Obstructive sleep apnea linked to certain conditions

Key Points

Rochester, MN-Eye disease and sleep disorders are linked in several ways, according to research published recently in Mayo Clinic Proceedings.

Multiple studies have identified obstructive sleep apnea (OSA) as an independent risk factor for the development of several medical conditions that are related to impairments or alterations in a person's vascular system. With their own complex and sensitive vascular system, the eyes sometimes can signal and be affected by systemic vascular problems.

"Given the vascular consequences of OSA, it is not surprising that ophthalmologic manifestations exist," said E. Andrew Waller, MD, a Mayo Clinic pulmonologist and sleep specialist. He was the article's lead author.

? Floppy eyelid syndrome can signal that a person also has OSA, which can lead to more significant health problems.

? OSA is linked to primary open-angle glaucoma and normal-tension glaucoma. The severity of glaucoma appears to correlate with the number and duration of apnea episodes in patients with OSA.

? An increased incidence of OSA exists in people in whom nonarteritic anterior ischemic optic neuropathy has been diagnosed.

? People with OSA may have a higher incidence of papilledema, which typically occurs due to increased pressure within the skull and can lead to progressively worsening vision and, in some cases, blindness.

According to Dr. Waller, knowing the links between these eye conditions and OSA may hasten early diagnosis and appropriate treatment.

"Our understanding of the mechanisms that link these disorders is minimal," he said. "However, the recognition of these associations is important for primary-care physicians, ophthalmologists, and sleep physicians. For patients with OSA, a routine eye examination to evaluate for early signs of glaucoma, particularly in the setting of visual loss or change, should be recommended. Patients with ophthalmologic diseases known to be associated with sleep apnea should be screened clinically for sleep apnea and referred to a sleep center if signs or symptoms are present."