleep disorders and diurnal intraocular pressure fluctuations in adults with glaucoma attending Jos University Teaching Hospital (JUTH), Plateau State, North Central Nigeria. An analytical cross-sectional study will be conducted among 150 adults with confirmed open-angle or normal-tension glaucoma. Sleep quality will be assessed using the Pittsburgh Sleep Quality Index, and obstructive sleep apnoea risk will be screened using the STOP-BANG questionnaire. Diurnal IOP curves will be performed through IOP measurement at six time points over a single day using Goldmann applanation tonometry. Oxygen saturation will be monitored overnight using pulse oximetry for patients screening positive for sleep apnoea. Multiple linear regression will examine the association between sleep disorder measures and peak IOP, mean IOP, and IOP fluctuation. Evidence from global glaucoma research confirms that nocturnal IOP spikes in sleep apnoea patients may contribute to optic nerve damage independent of daytime IOP readings. This association is unstudied in Nigerian glaucoma patients despite the known prevalence of sleep apnoea in overweight and obese populations. This study generates evidence for a novel and modifiable glaucoma risk factor in the Plateau State context. Recommendations will guide integration of sleep disorder screening into glaucoma management at JUTH. Keywords: sleep apnoea, intraocular pressure, glaucoma, Pittsburgh Sleep Quality Index, Plateau State