Article ; Online: Effects of continuous positive air pressure on intraocular pressure in patients with obstructive sleep apnea during the split-night study: An open-label randomized controlled trial.
2023 Volume 102, Issue 17, Page(s) e33566
Abstract: Background: Intraocular pressure (IOP) is known to increase at midnight, when continuous positive airway pressure (CPAP) is initiated in split-night CPAP titration (SN-CPAP titration), in patients with obstructive sleep apnea (OSA); therefore, possible ... ...
| Abstract | Background: Intraocular pressure (IOP) is known to increase at midnight, when continuous positive airway pressure (CPAP) is initiated in split-night CPAP titration (SN-CPAP titration), in patients with obstructive sleep apnea (OSA); therefore, possible excessive increase in the IOP should be investigated. However, related studies on this topic are scarce. OSA causes increases and decreases in the IOP; however, its fluctuation during sleep remains unclear. Therefore, we determined the timing of these fluctuations in the IOP during sleep at night. Methods: This study included 25 patients with OSA. A 7-hour period of night sleep was divided into first (Sleep-1) and second halves (Sleep-2). Patients were randomly divided into the SN (natural breathing during Sleep-1, CPAP applied during Sleep-2) and C (without CPAP) groups. IOP was measured using the iCare Pro before Sleep-1 and after Sleep-1 and Sleep-2. The main hypothesis was that IOP would be significantly higher in the SN group than in the C group. The sub-hypothesis was that the effects of OSA on IOP are manifested at different times. The correlation is shown as Pearson's r for normally distributed data or Spearman's rho for non-normally distributed data. The difference between the SN and C groups in the time course of IOP during the night's sleep was analyzed using repeated-measures analysis of variance. A P value of <.05 was considered significant. Results: No significant difference was found in IOP between the groups, but the SN group showed a significantly increased IOP during Sleep-2 (post hoc Bonferroni test). The apnea-hypopnea index inversely correlated with IOP changes in Sleep-1 and positively correlated with those in Sleep-2. Conclusion: This study does not support our main hypothesis that SN-CPAP titration promotes the effect of CPAP in increasing IOP. However, an expected range of the effect of increased CPAP on IOP has also been suggested. IOP-lowering and IOP-raising effects were predominant in the first and second halves of sleep in OSA, thereby providing a new perspective on measured IOP and supporting the subhypothesis. |
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| MeSH term(s) | Humans ; Intraocular Pressure ; Air Pressure ; Sleep Apnea, Obstructive/therapy ; Continuous Positive Airway Pressure ; Tonometry, Ocular |
| Language | English |
| Publishing date | 2023-05-15 |
| Publishing country | United States |
| Document type | Randomized Controlled Trial ; Journal Article |
| ZDB-ID | 80184-7 |
| ISSN | 1536-5964 ; 0025-7974 |
| ISSN (online) | 1536-5964 |
| ISSN | 0025-7974 |
| DOI | 10.1097/MD.0000000000033566 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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