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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 4/2018

01-04-2018 | Glaucoma

Effect of prolonged supine position on the intraocular pressure in patients with obstructive sleep apnea syndrome

Authors: Sin Yee Fang, Wan Haslina Wan Abdul Halim, Marina Mat Baki, Norshamsiah Md Din

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 4/2018

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Abstract

Purpose

Obstructive sleep apnea syndrome (OSAS) patients are at risk of glaucoma but the risk increases if they have higher intraocular pressure (IOP) while sleeping. We aim to evaluate the postural effect of upright and prolong supine positions on IOP in these patients.

Methods

This is a cross-sectional study involving 27 patients with symptoms of OSAS seen at a tertiary institutional center and 25 normal controls performed between June 2015 and June 2016. All patients and controls underwent a polysomnography (PSG) test and were diagnosed with OSAS based on the apnea-hypopnea index (AHI). Patients are those with OSAS symptoms and had AHI > 5, whereas controls are staffs from the ophthalmology clinic without clinical criteria for OSAS and had PSG result of AHI < 5. IOP was measured 10 min after sitting, immediately and at 30 min on supine position and immediately after resuming sitting position. The main outcome measures were the changes in mean IOP in different positions.

Results

The increase in mean IOP when changing from sitting to supine position was significantly higher in OSAS patients in both the right eye (RE) (1.01 ± 1.14 vs 0.44 ± 0.41 mmHg, p = 0.033) and left eye (LE) (1.20 ± 1.26 vs 0.48 ± 0.62 mmHg, p = 0.044). After 30 min supine, the IOP in OSAS patients showed a further increase in IOP than controls (RE 1.20 ± 1.79 vs 0.12 ± 0.66 mmHg, p = 0.001 and LE 0.59 ± 2.00 vs 0.15 ± 0.78 mmHg, p = 0.246). Higher IOP when sitting post supine is associated with higher IOP on supine position.

