Assessing physical activity and sleep patterns in glaucoma using wearable devices

Background/aims Glaucoma has been linked to reduced physical activity and disturbed sleep, but large-scale studies using objective wearable data are scarce. We compared activity and sleep metrics between adults with and without glaucoma using commercial wrist-worn devices. Methods We conducted a retrospective cross-sectional study within the All of Us Research Program (Registered Tier v8). Participants aged ≥40 years with Fitbit data and with or without a glaucoma diagnosis were included (n=40 743). Daily averages of steps, activity intensity, active calories and time in sleep stages were calculated. Multivariable linear mixed-effects models were adjusted for demographics, body mass index, comorbid sleep disorders and cardiovascular diseases. Results Of 40 743 participants with complete data, 1245 (3.1%) had glaucoma, contributing a mean of 2.5 years of wearable data. Compared with controls, glaucoma participants had lower daily active calories, fewer lightly and fairly active minutes and fewer steps. They spent less time in bed and asleep, with relatively more light sleep but less deep sleep, REM sleep and restless time. After adjustment, glaucoma remained associated with fewer restless minutes of sleep. Conclusion In this large wearable-based cohort, glaucoma was independently associated with modest reductions in restless minutes, but not physical activity or other measures of sleep architecture.