Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

Karaca, Emine Esra; Akcam, Hanife Tuba; Uzun, Feyzahan; Özdek, Şengül; Çiftçi, Tansu Ulukavak

doi:10.4274/tjo.57778

Cited by 31 publications

(30 citation statements)

References 30 publications

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“…The results of closed-eye studies and elevated tear matrix metaprotease-9 in DED suggest that patients with DED may have more inflammatory processes than controls during sleep. 54,55 Patients with DED have a high prevalence of obstructive sleep apnea, [56][57][58][59] and its therapy, continuous positive airway pressure, may worsen DED. 60 Air conditioning and sleep position 61,62 also may worsen DED.…”

Section: Eyes Are Disturbed At Night With Dedmentioning

confidence: 99%

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Ayaki

Ohta

Kawashima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Sleep is an essential life habit and closely associated with lifespan, diabetes, hypertension, and mental health. Sleep disorders are a prominent, but overlooked problem in patients with dry eye disease (DED), characterized by a poor sleep index, short sleep duration, long sleep latency, and poor subjective sleep. DED and sleep disorders are more prevalent in women than men. Moreover, sleep quality in DED is worse than in other eye diseases, including glaucoma, retinal diseases, cataract, and allergic and chronic conjunctivitis. METHODS. We reviewed the literature for studies investigating sleep and health, eyes and sleep, and DED and sleep, in terms of systemic and eye health, especially in women. RESULTS. Two studies reported that approximately half of patients with DED suffer from poor sleep. The severity of mood disorders, including anxiety and depression, is correlated strongly with sleep disorders in DED, and the symptoms and signs of DED, especially pain, also are correlated with sleep quality. Sleep disorders are documented in primary Sjögren's syndrome and an association with sleep apnea and depression is suggested. Primary Sjögren's syndrome includes arthritis and other rheumatic disease causing pain and fatigue; however, how sicca contributes to sleep disorders is not known. CONCLUSIONS. Possible explanations for sleep disorders in DED may be depression, pain, and eye exposure at night. Reciprocal effects may be expected and consultation-liaison psychiatry is recommended for the management of sleep disorders in DED. Topical medication and lid heating also may be advantageous for sleep quality in DED.

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Section: Eyes Are Disturbed At Night With Dedmentioning

confidence: 99%

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Ayaki

Ohta

Kawashima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Highlighted as a multifactorial disease with complex ocular disorders involving diverse findings and symptoms resulting from various origins [27] is important to monitor patients with OSA for possible relating eye manifestations and being aware of the association. Previous studies have reported that early diagnosis of DED has clinical relevance in OSA patients due to greater inclination to develop DED [28,29]. Identification of patients with ocular injuries is important, as these patients are at increased risk of developing alteration of the ocular surface anatomy and further ocular manifestations of which floppy eyelid syndrome (FES), nonarteritic anterior ischemic optic neuropathy, glaucoma and central serous retinopathy imbed [30,31].…”

Section: Resultsmentioning

confidence: 99%

Sleep apnea and dry eye: how sleep apnea affects the eye surface

et al. 2020

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Purpose: The purpose of this study was to determine the presence of dry eye disease and possible treatment options in patients with obstructive sleep apnea and continuous positive airway pressure. Materials and methods: A total of 72 patients (midlife age) with obstructive sleep apnea and continuous positive airway pressure therapy underwent a comprehensive eye examination. Fluorescein staining of the anterior ocular surface and tear break-up test were performed. All of the patients who were diagnosed with dry eye disease received personalized therapy. One month later, re-examination was performed using the same methodology and clinical settings. Results: On the first examination, 48 of 72 patients (66.67%) were diagnosed with dry eye disease. Floppy eyelid syndrome was reported in 26 patients (54.17%) with dry eye disease. The treatment of 40 patients included artificial tear supplements during the day in combination with high-viscosity topical gels before bedtime. In more severe cases (10.42% of all participants), the application of bandage contact lenses for 3 months was necessary. Because of excessive lid laxity, surgical reconstruction of the eyelids was performed in three patients (6.25%). Conclusions: A multidisciplinary approach is essential for obstructive sleep apnea. Practitioners from different specialties must be well acquainted with risk factors, signs, and symptoms. The early detection of dry eye disease in patients with obstructive sleep apnea and appropriate treatments are important for improving the quality of life in this patient group.

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“…Shift work primarily results in sleep disturbances, with acute symptoms including difficulty falling asleep, reduced sleep duration, and somnolence in the following days [ 11 ]. Previous studies have reported that sleep disorders and DED interact with each other [ 13 – 16 ]. Poor sleep quality has been reported in 45% of young and middle-aged DED office workers [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sleep duration of ≥9 h/d has been found to be a protective factor for dry eye symptoms [12]. Patients with obstructive sleep apnea syndrome (OSAS) have a tendency to develop dry eye [13]. In addition, the prevalence of sleep and mood disorders was higher in patients with DED than in patients with other ocular surface diseases, and the severity of sleep quality was correlated with the grade of DED [14,15].…”

Section: Introductionmentioning

confidence: 99%

Function and Morphology of the Meibomian Glands Using a LipiView Interferometer in Rotating Shift Medical Staff

Zhang

Sun

et al. 2020

Journal of Ophthalmology

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Purpose. To investigate the function and morphology of meibomian glands (MG) in night shift medical staff (MS). Methods. Sixty-two eyes of 31 patients in the MS group and 59 eyes of 31 patients in the control group were consecutively enrolled. All participants completed Ocular Surface Disease Index (OSDI) and Standard Patient Dry Eye Evaluation (SPEED) questionnaires for dry eye severity, as well as Schirmer I and tear break-up time (TBUT) tests. LipiView® II Ocular Surface Interferometer was used for lipid layer thickness (LLT), MG dropout, and partial blink (PB) rate tests. MG expression was measured with an MG evaluator. Results. The OSDI score in the MS group was 22.39 ± 13.42, which was significantly higher than that in the control group (9.87 ± 6.64 Z = −3.997, P=0.001). The SPEED score in the MS group was 7.94 ± 3.81, which was significantly higher than in the control group (3.65 ± 2.11, Z = −4.766, P=0.001). There was no significant difference in Schirmer I test between the MS group and control group (Z = −1.346, P=0.178). TBUT in MS group was significantly shorter than that in the control group (Z = −5.201, P=0.001). The mean LLT of the MS group was 55.02 ± 21.17 nm significantly thinner than that of the control group 72.76 ± 21.62 nm (Z = −4.482, P=0.001). MG loss occurred in 45.16% of affected eyes in the MS group and 16.13% of affected eyes in the control group, and the difference was statistically significant (χ2 = 14.352, P=0.001). MG yielding liquid secretion and MG yielding secretion score were significantly lower in the MS group than in the control group (Z = −3.641, P=0.001; Z = −3.146, P=0.001, resp.). There was a negative correlation between mean LLT and SPEED score (Spearman r = −0.363, P=0.045). Conclusions. Night shift MS had a higher incidence of MGD compared to day workers.

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Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

Cited by 31 publications

References 30 publications

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Sleep apnea and dry eye: how sleep apnea affects the eye surface

Function and Morphology of the Meibomian Glands Using a LipiView Interferometer in Rotating Shift Medical Staff

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