Severe obstructive sleep apnea increases floppy eyelid risk
MedWire News: Researchers have found an association between obstructive sleep apnea syndrome (OSAS) severity and floppy eyelid syndrome (FES).
They suggest that severe OSAS may be an independent risk factor for FES, and that eyelid laxity evaluation in affected patients could therefore be beneficial.
"The current findings are of particular value, as our study is the only one with larger sample size of consecutive non-treated patients and with a reference method of OSAS diagnosis while controlling for confounding factors," say Patrice Bourgin (Strasbourg University Sleep Clinic, France) and colleagues.
FES, which is an easily inverted floppy eyelid with papillary conjunctivitis, was observed in 22.8% of 127 patients with OSAS. Its prevalence was significantly higher in patients with severe OSAS, affecting 40.0% of patients with an Apnea Hypopnea Index (AHI) score above 30 events/hour and 25.8% of patients with an AHI score above 5 events/hour versus just 15.8% of patients with an AHI score below 5 events/hour.
The prevalence of lax eyelid syndrome also increased significantly with OSAS severity.
The association between OSAS and FES remained significant even after accounting for variables such as age, gender, clinical, polygraphic, and comorbidity data, indicating that OSAS might be an independent risk factor for eyelid hyperlaxity, including FES.
The researchers suggest that hypoxia caused by OSAS could lead to an increased metalloproteinase activity and a subsequent loss of elastic fibers.
"This hypothesis might explain the possibility of improvement of FES under CPAP [continuous positive airway pressure] treatment," they write in the Journal of Sleep Research.
"Ultimately, treatment of OSAS may reduce eyelid laxity, and thus have beneficial effects on chronic papillary conjunctivitis outcome and CPAP tolerance."
By Lucy Piper