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Mariana Cabrera, Numan A.E. Hallaji, Colin M. Shapiro, Sharon Chung, Naheed K. Hossain, Graham Eric Trope, Yvonne M Buys; Frequency of Obstructive Sleep Apnea in Open-Angle Glaucoma using the STOP-BANG Questionnaire.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5014.
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A higher prevalence of sleep apnea has been reported in patients with glaucoma (ranging from 20 to 54%). It is not known if sleep apnea contributes to progression of glaucoma. The purpose of this study was to evaluate the frequency of high risk for obstructive sleep apnea utilizing the stop bang questionnaire among patients with open-angle glaucoma.
Cross-sectional survey. 177 patients with a diagnosis of glaucoma (primary open-angle, low tension, pseudoexfoliation and pigmentary) completed the STOP-BANG questionnaire, a validated tool to identify patients at high risk for obstructive sleep apnea. Patients were considered at high risk if they scored 3 or more out of the maximum 8 points.
Mean age was 71.6 (range 31-98), 51% were females. 111 (63%) patients were at high risk for obstructive sleep apnea, with 14.1% being at risk for moderate/severe obstructive sleep apnea (score ≥ 5). 46% of patients complained of snoring, 47% complained of feeling tired during the day and 7.3% stated that they had been told they stopped breathing in their sleep. 5 patients (2.8%) had a previous diagnosis of obstructive sleep apnea. 68% of patients had primary open-angle glaucoma, 15% low tension glaucoma, 13% had pseudoexfoliation and 4% had pigmentary glaucoma. 23.7% (n=44) of patients had progression of their glaucoma at the time of the study. 62% of these patients were at risk for obstructive sleep apnea. 35% (n=62) of patients had IOP above target. Of these, 74% were at high risk of obstructive sleep apnea. The prevalence of high risk for obstructive sleep apnea was 64% for primary open angle, 59% for normal tension glaucoma, 52% for pseudoexfoliation glaucoma and 85% for pigmentary glaucoma (p=0.4).
Our results show a higher frequency of patients at risk for obstructive sleep apnea (63%) compared to the general population (a large surgical cohort reported 41.2%), with a higher frequency in patients with uncontrolled IOP. Patients with progression of glaucoma did not have a higher prevalence of risk for sleep apnea (62%). The prevalence of risk for sleep apnea was similar between primary open-angle, low tension and pseudoexfoliation glaucoma. A higher prevalence was seen in pigmentary glaucoma although the sample size was small. Despite a high percentage of patients at risk of severe sleep apnea, only 5 had a diagnosis and were on treatment for sleep apnea.
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