Sleep Apnea and Eyes: The Surprising Connection

Did you know that sleep apnea could be affecting your vision in ways you never imagined? What if untreated sleep apnea was silently causing long-term damage to your eyesight?

You might think that eye conditions like glaucoma are unrelated to sleep, but sleep apnea can directly contribute to optic nerve damage.

I’m Juliet Menakaya, the owner and principal optometrist at Junic Eye Care. Over the years, I’ve helped many patients who were surprised to learn that their sleep apnea was affecting their eye health. I’m passionate about providing personalized eye care to my Canberra community and making sure that no underlying condition goes unnoticed.

Your eye health is essential for independence and daily function—don’t let sleep problems undermine it. Keep reading to learn more.

3 Key Takeaways:

• Sleep apnea is closely linked to several serious eye conditions, including glaucoma, dry eye, and NAION.
• Regular eye exams are crucial for detecting sleep apnea-related issues early and preventing long-term damage.
• CPAP therapy, while helpful for managing sleep apnea, can contribute to dry eyes and should be monitored closely.

Understanding Sleep Apnea

What exactly is sleep apnea, and why does it matter? Sleep apnea, particularly obstructive sleep apnea (OSA), is a condition where breathing repeatedly stops and starts during sleep. It occurs when the muscles in the throat relax too much, causing a blockage in the airway. While this may seem harmless at first, the reality is that sleep apnea can have serious consequences for your overall health. It’s more common in people over 40, especially those with risk factors such as obesity, being male, or having a family history of the condition.

The symptoms are often subtle but impactful. You might experience excessive daytime sleepiness, loud snoring, or waking up gasping for air. Many people don’t realise they have sleep apnea until a partner or family member points out the symptoms. Doctors typically conduct sleep monitoring to diagnose the condition by analysing your breathing patterns overnight.

What makes sleep apnea dangerous is how it affects the entire body. Each time your breathing stops, your body is deprived of oxygen, leading to hypoxia. This triggers oxidative stress, which not only impacts your organs but also has a direct effect on your eyes and vision. It’s also closely linked to several serious health conditions, including high blood pressure, heart disease, and stroke.

The Connection Between Sleep Apnea and Eye Conditions

Sleep apnea does more than disrupt your sleep—it can also significantly affect your eye health. The constant interruptions in breathing can contribute to several serious eye conditions. Understanding these connections is vital for protecting your long-term vision.

Here are some common eye conditions associated with sleep apnea:

• Floppy Eyelid Syndrome (FES): Sleep apnea can cause the eyelids to become unusually loose and easily flipped upwards. This leads to irritation, tearing, and blurred vision, as the repeated waking disrupts normal eyelid function.
• Glaucoma: Sleep apnea often causes episodes of low oxygen (hypoxia), which can increase intraocular pressure (IOP), damaging the optic nerve. If untreated, this can result in permanent vision loss. The severity of sleep apnea often correlates with the progression of glaucoma, making early diagnosis crucial.
• Nonarteritic Anterior Ischemic Optic Neuropathy (NAION): This optic nerve damage leads to sudden vision loss. People with sleep apnea are at higher risk due to reduced oxygen and blood flow during apnea episodes.
• Retinal Vein Occlusion (RVO): Sleep apnea-induced hypoxia can lead to blockages in the veins that drain blood from the retina, increasing the risk of RVO and potential vision impairment.
• Central Serous Chorioretinopathy (CSR): Stress from sleep apnea can cause fluid accumulation under the retina, leading to blurred or distorted central vision. CSR requires careful monitoring to prevent further complications.
• Papilledema: This condition involves swelling of the optic nerve due to increased intracranial pressure from repeated hypoxia during sleep apnea episodes. It can lead to headaches, double vision, or temporary vision loss. In severe cases, prolonged papilledema can cause permanent damage.

Addressing these conditions early and regularly monitoring your eyes can help prevent long-term damage and maintain healthy vision. Don’t ignore the potential impact of sleep apnea on your eyes.

The Connection Between Keratoconus and Sleep Apnea

Interestingly, there’s also evidence suggesting a link between keratoconus and sleep apnea. Keratoconus is a progressive eye condition in which the cornea thins and begins to bulge into a cone-like shape, distorting vision. While the exact connection between sleep apnea and keratoconus isn’t fully understood, studies suggest that patients with sleep apnea, particularly men, are at higher risk of developing this condition. One possible explanation is that chronic eye rubbing, often seen in sleep apnea patients could contribute to the progression of keratoconus.

Additionally, sleep apnea can worsen the condition in those already predisposed to keratoconus, particularly individuals with a family history of either condition. The repeated episodes of low oxygen during apnea may compromise corneal health, making it more susceptible to thinning and deformation. For patients with sleep apnea and keratoconus, early diagnosis and appropriate management—whether through special contact lenses or corneal cross-linking—are essential to prevent the condition from worsening.

