Most people understand the importance of a good night’s sleep. Just one night or two of disrupted sleep is nothing to worry about. But, if like 25 million other people in the U.S., you suffer from sleep apnea, think again. In addition to many other serious health risks, sleep apnea and eye problems actually go hand in hand too. This is what you need to know.
Why are sleep apnea and eye problems related?
Sleep apnea is one of the most common types of sleep disordered breathing. Although estimates hover around 25 million people in the U.S., the World Health Organization places that number much higher (one billion people worldwide and 100 million in the U.S.).
The most common type of sleep apnea is obstructive sleep apnea. This occurs when the tongue and throat muscles relax down and back during sleep, blocking the sleeper’s airway. Once the brain recognizes the lack of oxygen, it jars the sleeper awake. These apneas (pauses in breath) can occur 30 or more times every hour, all night long.
Understandably, this constant lack of oxygen causes significant stress and strain on all of the systems of the body. This includes the blood vessels. The tiny blood vessels of the eyes are often affected by this strain. They may swell or become damaged over time, causing a number of different eye problems.
Traditionally, sleep apnea is managed with the following treatment options:
- Weight loss
- Stress management
- Improved sleep hygiene
- Continuous positive airway pressure (CPAP) machine
- Sleep apnea dental devices
A comprehensive approach to sleep apnea that includes lifestyle changes in addition to other treatment options usually produces the best results. CPAP machines, however, can also lead to some of the eye issues we discuss here.
An overview of sleep apnea and eye problems
Sleep apnea and eye problems range from symptoms that are mildly problematic to life-changing. These most common eye issues related to sleep apnea include:
- Dry, itchy eyes
- Floppy eye syndrome
- Eye twitch
- Nystagmus
- Nonarteritic anterior ischemic optic neuropathy
- Glaucoma
- Papilledema
- Diabetic macular edema
- Diabetic retinopathy
Let’s look at all of these in more detail.
Floppy eyelid syndrome
Floppy eyelid syndrome is just what it sounds like and can be an indication of a less common type of sleep apnea: central sleep apnea. For obese patients, floppy eyelid syndrome may also indicate obstructive sleep apnea. Eyelids may actually turn inside out during sleep, resulting in discomfort, watering, stickiness, and blurred vision.
The takeaway? Floppy eyelids can be a canary in the coal mine for sleep apnea.
Sleep apnea eye twitch
Also referred to as myokymia, eye twitching due to sleep apnea is a more benign condition.
Usually centered on the eyelid, myokymia goes away on its own, unless the cause is not removed. In this case, sleep apnea can make this condition become chronic.
Sleep apnea nystagmus
Although rapid-eye movement is a normal phase of sleep, sleep apnea nystagmus is like that phase on steroids. Movement of the eye increases so much that it can cause symptoms more in line with motion sickness than dreaming.
Nystagmus can also affect depth perception and balance.
Nonarteritic anterior ischemic optic neuropathy (NAION)
One of the most frightening conditions associated with sleep apnea and eye problems is nonarteritic anterior ischemic optic neuropathy (NAION).
Though fortunately rare, this condition is marked by a sudden loss of vision, usually upon awakening. This affects approximately 6,000 people in the U.S.
Glaucoma
Glaucoma is the second leading cause of blindness and is closely associated with sleep apnea. Sleep apnea increases the risk of two types of glaucoma: primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG).
One study found that 69% of glaucoma patients also suffered from severe obstructive sleep apnea.
Papilledema
The increase of carbon dioxide in the blood from sleep apneas can increase the chances of developing papilledema. Increased CO2 dilates blood vessels, increasing pressure that results in optic disc swelling.
This optic disc swelling causes not only visual disturbances but also many of the following symptoms:
- Headache
- Nausea
- Tinnitus
- Vomiting
Diabetic macular edema
In patients with comorbid sleep apnea and diabetes, diabetic macular edema may occur. This disorder may cause vision loss or blindness.
Uncontrolled diabetes leads to damage to blood vessels all over the body, including those located behind the eyes. Patients with sleep apnea also have damage due to the constant fluctuation of blood oxygen levels.
The damage to blood vessels from both of these conditions not only increases the risk of diabetic macular edema but also makes it much harder to treat.
Diabetic retinopathy
Another complication of diabetes, diabetic retinopathy occurs when light-sensitive tissue in the eye is damaged by fluctuations in blood sugar.
As with diabetic macular edema, this damage worsens with obstructive sleep apnea.
Complications with treatment
Not only can sleep apnea cause eye problems, but in some cases the treatment may harm the eyes as well. A common treatment for severe sleep apnea is the continuous positive airway pressure (CPAP) machine. This machine forces a steady stream of air into the sleeper’s throat all night to keep the airway clear.
In addition to challenges with treatment compliance, air from the mask can seep into a sleeper’s eyes, causing dry eyes. Dryness makes the eyes more easily scratched and sensitive to light. Over time, dry eyes are at increased risk of infection and may become blurry.
Get help for sleep apnea and eye problems
What do you do when the treatment for sleep apnea might cause more problems? You look for a better solution.
A sleep apnea dental device is the standard of care for many who suffer from sleep apnea. Worn at bedtime, this dental device gently keeps your airway clear during sleep. At AZ Dentist, we custom-fit your dental device, gradually adjusting it to ensure comfort and efficacy.
We believe in a comprehensive approach to sleep apnea and eye problems. Get in touch today to get started on a treatment plan that’s right for you!