Tuesday, August 29, 2017

Do you know if you have sleep apnea? An eye exam may tell you

Sleep apnea is a lot more common than you might think, and it is affecting your eyes and vision in drastic ways. August happens to be National Eye Exam Month and this is as good of a reason as any to go get checked out.
There are three types of sleep apnea, but most people suffer from Obstructive Sleep Apnea (OSA), which makes up 84 percent of sleep apnea cases.

To find out why that matters, let’s layout a quick biology overview:

Our bodies need oxygen – we inhale it, our lungs hold it, our blood picks it up from the lungs and takes it to all of our cells and tissues. Every organ needs it. The brain, for instance, uses 25 percent of your oxygen intake. Without enough, your brain function declines.
OSA occurs when the soft tissue of the throat collapses and blocks the airway. It happens continually throughout the sleep cycle.
The blocked airway means you aren’t inhaling enough oxygen for your blood to carry throughout your body (decreased blood oxygen). The pause in breathing—called an apnea—can last anywhere from seconds to minutes. The brain then signals the body to wake up and breathe.
OSA is most common in overweight or obese men. It occurs in approximately 24 percent of men and 9 percent of women. African Americans also have a 2.5 times higher risk.
  • Other factors that may predispose us to this condition include:
    • Age – over 40
    • Smoking
    • Neck circumference over 19 inches (Trivia: OSA occurs in 34 percent of NFL linemen!)
  • Some of the most common signs and symptoms include:
    • Snoring – although not everyone who snores has sleep apnea
    • Daytime sleepiness – do you nod off at work; maybe it isn’t that you are just bored?
    • Cognition problems – losing your train of thought sporadically
    • Restless sleep – do you toss and turn a lot?
    • Loved ones mention you seem to stop breathing in your sleep

Despite its relatively high rate of occurrence, OSA goes undiagnosed in 80 percent of the men and 90 percent of the women who suffer from the condition. High rates of undiagnosed patients may be due to the fact that the best test—a sleep study—is both inconvenient and can be expensive for patients.

Sleep Apnea and the eye

An association of OSA and eye and vision problems is very common and often missed during any type of eye exam or physician visit. At your next eye exam, consider if you have any of these symptoms and share them with your provider. You may help them catch something they otherwise might miss!

There are three common eye-related OSA side effects to watch for:
  • Floppy eyelid syndrome – this is the most common and the easiest to miss during your eye exam. The person often wakes with scratchy or irritated eye(s) and some mucus discharge (some people refer to it as crusty eyes) that comes and goes over a long period of time. Close to 100 percent of people with floppy eyelid syndrome have some form of OSA.
  • Keratoconus – the person experiences irregular astigmatism and chronic blurred vision that glasses only partially correct.
  • Glaucoma – everyone should be tested for glaucoma. Its association to OSA is often missed. If a provider suspects someone has glaucoma, and also has any risk factors for OSA, they should consider further screening.


OSA is not harmless – get checked.

OSA is not a benign condition; as such, be aware of this condition especially if you have any of the common risk factors. This condition is a lot more common than you think and will take its toll if not treated. Since OSA so often goes unrecognized and misdiagnosed, mention any of the common signs and symptoms to your eye doctor and your family doctor. 

Special thanks to EyeQuest Vision Director Dr. John Davis for contributing this post!