Association between poor sleep quality and an increased risk of dry eye disease in patients with obstructive sleep apnea syndrome

Pu, Qi; Wu, Zhen; Li, Ao-Ling; Guo, Xinwen; Hu, Jiang; Li, Xinyu

doi:10.3389/fmed.2022.870391

Cited by 4 publications

(13 citation statements)

References 34 publications

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“…In our study, the OSDI scores in mild & moderate and severe OSAS groups were significantly higher ( p < 0.05) compared to the control group. Similar findings were reported in previous studies by Jian Sun et al ( 21 ), Qi Pu et al ( 22 ), and Mutlu Acar et al ( 9 ), who found that severe OSAS cases had high scores in OSDI questionnaire. Another study found a positive correlation between high OSDI scores and low TBUT ( 9 ).…”

Section: Discussionsupporting

confidence: 91%

“…In a previous investigation of the sleep status and dry eye-related risks of OSAS patients, the oxford corneal staining score was higher in OSAS patients with poor sleep quality than those with good sleep quality, with significant staining differences observable between the two groups. Though not the same as our observation index, i.e., corneal fluorescence staining, both measures indicate the ocular surface health of patients (22). Wu et al (30) also reported significant CFS differences between dry eye patients and controls, with higher scores of dry eye patients as compared to the control group, which supports the findings of our study.…”

Section: Discussionsupporting

confidence: 84%

“…Our study also reported significant differences in CFS between the control and OSAS groups, and between mild–moderate and severe OSAS patients. These findings suggested that the corneal epithelium of OSAS patients was inferior to that of normal individuals, which was corroborated by several studies ( 22 , 30 , 31 ). In a previous investigation of the sleep status and dry eye-related risks of OSAS patients, the oxford corneal staining score was higher in OSAS patients with poor sleep quality than those with good sleep quality, with significant staining differences observable between the two groups.…”

Section: Discussionsupporting

confidence: 83%

“…Consistent with earlier studies, we found that OSAS, particularly the severe forms, was associated with significantly reduced FNITBUT and MNITBUT, implying excessive tear evaporation, relative to controls ( p < 0.005). Other studies found that OSAS, particularly the moderate and severe forms, was associated with low SIT and TBUT values ( 9 , 22 – 24 ). Moreover, we also observed that OSAS was associated with declining TMH levels, which indicated a deficiency of aqueous and propensity towards DES.…”

Section: Discussionmentioning

confidence: 93%

“…Moreover, patients with OSAS tend to have an increased Meiboscore, indicating that morphological changes such as ductal thinning, distortion, and dilatation of Meibomian glands are more common. Previous case-control studies showed that OSAS patients had a greater loss of Meibomian glands in both upper and lower eyelids than controls, and such loss significantly correlates with the severity of OSAS ( 10 , 22 , 24 ). In this population, meibomian gland loss leads to a greater risk of lipid-deficient dry eye.…”

Section: Discussionmentioning

confidence: 93%

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Alterations of ocular surface parameters in patients with obstructive sleep apnea syndrome

Hao,

Tian,

Liu

et al. 2023

Front. Med.

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PurposeThis study aimed to evaluate changes in ocular surface parameters among obstructive sleep apnea syndrome (OSAS) patients.Methods44 healthy volunteers (88 eyes) and 27 OSAS patients (54 eyes) were recruited in our cross-sectional study. 14 patients were classified as mild&moderate OSAS, and 13 patients were classified as severe OSAS. For evaluating the ocular surface, the following tests were conducted: the height of tear meniscus (TMH), first non-invasive tear break-up time (FNITBUT), mean non-invasive tear break-up time (MNITBUT), the score of Meibomian gland dropout area (Meiboscore), the tear test of anesthesia-free Schirmer I (SIT), corneal fluorescein staining (CFS), partial blinks rate (PBR), the lipid layer thickness (LLT), ocular surface disease index (OSDI). The results obtained from the study were analyzed and compared among the groups.ResultsFNITBUT, MNITBUT, and TMH were lower. OSDI, CFS, Meiboscore and PBR were higher in the OSAS group than those in the control group. The mild&moderate as well as the severe OSAS subgroups had statistically significantly lower TMH, and higher OSDI and PBR than the control group. Meanwhile, we found there were no significant differences between two OSAS subgroups. CFS was higher in the severe OSAS group than the mild&moderate OSAS group. Significantly lower FNITBUT, MNITBUT and higher Meiboscore were observed in the severe OSAS subgroup than in the control group, and MNITBUT was higher in severe OSAS objects than in the mild&moderate OSAS objects. LLT and SIT did not exhibit significant differences among control and OSAS subgroups. FNITBUT and MNITBUT showed significantly negative correlations with BMI, while Meiboscore showed a significant positive correlation with AHI.ConclusionPatients with OSAS have a tendence of dry eyes, whereas control subjects do not. This indicates us that the OSAS patients should pay more attention to ocular surface care.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