Conclusion

IOP increase is significantly more in OSAS patients on prolong supine position.
Literature
1.
go back to reference Caprioli J, Coleman AL (2008) Intraocular pressure fluctuation a risk factor for visual field progression at low intraocular pressures in the advanced glaucoma intervention study. Ophthalmology 115(7):1123–1129.e3CrossRefPubMed Caprioli J, Coleman AL (2008) Intraocular pressure fluctuation a risk factor for visual field progression at low intraocular pressures in the advanced glaucoma intervention study. Ophthalmology 115(7):1123–1129.e3CrossRefPubMed
2.
go back to reference Omar F, Sung CP, Jeffrey ML, Robert R (2012) Glaucoma and obstructive sleep apnoea syndrome. Clin Exp Ophthalmol 40(4):408–419CrossRef Omar F, Sung CP, Jeffrey ML, Robert R (2012) Glaucoma and obstructive sleep apnoea syndrome. Clin Exp Ophthalmol 40(4):408–419CrossRef
3.
go back to reference Lin PW, Friedman M, Lin HC et al (2011) Normal tension glaucoma in patient with obstructive sleep apnoea/hyponoea syndrome. J Glaucoma 20(9):553–558CrossRefPubMed Lin PW, Friedman M, Lin HC et al (2011) Normal tension glaucoma in patient with obstructive sleep apnoea/hyponoea syndrome. J Glaucoma 20(9):553–558CrossRefPubMed
4.
go back to reference John G, Robert L, Yves S, Bo L (2013) The European lung white book: respiratory health and disease in Europe, vol 271. European Respiratory Society John G, Robert L, Yves S, Bo L (2013) The European lung white book: respiratory health and disease in Europe, vol 271. European Respiratory Society
5.
go back to reference American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 22:667–689 American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 22:667–689
6.
go back to reference De Groot V (2009) Eye diseases in patients with sleep apnea syndrome: a review. Bull Soc Belge Ophtalmol 312:43–51 De Groot V (2009) Eye diseases in patients with sleep apnea syndrome: a review. Bull Soc Belge Ophtalmol 312:43–51
7.
go back to reference Daniel SM, Christian WH, David G et al (1999) High prevalence of glaucoma in patients with sleep apnea syndrome. Ophthalmology 106:1009–1012CrossRef Daniel SM, Christian WH, David G et al (1999) High prevalence of glaucoma in patients with sleep apnea syndrome. Ophthalmology 106:1009–1012CrossRef
8.
go back to reference Bendel RE, Kaplan J, Heckman M et al (2008) Prevalence of glaucoma in patients with obstructive sleep apnoea—a cross-sectional case-series. Eye 22:1105–1109CrossRefPubMed Bendel RE, Kaplan J, Heckman M et al (2008) Prevalence of glaucoma in patients with obstructive sleep apnoea—a cross-sectional case-series. Eye 22:1105–1109CrossRefPubMed
9.
go back to reference Sasan M, Aliasghar A, Hamed SK et al (2013) Retinal nerve fibre thickness is reduced in sleep apnea syndrome. Sleep Med 14:53–57CrossRef Sasan M, Aliasghar A, Hamed SK et al (2013) Retinal nerve fibre thickness is reduced in sleep apnea syndrome. Sleep Med 14:53–57CrossRef
10.
go back to reference Jain MR, Marmion VJ (1976) Rapid pneumatic and Mackay-Marg applanation tonometry to evaluate the postural effect on intraocular pressure. Br J Ophthalmol 60:687CrossRefPubMedPubMedCentral Jain MR, Marmion VJ (1976) Rapid pneumatic and Mackay-Marg applanation tonometry to evaluate the postural effect on intraocular pressure. Br J Ophthalmol 60:687CrossRefPubMedPubMedCentral
11.
go back to reference Galin MA, McIvor JW, Brock Magruden G (1963) Influence of position on intraocular pressure. Am J Ophthalmol 55:720–723CrossRefPubMed Galin MA, McIvor JW, Brock Magruden G (1963) Influence of position on intraocular pressure. Am J Ophthalmol 55:720–723CrossRefPubMed
12.
go back to reference Weber AK, Price J (1981) Pressure differential of intraocular pressure measured between supine and sitting position. Ann Ophthalmol 13:323–326PubMed Weber AK, Price J (1981) Pressure differential of intraocular pressure measured between supine and sitting position. Ann Ophthalmol 13:323–326PubMed
13.
go back to reference Shigeki Y, Romulo NA, Motohiro H, Shigeo T (1991) Postural change of intraocular and blood pressures in ocular hypertension and low tension glaucoma. Br J Ophthalmol 75:652–655CrossRef Shigeki Y, Romulo NA, Motohiro H, Shigeo T (1991) Postural change of intraocular and blood pressures in ocular hypertension and low tension glaucoma. Br J Ophthalmol 75:652–655CrossRef
15.
go back to reference Dempsey JA, Skatrud JB, Jacques AJ et al (2002) Anatomic determinants of sleep-disordered breathing across the spectrum of clinical and non clinical male subjects. Chest 122:840–851CrossRefPubMed Dempsey JA, Skatrud JB, Jacques AJ et al (2002) Anatomic determinants of sleep-disordered breathing across the spectrum of clinical and non clinical male subjects. Chest 122:840–851CrossRefPubMed
16.
go back to reference Young T, Palta M, Dempsey J et al (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235CrossRefPubMed Young T, Palta M, Dempsey J et al (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235CrossRefPubMed
