Sleep Apnea and Eye Problems – Healthvires

Are sleep apnea and eye problems related? Obstructive sleep apnea which is one of the most common sleep disorders has been linked with various eye conditions, including glaucoma, nonarteritic anterior ischemic optic neuropathy, floppy eyelid syndrome, etc. 

A potentially serious disorder sleep apnea causes breathing stops and resumes several times throughout the night. If you snore loudly and are tired even after a good night’s sleep, you may suffer from sleep apnea.

These breathing intervals can last longer than 10 seconds and can appear several times during the night. Almost 1 in 4 men and 1 in 10 women have difficulty breathing during sleep.

Untreated sleep apnea causes repeated breathing breaks during sleep, leading to strong snoring and fatigue during the day, even throughout the night’s sleep. Sleep apnea can affect anyone but is more common in overweight older men.

Sleep Apnea Types

Sleep apnea has three main types which are: 

  • Obstructive Sleep Apnea
  • Central Sleep Apnea
  • Complex Sleep Apnea Syndrome

Obstructive Sleep Apnea

This type of sleep apnea is the most common type related to breathing disorder. This will make you stop and start breathing repeatedly while you sleep.

Sleep apnea has several types, but the most common is obstructive sleep apnea. Obstructive sleep apnea occurs when throat muscles periodically relax and block the airways during sleep. Snoring is an obvious sign of this type of sleep disorder. 

Central Sleep Apnea

Central sleep apnea is a sleeping disorder in which breathing stops and begins repeatedly during sleep.

This type of sleep disorder occurs because the brain does not send the right signals to the muscles that control your breathing. This type differs from obstructive sleep apnea in that you cannot breathe normally due to upper airway obstruction.

Central sleep apnea is not as common as obstructive sleep apnea. Central apnea can be caused by other conditions like stroke and heart failure. Sleeping at a high altitude is another possible cause. 

Complex Sleep Apnea Syndrome (CSA) 

This type is also known as treatment-emergent sleep apnea, which occurs when a person suffers from both Obstructive and Central Sleep Apnea. CSA occurs when a person stops breathing regularly during sleep because the brain is not telling your muscles to suck air in.

This sleep disorder differs from obstructive sleep apnea, in that breathing is blocked physically by something. But a person can have both types together, known as mixed sleep apnea.

Complex sleep apnea is usually caused by a serious illness, particularly a disease that affects the lower part of the brainstem that controls breathing. CSA causes a break in breathing in young babies that can last up to 20 seconds.

Also Read: Vitamin C Deficiency Diseases List

Can Sleep Apnea Cause Eye Problems?

In the last decade, the relationship between certain eye disorders and certain sleep disorders has become more significant. Our understanding of the precise pathophysiology mechanisms that link these diseases is the least. But, it is important to recognize these associations for primary care ophthalmologists, physicians, and sleep physicians.

Here are 5 sleep Apnea related eye problems.

Floppy Eyelid Syndrome 

Floppy Eyelid Syndrome (FES) is often a misdiagnosed eye disease in which patients have very large and smooth upper eyelids that can be easily turned in or out.

It is often linked with ocular and systemic diseases, especially keratoconus (progressive thinning of the cornea) and obstructive sleep apnea. [1]

About 96 percent of patients with Floppy Eyelid Syndrome also have Obstructive sleep apnea and about 16 percent of patients with OSA also have FES. The common factor of these two diseases is obesity. 

There is often eye irritation, discharges, and redness complaint in patients with FES. Some people may find that their eyelids “lift” themselves.

Floppy Eyelid Syndrome conservative treatment includes aggressive lubrication, night protection for eyes, and sleep avoidance in the affected eye. 

Glaucoma

Glaucoma is a major cause of blindness in people who are more than 60 years and affects approximately 60 million people around the world. This eye disease damages the optic nerve in the eye. Glaucoma usually begins with the accumulation of fluid in front of the eye.

As the accumulation increases pressure, it causes damage to the optic nerve. Early diagnosis and treatment can prevent blindness due to Glaucoma.

Primary open-angle glaucoma is the most common type of glaucoma. The Taipei Medical University Research shows that sleep apnea is a risk factor for open-angle glaucoma.

It states that people diagnosed with OSA are almost twice as likely to develop open-angle glaucoma in five years after their diagnosis compare to those who are without sleep disorders. It has also been found that patients having glaucoma are at almost 13 percent higher risk of developing obstructive sleep apnea (OSA).

Nonarteritic Anterior Ischemic Optic Neuropathy

This eye problem refers to the loss of blood flow to the optic nerve in the eye. Nonarteritic anterior ischemic optic neuropathy (NAION) is a condition without pain that generally leads to vision loss in one eye. For patients who are more than 50 years, it is the most common acute optic neuropathy condition.   

According to some large studies, 70 to 80 percent of patients with NAION were diagnosed with OSA. Recent research has recommended that NAION patients should done a polysomnogram examination to rule out the possibility of Obstructive Sleep Apnea (OSA) as well.

Studies also suggest that if patients with acute OSA do not adhere to continuous positive airway pressure (CPAP) treatment properly, they increase the risk of NAION vision loss in the second eye or complete blindness.

Papilledema

Papilledema is a condition that causes optic nerve inflammation inside the eye due to increased pressure in or around the brain. Symptoms may include blurred vision, headache, vomiting, or a combination of these.

Papilledema, also called optic disc swelling, can be very lethal and lead to blindness. It is associated with idiopathic intracranial hypertension (spontaneous cerebral hypertension) and may be associated with blood flow increase. 

The AAO points out that an increase in carbon dioxide levels due to difficulty breathing – as seen in Obstructive Sleep Apnea – can dilate blood vessels and increase blood pressure, leading to optic disc swelling. Patients with OSA have greater chances of papilledema. 

However, continuous positive airway pressure (CPAP) treatment has been shown to cure or even solve the problem.  

Retinal Vein Occlusion (RVO)

Retinal Vein Occlusion occurs when blood vessels carrying oxygen and essential nutrients away from the nerve cells in the retina are blocked. Blockage in the main vein of the retina is called central retinitis vein occlusion (CRVO), while smaller vein blockage is called retinal branch retinal vein occlusion (BRVO).

The retina is the tissue layer behind the inner eye that converts light images into nerve impulses and sends these impulses to the brain.

In most patients, it is a sudden and painless change or worsening of vision in the affected eye. Some studies show that obstructive sleep apnea (OSA) is often a concurrent disease in patients with RVO and can even be an activating factor. These associations are considered to be the reason why several patients lose their sight when they wake up. 

Conclusion

Sleep apnea is a breathing issue in which breathing stops and starts several times during the night. These breathing breaks can appear many times throughout the night and can last for several seconds. 

Sleep apnea and eye problems are considered to be linked. Regular eye examinations by an ophthalmologist are necessary to diagnose possible eye diseases to prevent loss of vision.

If you are concerned about an association between eye problems and sleep disorders, you should discuss your worry and examine your eyes. An ophthalmologist can check the symptoms of ocular sleep apnea.

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