Associations of sleep duration and nocturnal oxygenation with OCT-derived retinal arterial structure

PURPOSE: To examine the associations of objectively measured sleep parameters (sleep duration, efficiency, and nocturnal oxygen desaturation) with retinal arterial structure assessed using optical coherence tomography (OCT). METHODS: This cross-sectional study included 5991 adults from the community-based Nagahama Study in Japan (2012-2016). All participants underwent OCT and wrist actigraphy. Retinal arterial outer diameter (OD), inner diameter (ID), and wall thickness were measured from peripapillary OCT B-scans. Sleep period time (SPT) and sleep efficiency (defined as total sleep time divided by SPT) were derived from actigraphy. Nocturnal oxygen desaturation was evaluated using the 3% oxygen desaturation index (3%ODI) obtained from synchronized actigraphy and oximetry recordings. Associations between retinal arterial parameters and sleep/oxygenation metrics were evaluated using multivariable linear regression models adjusted for demographic, ocular, and systemic covariates. RESULTS: Among 5991 participants (mean age 57.6 years; 30.6% male), shorter sleep duration was associated with narrower retinal arterial diameters (OD: β = 0.399; 95% confidence interval [CI], 0.165-0.632; ID: β = 0.402; 95% CI, 0.188-0.616). Higher 3%ODI were associated with thicker arterial walls (β = 0.121; 95% CI, 0.050-0.192) and wider OD (β = 0.431; 95% CI, 0.003-0.859). Sleep efficiency showed no significant associations with any vascular parameter. CONCLUSIONS: Sleep duration and nocturnal oxygen desaturation showed distinct associations with retinal arterial characteristics. OCT-based vascular metrics may serve as noninvasive indicators of sleep-related microvascular alterations.