Risk For Sleep Disordered Breathing In Patients With Glaucoma

Abstract

Purpose: : Sleep disordered breathing (SDB) represents an independent risk factor for cardiovascular diseases. Scientific studies suggest that SDB also occurs in a higher prevalence in patients with glaucoma^1,2,3. However, it is still unclear how the prevalences between primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) differ. High intraocular pressure and hemodynamic changes are the main risk factors for POAG. The clinical signs of SDB are snoring, repetitive reduction of the respiratory flow but also fragmentation of sleep and is accompanied by fluctuations of blood pressure amplitude and repeated hypoxic phases during sleep. The aim of this study is to evaluate the risk of SDB in patients with POAG respectively NTG.

Methods: : In this prospective monocentric study we screened patients with glaucoma by means of the Berlin Questionnaire for the risk of SDB. The Berlin Questionnaire is a standardized tool which is used to screen patients for the risk of SDB⁴. 66 patients (19 male and 47 female; mean age 67.0±14.1 years; BMI 25,7±4.3) with a diagnosed glaucoma (26 NTG and 40 POAG) have been included in this study so far.

Results: : The Berlin Questionnaire classified 23 out of 66 patients (34,8%) as a high risk group for sleep disordered breathing. According to the Berlin Questionnaire 11 out of 40 patients (27.5%) with primary open-angle glaucoma showed a high risk to suffer from a SDB. In comparison 12 out of 26 patients (46.1%) with a diagnosed normal tension glaucoma demonstrated a high risk for having a SDB.

Conclusions: : As other scientific studies have already illustrated, patients with glaucoma show an increased risk to suffer from sleep disordered breathing. This could be an additional risk factor for the progression of glaucoma. In our study we were able to show a difference in the risk for sleep disordered breathing between patients with POAG and NTG, despite the small number of patients. There was a tendency to a higher risk for sleep disordered breathing in patients with normal tension glaucoma in comparison to patients with primary open-angle glaucoma. In its further course this study will show if this tendency can be confirmed, as a higher number of patients will be examined. Furthermore we are planning objective diagnostics by means of polygraphy and polysomnography in order to get a valid statement in regard of the prevalence of SDB in patients with glaucoma.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • intraocular pressure • intraocular pressure