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Floppy eyelids: sleeping patterns of spouses as indicators of laterality

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Abstract

Floppy eyelids are usually asymmetrical, and more severe on the side the patient sleeps on. This has been related to the mechanical basis of this entity’s pathophysiology. Patients who exhibit floppy eyelid syndrome (FES) tend to suffer from obstructive sleep apnea and other sleeping disorder such as snoring; therefore, their spouses are likely to be found sleeping facing away from them. In this study, we aim to assess this correlation between FES laterality and the spouse’s sleeping side. 185 patients with floppy eyelid were assessed. Upper lids were pulled cephalad towards the orbital rim to assess which side everted and was more floppy. Based on the upper lid distraction test, a prediction was made to which side of the bed the spouse slept on. 185 patients with floppy eyelid syndrome were assessed, 160 male patients and 25 females, at an average age of 68. All 25 female patients, and 117 of the male patients, had spouses that slept in the same bed. Their side of sleep was predicted correctly in 87% of cases. The physician extrapolated the spouse slept on the opposite side facing away from the snoring spouse and was correct in 91% of cases. There is a high correlation between FES laterality and the patient’s spouse’s sleeping side. These data strengthen the mechanical etiology, and can also be used to confirm the worse-affected side in FES patients.

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Acknowledgements

No financial support was granted. IRB permission 0327-19-ASF

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The authors have no financial interests to disclose.

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Authors and Affiliations

  1. Ophthalmic Plastic and Reconstructive Surgery, Shamir Medical Center, Zerifin, Israel

    Ran Stein & Morris E. Hartstein

  2. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Ran Stein & Morris E. Hartstein

  3. Center for Sight, Sarasota, FL, USA

    John P. Fezza

  4. University of Minnesota, Minneapolis, MN, USA

    Andrew R. Harrison

  5. Ophthalmic Plastic and Reconstructive Surgery, USC Keck School of Medicine, Los Angeles, CA, USA

    Guy G. Massry

  6. Department of Ophthalmology/Division of Oculoplastic Surgery, NYU Langone Health, NYU School of Medicine, New York, NY, USA

    Robert M. Schwarcz

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  1. Ran Stein
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Correspondence to Ran Stein.

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Stein, R., Fezza, J.P., Harrison, A.R. et al. Floppy eyelids: sleeping patterns of spouses as indicators of laterality. Sleep Biol. Rhythms 19, 63–67 (2021). https://doi.org/10.1007/s41105-020-00288-4

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  • DOI: https://doi.org/10.1007/s41105-020-00288-4

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