<p>The Prevalence and Incidence of Dry Eye Disease Among Patients Using Continuous Positive Airway Pressure or Other Nasal Mask Therapy Devices to Treat Sleep Apnea</p>

Abstract

Introduction: Dry eye disease (DED) prevalence is estimated at 9.3% of the US adult population, although diagnosed rate is much lower. This study examined real-world incidence rates (IR) and prevalence rates (PR) of DED in adults using continuous positive airway pressure (CPAP) or nasal mask therapy (NMT) devices to treat sleep apnea. Methods: Using IBM MarketScan Commercial and Medicare Supplemental claims databases, this study identified adults with ≥1 claim of CPAP or other NMT device between January 1, 2014 and June 30, 2018, ≥1 diagnosis of sleep apnea during a 12-month pre-index period, and continuous benefit enrollment ≥12 pre-and post-index date. The date of the first CPAP or NMT device claim was considered the index date. Descriptive analyses included PR, IR, and IR per 100-person years (100PY) for the overall population and subgroups including age, sex, and baseline comorbidities. Results: The 1-, 2-, and 3-year PR of DED was 6.2%, 10.0%, and 13.0%, while the IR of DED was 4.0%, 7.3%, and 10.3%, respectively. Females had a higher IR of DED compared to males: 5.8%, 10.8%, and 15.1% vs 3.0%, 5.4%, and 7.9%, respectively. DED increased with age with a 1-, 2-, and 3-year PR for patients aged 18-24 years of 2.2%, 3.4%, and 5.0% vs 17.6%, 25.8%, and 32.1% in patients aged ≥75, respectively. Overall, IR per 100PY of DED was 3.68, higher for females than males (5.51 vs 2.73). PR and IR of DED were high among patients with comorbid inflammatory or metabolic conditions. Conclusion: The PR and IR of DED in CPAP or NMT users were higher than the reported prevalence of DED in the general population. CPAP/NMT users who were female, older, or had comorbid inflammatory or metabolic conditions may experience a higher incidence and prevalence of DED.

Investigation of Dry Eye Symptoms in Health Workers of National Medical College and Teaching Hospital following Corona Virus Pandemic

“…In a four year old Incident rate (IR) and Prevalence (PR) rate study done on patient using Continuous Positive airway pressure mask and nasal mask therapy,the IR and PR were significantly greater than reported prevalence report of Dry Eye Disease. 19 In a recent online survey, 18.3% had experienced mask associated dry eye symptoms which was not significant. 18 Regarding VDU users, 54 (56.84%) had dry eye symptoms with highest OSDI scores out of 95 participants who were using electronic devices for more than 8 hours.…”

Sleep Disorders, Mental Health, and Dry Eye Disease: A Population-Based Study in South Korea

“…This is thought to be due to the stress from sensory discomfort or optical disturbance experienced by patients with DED as well as sleep di culty from in ammatory processes (pain, brightness due to in-complete eye closure, and others) during sleep. Previous studies also show that persistent positive airway pressure, a treatment option for obstructive sleep apnea, may exacerbate DED 24 .…”

Ocular Complications of Obstructive Sleep Apnea

“…Shortened tear break-up time (TBUT) and noninvasive tear break-out time (NTBUT), which represent excessive tear evaporation, were also detected in patients with OSA [ 98 , 99 , 100 ]. Among patients using CPAP or other nasal mask therapies, the prevalence and incidence of DES were significantly higher, as compared to the general population [ 101 ]. Additionally, in patients with severe OSA, morphological alterations of the Meibomian glands, including ductal thinning, dilatation, and distortion, were more frequently demonstrated on meibography [ 102 ].…”