Abstract
Purpose
Obstructive sleep apnea (OSA) is associated with many systemic diseases including diabetes, hypertension, stroke, and cardiovascular disease. The aim of our study was to investigate the association between OSA and optic neuropathy (ON), and to evaluate the efficacy of treatment for OSA on the risk of ON.
Methods
We used the data from the Longitudinal Health Insurance Database, which involved one million insurants from Taiwan National Health Insurance program (Taiwan NHI).
Results
OSA patients had a 1.95-fold higher risk of ON compared with non-OSA patients in all age group. The risk was significantly higher (adjusted hazard ratio: 4.21) in the group aged <45 years and male individuals (adjusted hazard ratio: 1.93). Meanwhile, sleep apnea was associated with ON regardless of the existence of comorbidity or not. OSA patients treated with continuous positive airway pressure (CPAP) had an adjusted 2.31-fold higher hazard of developing ON compared to controls, and those without any treatment had an adjusted 1.82-fold higher hazard of developing ON compared to controls. Moreover, ON patients had a 1.45-fold higher risk of OSA, and those aged between 45 and 64 years (hazard ratio: 1.76) and male individuals (hazard ratio: 1.55) had highest risk.
Conclusions
Our study showed that OSA increased the risk of developing ON after controlling the comorbidities; however, treatment with CPAP did not reduce the risk of ON. Further large population study accessing to medical records about the severity of OSA and treatment for OSA is needed to clarify the efficacy of treatment for OSA in reducing the risk of ON.
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References
Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol. 2010;7:677–85.
Langenfeld MR, Simmons LA, McCrohon JA, Raitakari OT, Lattimore JD, Hennessy A, et al. Nitric oxide does not mediate the vasodilation of early human pregnancy. Heart Lung Circ. 2003;12:142–8.
Archer EL, Pepin S. Obstructive sleep apnea and nonarteritic anterior ischemic optic neuropathy: evidence for an association. J Clin Sleep Med. 2013;9:613–8.
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.
Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature. BMC Pulm Med. 2013;13:10.
Chuang LP, Hsu SC, Lin SW, Ko WS, Chen NH, Tsai YH. Prevalence of snoring and witnessed apnea in Taiwanese adults. Chang Gung Med J. 2008;31:175–81.
Pepin JL, Tamisier R, Baguet JP, Levy P. Arterial health is related to obstructive sleep apnea severity and improves with CPAP treatment. Sleep Med Rev. 2013;17:3–5.
Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003;290:1906–14.
Nagayoshi M, Punjabi NM, Selvin E, Pankow JS, Shahar E, Iso H, et al. Obstructive sleep apnea and incident type 2 diabetes. Sleep Med. 2016;25:156–61.
Woodson BT, Brusky LT, Saurajen A, Jaradeh S. Association of autonomic dysfunction and mild obstructive sleep apnea. Otolaryngol Head Neck Surg. 2004;130:643–8.
Lattimore JD, Celermajer DS, Wilcox I. Obstructive sleep apnea and cardiovascular disease. J Am Coll Cardiol. 2003;41:1429–37.
Levy P, Pepin JL, Arnaud C, Baguet JP, Dematteis M, Mach F. Obstructive sleep apnea and atherosclerosis. Prog Cardiovasc Dis. 2009;51:400–10.
McNab AA. The eye and sleep apnea. Sleep Med Rev. 2007;11:269–76.
Stein JD, Kim DS, Mundy KM, Talwar N, Nan B, Chervin RD, et al. The association between glaucomatous and other causes of optic neuropathy and sleep apnea. Am J Ophthalmol. 2011;152:989–.e983.
Liguori C, Palmieri MG, Pierantozzi M, Cesareo M, Romigi A, Izzi F, et al. Optic nerve dysfunction in obstructive sleep apnea: an electrophysiological study. Sleep. 2016;39:19–23.
Wu Y, Zhou L-M, Lou H, Cheng J-W, Wei R-L. The association between obstructive sleep apnea and nonarteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis. Curr Eye Res. 2015;41:987–92.
Fraser CL. Obstructive sleep apnea and optic neuropathy: is there a link? Curr Neurol Neurosci Rep. 2014;14:465.
Bilgin G, Koban Y, Arnold AC. Nonarteritic anterior ischemic optic neuropathy and obstructive sleep apnea. J Neuro-Ophthalmol. 2013;33:232–4.
Li J, McGwin G Jr., Vaphiades MS, Owsley C. Non-arteritic anterior ischaemic optic neuropathy and presumed sleep apnoea syndrome screened by the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ). Br J Ophthalmol. 2007;91:1524–7.
Mojon DS, Hedges TR III, Ehrenberg B, Karam EZ, Goldblum D, Abou-Chebl A. et al. Association between sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy. Arch Ophthalmol. 2002;120:601–5.
Arda H, Birer S, Aksu M, Ismailogullari S, Karakucuk S, Mirza E, et al. Obstructive sleep apnoea prevalence in non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol. 2013;97:206–9.
Palombi K, Renard E, Levy P, Chiquet C, Deschaux C, Romanet JP, et al. Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea. Br J Ophthalmol. 2006;90:879–82.
Behbehani R, Mathews MK, Sergott RC, Savino PJ. Nonarteritic anterior ischemic optic neuropathy in patients with sleep apnea while being treated with continuous positive airway pressure. Am J Ophthalmol. 2005;139:518–21.
Acknowledgements
This study was supported by Taiwan Ministry of Health and Welfare, Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019); China Medical University Hospital and Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037); NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039 -005); and Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan as well as Katsuzo and Kiyo Aoshima Memorial Funds, Japan, respectively.
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Sun, MH., Liao, Y.J., Lin, CC. et al. Association between obstructive sleep apnea and optic neuropathy: a Taiwanese population-based cohort study. Eye 32, 1353–1358 (2018). https://doi.org/10.1038/s41433-018-0088-1
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DOI: https://doi.org/10.1038/s41433-018-0088-1
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