Long-term effects of PAP on ocular surface in obstructive sleep apnea syndrome

A case of obstructive sleep apnea syndrome associated with floppy eyelid syndrome: positive effect of CPAP therapy

“…Acar et al [10] performed CPAP treatment on 51 patients suffering from moderate and severe OSAS for 18 months and the eye examination findings pre-and post-CPAP were compared. In this study the Authors concluded that 'an appropriate CPAP therapy helps to relieve both the systemic findings and the ocular surface problems probably by reducing intermittent hypoxemias and arousals, and providing a better quality of sleep pattern'.…”

“…In this study the Authors concluded that 'an appropriate CPAP therapy helps to relieve both the systemic findings and the ocular surface problems probably by reducing intermittent hypoxemias and arousals, and providing a better quality of sleep pattern'. However, from this study [10] a long-term CPAP therapy (at least 1 year) is expected to be used for improving the clinical picture of FES and overcoming the problem of ocular surface irritation encountered in the early stage.…”

Re: Ulander et al.: Side effects to continuous positive airway pressure treatment for obstructive sleep apnoea: changes over time and association to adherence. (Sleep Breath. 2014 Dec;18(4):799-807)

“…In a recently published article entitled "Ocular surface assessment in patients with obstructive sleep apnea hypopnea syndrome" [3], we reported that the shortened tear film break-up times, reduction in Schirmer test results and high levels of OSDI scores in the severe disease group correlated with Apnea-Hypopnea Index (AHI). In a second article entitled "Long-term effects of PAP on ocular surface in obstructive sleep apnea syndrome" [4], we observed a decrease in the OSDI scores in 51 patients with OSA, following PAP therapy for a period of 18 months. We conjecture that a decrease of the OSDI scores was associated with healing of eyelid ischemia, floppy eyelid syndrome (FES), tear function tests, and improvement of overall health of the ocular surface with CPAP therapy.…”

The effects of anterior palatoplasty on floppy eyelid syndrome patients with obstructive sleep apnea

“…In a prolonged continuous PAP study conducted by Acar et al, at the end of 18 months, OSA patients' FES presence and stages were reported to regress. The authors indicated that this condition was rectified by correcting tissue hypoxia, and they indicated the necessity of lying in a supine position during treatment …”

“…Although, the pathophysiological mechanisms involved in FES, and the association of these mechanisms with OSA, have not yet been elucidated, tissue hypoxia and consequent inflammation are suggested to be possible etiologic factors. FES more commonly occurs in advanced stages of OSA …”