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The effect of nocturnal CPAP therapy on the intraocular pressure of patients with sleep apnea syndrome

  • Glaucoma
  • Published:
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Abstract

Purpose

Few studies have documented that nocturnal continuous positive airway pressure (CPAP) therapy is associated with an increase in intraocular pressure (IOP) in patients with severe obstructive sleep apnea syndrome (OSAS). We re-examined the effect of CPAP therapy on the IOP of OSAS patients.

Methods

The IOP of two different groups of newly diagnosed OSAS patients was compared at their first sleep lab exam without CPAP treatment (non-CPAP treated group; n = 20) and at the second sleep lab exam with CPAP treatment (CPAP treated group; n = 31). The sleep lab exam (sleep period: from 11:00 p.m. until 6:00 a.m.) included IOP measurements, a complete ophthalmologic exam, and nocturnal hemodynamic recordings. The IOP was measured serially using rebound tonometer (IOP; ICARE® PRO) performed while in sitting and supine positions before, during, and after the sleep period. We compared the difference in IOP of CPAP and non-CPAP groups.

Results

The mean IOP of the CPAP and non-CPAP groups measured in sitting position before the sleep period was 13.33 ± 2.04 mmHg and 14.02 ± 2.44 mmHg, respectively (p = 0.9). Assuming a supine position for 1 minute significantly increased the IOP by 1.93 mmHg and 2.13 mmHg for both the non-CPAP and CPAP groups (paired t-test; p = 0.02, p = 0.001 respectively), but this IOP rise showed no difference between the two groups. The IOP increased significantly further after 7 hours of sleep in the supine position, and the mean IOP of the CPAP and non-CPAP groups was 19.2 ± 5.68 mmHg and 19.69 ± 5.61 mmHg respectively (independent t-test; p = 0.74). The rise in IOP for both groups was not correlated with any hemodynamic parameters. Three OSAS patients with glaucoma treated with CPAP had mean IOP of 23.75 mmHg after 7 hours of sleep.

Conclusions

OSAS patients have a significant rise in IOP during the sleep period when comparing measurements before and after the sleep period; however, CPAP therapy did not affect the measured IOP. The presented findings suggest that in terms of IOP, CPAP is safe for non-glaucomatous patients, but this may not hold true for glaucomatous patients.

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Funding

This study was funded by an Aya Baharav Kariel Glaucoma Research Grant and Elba Cuenca Institute for Anti-Aging Therapy Research.

Conflict of interest

The authors declare that they have no conflict of interest.

All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Goldschleger Eye Research Institute, Tel Aviv University, 53621, Tel Hashomer, Israel

    Yuval Cohen & Arieh S. Solomon

  2. The Institute for Fatigue and Sleep Medicine, Chaim Sheba Medical Center, 53621, Tel Hashomer, Israel

    Eyal Ben-Mair, Eyal Rosenzweig & Dalia Shechter-Amir

Authors
  1. Yuval Cohen
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  2. Eyal Ben-Mair
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Correspondence to Yuval Cohen.

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Cohen, Y., Ben-Mair, E., Rosenzweig, E. et al. The effect of nocturnal CPAP therapy on the intraocular pressure of patients with sleep apnea syndrome. Graefes Arch Clin Exp Ophthalmol 253, 2263–2271 (2015). https://doi.org/10.1007/s00417-015-3153-5

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  • DOI: https://doi.org/10.1007/s00417-015-3153-5

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