See 3 more Smart Citations

Alterations of ocular surface parameters in patients with obstructive sleep apnea syndrome

Hao,

Tian,

Liu

et al. 2023

Front. Med.

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ECGDT: a graphical software tool for ECG diagnosis

Mondelo,

Lado,

Méndez

2023

Multimed Tools Appl

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While cardiovascular diseases are the leading causes of death in developed countries, detection of cardiac abnormalities can reduce mortality rates, through early and accurate diagnosis. One of the main assets used to help in the diagnosis process is the electrocardiogram (ECG). A free software tool for electrocardiogram analysis and diagnosis is presented. The tool, named ECGDT, allows: (1) to detect beats present on the ECG, both in single and multi-channel levels, (2) to identify beat waves, and (3) to diagnose different cardiac abnormalities. System evaluation was performed in two ways: (1) diagnostic capabilities were tested with Receiver Operating Characteristic (ROC) analysis, and (2) Graphical Software Interface (GUI) aspects, such as attraction, efficiency, or novelty, were evaluated employing User Experience Questionnaire (UEQ) scores. For disease diagnosis, the mean Area Under the ROC Curve (AUC) was 0.821. The system was also capable of detecting 100% of several cardiac abnormalities, such as bradycardia or tachycardia. Related to the GUI, all usability estimators scored values ranged between 2.208 and 2.750 (overall positive evaluations are obtained for values over 0.8). ECGDT could serve as an aid in the diagnosis of different medical abnormalities. In addition, the suitability of the developed interface has been proven.

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Associations Between Obstructive Sleep Apnea Syndrome, Dry Eye Disease, and CPAP Usage Among Taiwanese Patients: A Retrospective Analysis

Fu,

Sun,

Chen

et al. 2024

NSS

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Study Objectives To evaluate the association between obstructive sleep apnea (OSA) and dry eye disease (DED) and analyze the impact of Continuous Positive Airway Pressure (CPAP) on DED. Methods This is a retrospective population-based case-control study. Patients who underwent polysomnography in Taiwan from March 1, 2009, to March 1, 2020, were identified from the database of a sleep center. Patients who were diagnosed with keratoconjunctivitis sicca or tear film insufficiency were included. Patients without data from Schirmer’s test, lacking tear break-up time values, or with a history of refractive surgery, Sjögren’s syndrome, ocular injuries, or a disability in eyelid closure were excluded. All patients with DED enrolled had DED in both eyes. OSA severity between patients with and without DED was compared. Results In total, 86 patients with DED and 86 age-matched patients without DED were enrolled. Significant differences in apnea-hypopnea index values (patients with DED: 29.1 ± 23.4, patients without DED: 17.9 ± 20.2, P < 0.001), OSA severity ( P < 0.001), and lowest oxygen saturation ( P = 0.040) between patients with and without DED were observed. A multivariate logistic regression model indicated that the use of CPAP was independently associated with DED after adjustments for OSA severity. Patients undergoing CPAP were at greater risk of developing DED than those not undergoing CPAP (Odds ratio: 3.93, 95% confidence interval: 1.47–10.49, P = 0.006). Conclusion OSA severity is associated with DED and might be attributed to the use of CPAP.

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Association between poor sleep quality and an increased risk of dry eye disease in patients with obstructive sleep apnea syndrome

Cited by 4 publications

References 34 publications

Alterations of ocular surface parameters in patients with obstructive sleep apnea syndrome

Alterations of ocular surface parameters in patients with obstructive sleep apnea syndrome

ECGDT: a graphical software tool for ECG diagnosis

Associations Between Obstructive Sleep Apnea Syndrome, Dry Eye Disease, and CPAP Usage Among Taiwanese Patients: A Retrospective Analysis

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