Recent studies have shown a connection between obstructive sleep apnea and glaucoma. Glaucoma is not a single eye disease but is a term for several eye conditions that can damage your optic nerve. Glaucoma is the second leading cause of adult blindness in the United States. Risk factors for glaucoma include increased or high pressure in the eyes, age, race, family history of glaucoma and diabetes. The most common form of glaucoma is referred to as open angle glaucoma. This typically is an inherited condition that can lead to blindness if not detected early.
We have approximately 1,000,000 nerve fiber layers running through our optic nerve in each eye. If the intraocular pressure is abnormally high this pressure is transferred to the optic nerve and starts to kill nerve fibers. As there is an increase in loss of nerve fiber patients will initially start to notice loss of peripheral or side vision. Peripheral vision is lost first due to how the nerve fibers are laid out in the retina. If left untreated the disease can progress to blindness.
Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing. About 1 in 4 men have sleep disordered breathing with most cases being undiagnosed. As we breathe in oxygen a negative pressure is created that pulls in the walls of the airway which can lead to narrowing or obstruction of the airways. This can occur during sleep many times per hour. This excessive laxity or narrowing of the airway causes the loud snoring and gasping or choking while asleep. Even more importantly is the decrease of oxygen delivery to vital parts of the body. Patients with sleep apnea have been shown to have a higher incidence of hypertension, stroke, myocardial infarction, arrhythmias1 and diabetes2. Risk factors for OSA include obesity, large neck size, male gender and African-American, Hispanic or Pacific Islander ethnicity.
We are now seeing evidence that oxygen deprivation in obstructive sleep apnea patients may play a role in decreased oxygen delivery to the optic nerve which may lead to glaucoma3. Several recent studies have related sleep apnea to glaucoma4, 5, 6. If you have been diagnosed with sleep apnea, I would recommend you make an appointment with your eye specialist to be tested for glaucoma. This disease can be relentless and an individual can’t tell if their eye pressure is increased or they have optic nerve damage unless they are evaluated. Because glaucoma does not cause any symptoms until it has progressed it has been referred to as the “silent vision thief in the night.” Let’s all be proactive in our ocular health and plan an appointment with your ophthalmologist to be evaluated.