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Sleep Apnea And Your Eyes

Do you snore loudly, do you gasp for air, you make choking noises while you’re sleeping, what about headaches in the morning or dry mouth, are you irritable, do you have problems concentrating?

If this sounds like you or your partner, sleep apnea could be the problem. Is very common condition affecting one in four men and one in 10 women. it is also associated with many eye conditions.

YOUR EYE CARE PROFESSIONAL’S ROLE

As you probably know already your eye care professional could save your eyesight – that’s part of their everyday job. But I bet you didn’t know that they could also save your life. Recognizing eye conditions that may be associated with sleep apnea may help detect the disease early so it can be managed properly. Often this can be the difference between life and death for some people.

Comprehensive eye examinations can allow your optometrist or opthamologist detect a whole host of pathological conditions associated with your eyes. Even more importantly, however, they can refer you for diagnosis and management of potentially life-threatening conditions Such as heart disease and stroke which are associated with sleep apnea.

Tell your optometrist or opthamologist if you have a family history of OSA or if any of the following apply:

  • loud snoring
  • gasping or choking noises while sleeping
  • morning headaches, dry mouth or sore throat
  • irritability
  • tiredness, even in the mornings
  • concentration problems
  • falling asleep / feeling sleep while watching TV, driving, at work

Some people have other risk factors that make them more likely to suffer from OSA, including:

  • obesity
  • male gender
  • race (African-American, Pacific Islander, Asian, Hispanic)

What happens during sleep apnea?

Why are you sleeping the muscles in your tongue, soft palate, and other airways are supposed to remain active that way they will keep your Airways open. instead what happens is that these muscles relax during sleep apnea. Breathing in causes suction on the walls of the Airways which are pulled in which Narrows and obstructs the airway.

This obviously reduces oxygen to the lungs. The drop or up and down and oxygen levels cause a range of negative effects on your body and aids in serious diseases such as heart attacks, high blood pressure, stroke, dementia, diabetes and many others.

SLEEP APNEA AND THE EYE

The following eye conditions are associated with sleep apnea. Diagnosis of one of these conditions may be the reason your optometrist refers you for further assessment or sleep studies:

Glaucoma: Some studies have shown a link between sleep apnea and glaucoma.

Central serous retinopathy: This is a retinal condition most often seen in steroid users or middle-aged men under stress. Fluid accumulates under the central retina (much like a wallpaper blister) and disrupts vision. OSA can raise stress hormones in the body and increase the risk of this condition. Sleep apnea treatment can speed your recovery.

Retinopathy: When your retina doesn’t get enough oxygen, blood vessels don’t function properly and leak fluid into the retina. This can clearly be seen during a comprehensive eye examination. This is more likely to occur if you already suffer from high blood pressure (hypertension) or diabetes. Your optometrist may see haemorrhages or ‘cotton wool spots’ when they examine the back of your eyes. These cotton wool spots usually signify retinal disease (e.g. from diabetes or hypertension) but sleep studies can reveal that they are caused by spikes in blood pressure due to OSA.
Papilloedema (optic nerve head swelling): This occurs due to increased pressure within your skull (intercranial hypertension). While rare, it’s most often seen in young women. Lack of oxygen during sleep can lead to dilated veins within the head, which increase pressure on the optic nerve from behind.

Floppy eyelid syndrome: This is where the eyelids are so lax that they can open or fold back during sleep. They can rub against pillows and bedding and become inflamed and sore. The sufferer doesn’t wake up from this sensation but has to deal with sore, inflamed eyes during the day. There is a STRONG association between this condition and sleep apnea.

Retinal vein occlusion is a serious eye condition where your retinal vein becomes blocked and leaks blood into the eye. It is known to be associated with OSA. Managing the sleep apnea can decrease the risk of further retinal vessel occlusions.

NAION: This is a sudden painless vision loss (when you wake up). It’s a rare but very serious eye condition caused by lack of oxygen to the retina. It is strongly associated with sleep apnea. Treating the OSA can help prevent NAION from occurring in your other eye.

WHAT IS THE TREATMENT?

Eye conditions associated with OSA can be individually managed by your eye-care practitioner. (E.g. topical treatment may help relieve symptoms of floppy eyelid syndrome).

Getting to the underlying problem, however, is essential to restore good general health. Sleep apnea is officially diagnosed by a medical doctor, who will assess how severe it is and what sort of treatment is required.

Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA. It involves wearing a close-fitting mask over the mouth and / or nose during sleep. These use a pump to deliver oxygen under light pressure through the airways to the lungs. The pressure can be continuous or automatic (depending on your needs).

WHAT ELSE CAN BE DONE?

As above, your sleep apnea needs to be managed by your doctor (and not your Eye care professional).

Losing excessive weight has many health benefits – not just with OSA.
Giving up smoking and avoiding or reducing alcohol can also help.
Specially designed dental plates (worn during sleep) can improve airflow through the airways
Surgery (tonsil removal etc) is the most invasive option and not always a success.


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