Ocular Pressure / eye issues related to cpap mask types?

[Cowboyup]

Been reading up as much as I can on this subject. Seems to be lots info relating inter ocular pressure increase / optic nerve swelling when using cpap.

Any idea if full face masks are prone to this more so than nasal masks?

[Julie]

Are you sure you're not confusing e.g. apnea induced glaucoma symptoms with using Cpap?

Otherwise, I don't know what you're referring to.

[ChicagoGranny]

Been reading up as much as I can on this subject. Seems to be lots info relating inter ocular pressure increase / optic nerve swelling when using cpap.

Any idea if full face masks are prone to this more so than nasal masks?

I believe you are worrying about the wrong thing. Here is a reasonable article with links to medical studies:

"... There have been a number of studies showing the reduction in IOP among glaucoma patients following use of a CPAP machine. Still, the complexities of glaucoma as well as the wide variations in OSA severities make a direct correlation more elusive. Some studies have suggested that CPAP therapy can even raise IOP to some degree, but many researchers generally agree that the risk is possible in a smaller subset of OSA patients.

Even then, most researchers and medical experts see the increased oxygen levels attained through use of a CPAP machine and the overall health benefits far outweighing the hypothetical risks. ... Intraocular pressure (IOP) is known to vary throughout the day and night with the highest pressures occurring during sleep. While these changes happen for everyone regardless of health, the reasons are still unclear.

http://www.thecpapshop.com/blog/sleep-apnea-glaucoma/

[Cowboyup]

Thanks for your reply’s! Here is an example of one I book marked.


https://www.ncbi.nlm.nih.gov/m/pubmed/18326715/

[Matt00926]

It's complicated as both treating and not treating OSA results in hemodynamic consequences. As far as I know, using CPAP can improve blood pressure and blood flow through the arteries. Just like when you quit drinking caffeine, there is improved cerebral blood flow. It would be interesting to see a longer-term study to trace the changes in IOP over time, as of course it can take many months, and sometimes years, for CPAP therapy to drastically change the way your body functions. And of course the person actually has to use their machine every time they sleep, and keep the mask on all night!

No idea regarding the differences between masks. To add to that, I wonder if APAP would have less consequences than a straight pressure, as at lower pressures it would not increase thoracic pressures the same level the entire night--only when pressures increase in reaction to events.

[chunkyfrog]

The very idea is nonsense, but if it were not:

Given the choice of living an extra 20 years, but losing my sight,
I WOULD LEARN BRAILLE.
It is a no-brainer.

[Matt00926]

Given the choice of living an extra 20 years, but losing my sight,
I WOULD LEARN BRAILLE.
It is a no-brainer.

Most people with Glaucoma don't even lose their sight. If you listen to your doctor, and take the prescribed eye drops as directed, odds are very good that you will see up until the moment you croak.

[chunkyfrog]

DONE. and done.
Note here:
I croak rather often, umm, being a frog.

[Duck]

Thanks for your reply’s! Here is an example of one I book marked.


https://www.ncbi.nlm.nih.gov/m/pubmed/18326715/

You know that is a very weak study? By the authors' own admissions:

Study Limitations
We did not have a matched control group. It is difficult, however, to find obese middle-aged patients without the presence of comorbidities such as arterial hypertension, metabolic syndrome, and diabetes, which act as confounding factors and would potentially influence all measurements performed in our study. Furthermore, the number of studied patients was limited. There are no studies, however, involving assessment of ophthalmic alterations in OSA before and during CPAP therapy.
An additional weakness, common to all sleep studies, is that the patients must be awakened from sleep to check IOP. This is an inevitable drawback, but does not affect the pre- and posttreatment comparison.

This also brings serious questions about the validity of the study and conclusions:

One month after onset of CPAP therapy

They measured the patients at the end of their first month on CPAP!

If you read this forum just a bit, you will find how the first month of CPAP often goes - mask leaks, machine pressure settings not optimized, difficulty sleeping with mask, unresolved aeropaghia and on and on.