17.
go back to reference Young T, Pepprd PE, Taheri S (2005) Excess weight and sleep-disordered breathing. J Appl Physiol 99:1592–1599CrossRefPubMed Young T, Pepprd PE, Taheri S (2005) Excess weight and sleep-disordered breathing. J Appl Physiol 99:1592–1599CrossRefPubMed
18.
go back to reference Ciscar MA, Juan G, Martinez V et al (2001) Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects. Eur Repir J 17:79–86CrossRef Ciscar MA, Juan G, Martinez V et al (2001) Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects. Eur Repir J 17:79–86CrossRef
19.
go back to reference Huang Y, White DP, Malhotra A (2005) The impact of anatomic manipulations on pharyngeal collapse: results from a computational model of the normal human upper airway. Chest 128:1324–1330CrossRefPubMedPubMedCentral Huang Y, White DP, Malhotra A (2005) The impact of anatomic manipulations on pharyngeal collapse: results from a computational model of the normal human upper airway. Chest 128:1324–1330CrossRefPubMedPubMedCentral
20.
go back to reference Schwab RJ, Gupta KB, Gefter WB et al (1995) Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 152:1673–1689CrossRefPubMed Schwab RJ, Gupta KB, Gefter WB et al (1995) Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 152:1673–1689CrossRefPubMed
21.
go back to reference Bacon WH, Turlot JC, Krieger J et al (1990) Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apneas syndrome. Angle Orthod 60:115–122PubMed Bacon WH, Turlot JC, Krieger J et al (1990) Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apneas syndrome. Angle Orthod 60:115–122PubMed
22.
go back to reference Rivlin J, Hoffstein V, Kalbfleisch J et al (1984) Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 129:355–360PubMed Rivlin J, Hoffstein V, Kalbfleisch J et al (1984) Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 129:355–360PubMed
23.
go back to reference Shelton KE, Woodson H, Gy S et al (1993) Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148:462–466CrossRefPubMed Shelton KE, Woodson H, Gy S et al (1993) Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148:462–466CrossRefPubMed
24.
go back to reference Schwab RJ, Gefter WB, Pack AI et al (1993) Dynamic imaging of the upper airway during respiration in normal subjects. J Appl Physiol 74:1504–1514CrossRefPubMed Schwab RJ, Gefter WB, Pack AI et al (1993) Dynamic imaging of the upper airway during respiration in normal subjects. J Appl Physiol 74:1504–1514CrossRefPubMed
25.
go back to reference Chiu KL, Ryan CM, Shiota S et al (2006) Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med 174:1378–1383CrossRefPubMed Chiu KL, Ryan CM, Shiota S et al (2006) Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med 174:1378–1383CrossRefPubMed
26.
go back to reference Redolfi S, Yumino D, Ruttanaumpawan P et al (2009) Relationship between overnight rostral fluid shift and obstructive sleep apnea in non-obese men. Am J Respir Crit Care Med 179:241–246CrossRefPubMed Redolfi S, Yumino D, Ruttanaumpawan P et al (2009) Relationship between overnight rostral fluid shift and obstructive sleep apnea in non-obese men. Am J Respir Crit Care Med 179:241–246CrossRefPubMed
27.
go back to reference Wessels IF, Oh Y (1990) Tonometer utilization, accuracy, and calibration under field conditions. Arch Ophthalmol 108:1709–1712CrossRefPubMed Wessels IF, Oh Y (1990) Tonometer utilization, accuracy, and calibration under field conditions. Arch Ophthalmol 108:1709–1712CrossRefPubMed
28.
go back to reference Van der Jagt LH, Jansonius NM (2005) Three portable tonometers, the TGDc-01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry. Ophthalmic Physiol Opt 25:429–435CrossRefPubMed Van der Jagt LH, Jansonius NM (2005) Three portable tonometers, the TGDc-01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry. Ophthalmic Physiol Opt 25:429–435CrossRefPubMed
29.
go back to reference Viestenz A, Lausen B, Junemnn AM et al (2002) Comparison of precision of the TonoPenXL with the Goldmann and Draeger applanation tonometer in a sitting and recumbent position of the patients—a clinical study on 251 eyes. Klin Monatsbl Augenheilkd 219(11):785–790CrossRefPubMed Viestenz A, Lausen B, Junemnn AM et al (2002) Comparison of precision of the TonoPenXL with the Goldmann and Draeger applanation tonometer in a sitting and recumbent position of the patients—a clinical study on 251 eyes. Klin Monatsbl Augenheilkd 219(11):785–790CrossRefPubMed
Metadata
Title
Effect of prolonged supine position on the intraocular pressure in patients with obstructive sleep apnea syndrome
Authors
Sin Yee Fang
Wan Haslina Wan Abdul Halim
Marina Mat Baki
Norshamsiah Md Din
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 4/2018
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-018-3919-7

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