Keratoconus & Obstructive Sleep Apnea

Would you describe yourself as sleepy?

dream-628797_1920People living with keratoconus may attribute symptoms of weariness to their vision problems, but researchers have identified a connection between keratoconus and a common sleep disorder.

Obstructive Sleep Apnea (OSA) occurs when the airway completely or partially collapses. During sleep, the soft tissues in the throat relax, and sometimes this blocks the upper airway enough to disrupt sleep. When the airway is blocked, oxygen levels drop, causing the person to wake up long enough to begin breathing normally. These awakenings are very brief, occurring perhaps hundreds of time each night, and the person may not every realize that sleep has been disrupted. This lack of continuous, settled sleep can cause daytime fatigue.

Not every person with keratoconus also suffers from sleep apnea, but researchers find that the likelihood is greater than in the general population. Doctors at the Duke Eye Center reported this in 2012 after patients in their eye clinic answered questions related to their sleep habits and troublesome snoring (another common symptom of OSA) and found 18% of their patients were previously diagnosed with obstructive sleep apnea, and 47% of those who responded to the survey had symptoms of OSA.

More recently, Dr. Maria Woodward MD, a cornea specialist at University of Michigan’s Kellogg Eye Center, and Dr. Joshua Stein MD analyzed healthcare claims of more than 32,000 individuals. They compared a group of people diagnosed and treated for keratoconus and a group without keratoconus. Dr. Woodward looked at factors that were found more often in the keratoconus group than in the control group. People with sleep apnea had 13% increased odds of also having KC. In this large sample, 10.6% of patients with keratoconus were also treated for sleep apnea, while 8.7% in the control group were treated for OSA.

Dr. Woodward noted that while she is primarily interested in improving the eye health of her patients, as a physician she is also interested in learning about systemic diseases that commonly occur in patients with specific eye problems. “Eye health is related to total body health. We want to make sure that people with keratoconus are aware of other risky diseases,” says Dr. Woodward.

Experts agree that the vast majority of adults with obstructive sleep apnea symptoms are undiagnosed. If you suspect you have sleep apnea, it might be worth raising your concerns with your primary care physician. Your doctor can refer to you to a sleep specialist for further evaluation.

Read references:
Gupta PK, et al, Prevalence of sleep apnea in patients with keratoconus Cornea 2012 31:595-599.

Woodward MA, et al, The Association Between Sociodemographic Factors, Common Systemic Disease and Keratoconus Ophthalmology, 2015, 123:457-465.

Learn more about Dr. Woodward’s research.

See a video from the NIH on obstructive sleep apnea.