As a CPAP user, this study does not cause any concern in my mind.

[Cowboyup]

Thanks for your reply’s! Here is an example of one I book marked.


https://www.ncbi.nlm.nih.gov/m/pubmed/18326715/

You know that is a very weak study? By the authors' own admissions:

Study Limitations
We did not have a matched control group. It is difficult, however, to find obese middle-aged patients without the presence of comorbidities such as arterial hypertension, metabolic syndrome, and diabetes, which act as confounding factors and would potentially influence all measurements performed in our study. Furthermore, the number of studied patients was limited. There are no studies, however, involving assessment of ophthalmic alterations in OSA before and during CPAP therapy.
An additional weakness, common to all sleep studies, is that the patients must be awakened from sleep to check IOP. This is an inevitable drawback, but does not affect the pre- and posttreatment comparison.

This also brings serious questions about the validity of the study and conclusions:

One month after onset of CPAP therapy

They measured the patients at the end of their first month on CPAP!

If you read this forum just a bit, you will find how the first month of CPAP often goes - mask leaks, machine pressure settings not optimized, difficulty sleeping with mask, unresolved aeropaghia and on and on.

As a CPAP user, this study does not cause any concern in my mind.

Ya, it’s pretty short. But Their are others on the same subject if you look for them. If you read my post, it’s clear that I’m not asking you about the correlation between cpap use and an increase in iOP. I’m asking if folks were aware of what type of mask might be referenced. But hey, if you feel better not worrying about it, that’s great.

[ezliv]

My ocular pressure has increased significantly since going on Cpap. I am now in the glaucoma range. I also was wondering if a full face mask would be better than nasal pillows to remedy that. One study I found was suggesting ocular pressures should be measured before Cpap is started and monitored thereafter. Seems to me not enough research yet to be helpful.

[SewTired]

If you have concerns, bring them up with your eye doctor. Talk to your eye doctor. You can arrange to have more frequent eye pressure tests without having a full visit, often at no charge. But even with my pretty bad eye issues, the doc said the risk of increased pressure is far outweighed by the benefit of the additional oxygen.

I didn't end up having to have 'special' visits to check eye pressure that first year because I was having a vision crisis anyway and had to go in nearly every month. There was no indication that cpap raised my eye pressure, but did contribute to my dry eye problem. Still working that problem.

Total Face masks by Respironics are contraindicated for people with abnormal eye pressure on the theory that it could increase the eye pressure. I thought I read that there was a study, but don't remember now.

[SewTired]

Given the choice of living an extra 20 years, but losing my sight,
I WOULD LEARN BRAILLE.
It is a no-brainer.

Actually, I would rather die than lose my sight. To each their own. I was far more distressed about my losing my sight than even caring that I had a very bad cancer (same aggressive one that killed my sister last year). That said, without a pacemaker, cpap is the best way to treat my low oxygen and I've made it work for me (and it's working much better with the larger pillows - thanks Pugsy).

[SewTired]

My ocular pressure has increased significantly since going on Cpap. I am now in the glaucoma range. I also was wondering if a full face mask would be better than nasal pillows to remedy that. One study I found was suggesting ocular pressures should be measured before Cpap is started and monitored thereafter. Seems to me not enough research yet to be helpful.

I know from other postings that people can experience a difference in dry eye depending on which mask they use and their specific eye structure, but not sure that there would be a difference in eye pressure. I know that I get worse dry eye with the full face (I only use it when I absolutely cannot breathe through my nose).

I would just say to talk to your eye doc. My high eye pressure isn't caused by glaucoma even though I use glaucoma drops so my eye doc is working from a different angle.

[ChicagoGranny]

CONCLUSIONS:
Patients with OSA demonstrated significant 24-hour IOP fluctuations, with the highest values at night. CPAP therapy causes an additional IOP increase, especially at night. Regular screening of visual fields and the optic disc is warranted for all patients with OSA, especially those treated with CPAP.

https://www.ncbi.nlm.nih.gov/pubmed/18326715