The Role of CPAP Therapy in Managing Sleep Apnea and Eye Health

Can CPAP therapy help with eye health if you have sleep apnea? Absolutely. CPAP (Continuous Positive Airway Pressure) is often the first line of treatment for obstructive sleep apnea, helping to keep your airway open during sleep. By delivering a continuous stream of air, the CPAP machine prevents those dangerous pauses in breathing, which not only improves sleep but also reduces the impact of sleep apnea on your overall health—eyes included.

CPAP therapy plays a significant role in protecting your eyes from conditions related to sleep apnea. By ensuring that oxygen levels remain stable during sleep, CPAP reduces the risk of hypoxia, a major contributor to eye damage. In fact, regular use of a CPAP machine has been shown to lower intraocular pressure (IOP), which is critical for preventing or slowing down the progression of glaucoma. Similarly, it helps to reduce the risk of conditions like Nonarteritic Anterior Ischemic Optic Neuropathy (NAION), where lack of oxygen and poor blood flow can lead to sudden vision loss.

However, CPAP therapy isn’t without its challenges. Air leakage from the mask can blow directly into the eyes, drying out the tear film and causing irritation or redness. It’s a manageable problem, but if left untreated, it can worsen eye discomfort. Making sure your CPAP mask fits well, or adjusting it to minimise air leakage, can significantly reduce these side effects. In some cases, adding a heated humidifier to your CPAP machine or using artificial tears can help maintain proper moisture levels in the eyes.

Another potential concern is the development of bacterial conjunctivitis. Poor cleaning habits with CPAP equipment can lead to bacterial growth, which can be transferred to your eyes. To avoid this, it’s crucial to clean your CPAP mask and tubing regularly.

CPAP therapy is an important step for managing sleep apnea and can significantly reduce the eye-related risks that come with the condition. Proper care of your CPAP machine and addressing minor side effects like dry eyes ensures you can protect your vision while you benefit from better sleep.

If you think your CPAP machine is giving you dry eyes, please watch the following video by Dr. Melanie J Denton.

Diagnosing and Treating Eye Conditions in Sleep Apnea Patients

How can regular eye exams help if you have sleep apnea? Early detection is key when it comes to preventing serious eye conditions caused by sleep apnea. Many of the conditions linked to sleep apnea can develop without noticeable symptoms until significant damage has occurred.

At Junic Eye Care, we use advanced diagnostic tools to detect these conditions early. For glaucoma, we rely on tonometry to measure the pressure inside your eyes, which helps identify elevated intraocular pressure (IOP) – a primary risk factor for the disease. Optical Coherence Tomography (OCT) scans allow us to closely monitor the optic nerve and retina, giving us a detailed look at any early signs of damage caused by sleep apnea.

For patients experiencing dry eye, we conduct thorough assessments of the tear film and eyelid function to diagnose and treat these issues. This can include tear film analysis to determine the extent of dryness and recommend treatments like artificial tears or humidification strategies.

Timely intervention are crucial for managing these conditions before they lead to permanent vision loss.

Lifestyle Adjustments for Sleep Apnea Patients to Protect Eye Health

How can you protect your eyes if you have sleep apnea? Start by focusing on improving your sleep hygiene. Ensuring that you sleep in a proper position, such as on your side, can help reduce the exposure of your eyes to air, which can aggravate dry eye symptoms. Additionally, minimising the use of fans or air conditioning blowing directly on your face can prevent further eye dryness.

If you use a CPAP machine, consider making small changes to your setup to avoid air leakage that can dry out your eyes. Adjusting your mask for a better fit or using moisture chamber goggles while you sleep can help keep your eyes hydrated.

Pay attention to your diet and hydration as well. Drinking plenty of water and adding Omega-3 supplements to your diet can boost your tear production and reduce the effects of dry eye syndrome. Reducing caffeine and alcohol consumption is also beneficial, as both can dehydrate the body and worsen eye conditions.

CONCLUSION

Sleep apnea is linked to several serious eye conditions, including glaucoma, floppy eyelid syndrome, and retinal vein occlusion. CPAP therapy, while beneficial for treating sleep apnea, can contribute to dry eye syndrome and other eye issues if not properly managed.

Unaddressed eye issues related to sleep apnea can worsen, leading to complications that are harder to treat later on.

Don’t wait for minor symptoms to evolve into serious problems —schedule your eye exam today and take control of your eye health.

To visit our optometry practice, click the “Book Online” button at the top of the page or call (02) 6152 8585 today.

You’ll find our clinic conveniently located in the Molonglo Health Hub, just a short 10 minute drive from central Canberra, with plenty of free parking when you get here.