Sleep Apnea & Eye Disorders – What’s the Link?

Written by Dr. David Evans   Last modified on August 6, 2018

I wrote an article last October about an interesting correlation between your sleeping position and dry eye risk. In short, dry eye sufferers who found their condition worse in the morning were able to improve by adjusting their sleep habits, avoiding sleeping on their side. As it turns out, the connection between sleep and eye health continues to evolve, with new studies suggesting a link between sleep apnea and a variety of eye conditions.

Sleep apnea — the abnormal cessation of breathing during sleep — is a relatively common sleep disorder impacting more than 15 million Americans. Also called obstructive sleep apnea (OSA), it causes the airway to become repeatedly blocked during sleep, depriving the body of oxygen. Although more prevalent among men, sleep apnea can affect anyone. It’s a serious condition that has a variety of negative health consequences, including high blood pressure, heart disease, stroke and even depression. The addition of eye disorders to the list of potential health problems associated with OSA is somewhat new.

Sleep apnea CPAP mask

A 2016 study evaluated the association between OSA and a range of eye conditions including glaucoma, optic neuropathy, keratoconus, floppy eyelid syndrome, age-related macular degeneration (AMD) and diabetic retinopathy. Although there is increasing evidence suggesting a strong correlation, considerably more research is needed to determine the exact nature of the link. However the study found that diabetic retinopathy seems have the strongest link to OSA. (This makes perfect sense given that sleep apnea has already been linked as a risk factor for pre-diabetes and diabetes.) However a strong glaucoma correlation is also being reported. Of course, we already know from years of research that there is already a relationship between diabetes and glaucoma as diabetic patients have higher risk of the disease.

The link between sleep apnea and the development of serious eye disorders is still very much under investigation, but it makes sense to heed these preliminary findings to be proactive about your eye health. If you suffer from sleep apnea and are not currently getting regular eye health checkups, consider speaking with your doctor about the need for more frequent visits.

The eye health connection to OSA has another angle as well. A simple dilated retinal exam could be enough for your eye doctor to find something indicative of OSA, prompting further evaluation from a sleep specialist. There are a number of treatments available for sleep apnea, most of which have the added benefit of aiding eye health by minimizing the associated OSA effects.

The bottom line appears to be that eye doctors can not only help to detect eye health side effects from OSA, they can also serve as a front line of defense to recommend patients at risk to see a sleep specialist. This is certainly a very interesting, developing area in eye health and one that I will be paying close attention to as the research continues to paint a clearer picture. Be sure to check back for updates.

To read more about the role ophthalmologists can play in diagnosing OSA, check out this article from the American Academy of Ophthalmology: