The Eyes Have It

[papoose]

I've been a member of this forum for a few months now, have learned a lot, but I've never posted. My numbers indicate that I'm doing well on CPAP therapy, but after four months, I haven't yet begun to feel better. I still find myself fully awake every hour or so, and have the same tired feeling in the morning.

My apnea is severe, mixed, and lifelong. I was finally diagnosed at age 56, after I had developed many complications. I've read that feeling the positive effects of CPAP therapy may take time, because my condition took so long to develop. I certainly don't expect to recover overnight.

But I don't expect to feel worse, either. One complaint that seems to have worsened is an annoying eye twitch. Both eyes have twitched for about three years now, off and on, but now it's relentless in the right eye. The twitching muscle is under the eye, not controlling the eyelid.

When I first reported this to my doctor, who observed it (everyone can see it), he advised, "hypervigilant people like you often experience eye twitch. Just lose 15 pounds and it should go away." Really. When I was finally diagnosed with OSA, he said the eye twitch was probably caused by sleep deprivation. I'm wondering if anyone else has experienced a similar reaction to poor sleep, and if the eye twitch ever went away.

I should also mention that I have another neurological problem related to the eyes. Two years ago, an ophthalmologist told me I had "dry eye" due to an "incomplete blink." (The bottom portion of both corneas is not hydrated when I blink because the eyelid doesn't close properly.) This caused me to avoid CPAP masks that could possibly leak into my eyes, but I think even the exhaust from the nasal pillows is somewhat bothersome. Since beginning CPAP therapy, I awaken with teary eyes, a sign that they are quite dry. I'm beginning to consider wearing goggles at night, which should be a sight with my nasal pillows, chin strap, and wrist splint I wear for carpal tunnel syndrome.

Thanks for any advice or encouragement.

[JeffH]

papoose, I have eye troubles too. I use Lacri-lube eye ointment in my eyes at night for lubrication. If you try it, in the morning, use a dab of baby shampoo on a warm wet washcloth to clean your eye lids with.

Good luck


JeffH

[Julie]

Look up Sjogren's syndrome... it will explain more about the dryness. The twitch will go away when you find some way to relax. Every try meditation? Could your MD let you try something mild that just relaxes you a bit before bed?

[VenDexter]

You may want to ask your MD for a referral to a neurologist.

Constant twitching of any type can be an indicator of many different things.

Have you had your thyroid checked recently? With the fatigue you still feel along with the twitching, it may be a good place to start.

[Vettecraze]

I second the motion for a neurologist referral, get it checked at your earliest convenience. Hopefully you can get some kind of treatment for that.
I have MS but didn't fit the profile at first, got checked and still took about 2yrs to get diagnosed. I am not saying you have MS but neurological symptoms should be taken serously. You don't want any kind of nerve damage.

[roster]

............ The twitching muscle is under the eye, not controlling the eyelid..........

My goodness, I had forgotten about that. In hindsight, I contribute it to my sleep deprivation and total exhaustion from undiagnosed osa. The problem went away after I started cpap therapy.

[barbpsleep]

Papoose, I don't know about the twitching, though now that you mention it, I recall times when I've been very tired when I've felt a kind of pulsing under my eye. Not sure that this is the same thing though.

Re the dry eye, though you note you'd been diagnosed with it previously, it's possible that it's being aggravated by the exhaust, depending at least in part on the mask design. Do you feel the air blowing up on your eyes? What's your pressure at and what mask are you using?

Shortly after beginning CPAP use, I began having excessive tearing. I didn't connect the two at first and neither did the ophthamologist. I was even sent for a sinus scan to rule out a blockage that was causing the tearing. At some point, it became obvious to me that it was the exhaust and the ophthamologist agreed. I too use the baby shampoo many mornings. I find that adding a couple of over the counter eye drops before bed and in the morning has helped too.

Good luck. It's frustrating when treatment for one issue aggravates another.

Barbara

[RosemaryB]

I agree with the suggestions to see a neurologist. But I also wonder if you drink enough water. If I get dehydrated, I get drier, including my eyes.

[papoose]

Thanks to all who have responded. I’m amazed that in just 24 hours, I received all sorts of ideas and advice…

JeffH: I’ll look for Lacri-lube eye ointment at my drug store. It might be more effective than the artificial tears I currently use.


Julie: Thanks for reminding me about Sjogren’s syndrome. I was tested for that and thankfully, I don’t have it. But the website I just checked gave me some good ideas about coping with dry eyes.

VenDexter, Vettecraze, and RosemaryB: Would you believe that my doctor referred me to a neurologist, sent my paperwork, but when I called for an appointment, they refused to see me because I had sleep apnea? The “gatekeeper” at the neurologist’s office said I should first see the pulmonologist who interpreted my sleep studies. Excuse me. I’m now scheduled to meet with the pulmonary specialist, and if necessary, I’ll ask her to send me to a different neurologist. Perhaps the one who treats my husband for his MS. I hope I don’t have that, as my husband depends on me for everything. (MS took his eyesight and his energy.)

Rooster: I’m glad your twitch went away. I’m hoping that with more effective treatment, mine will, too. My current setup, I think, does not address the central apnea reported in my initial sleep study.

Barbpsleep: Yes, the twitch is like a pulsing sensation under my eye, and definitely noticeable. More troublesome is that it distorts my vision. For example, I cannot read when it’s pulsating. BTW, my pressure is at 10 cm H20. I tried 11 for several days, but it only made my sleeping worse.

[Vettecraze]

You might be able to mention your problem to your husband's neurologist on his next visit. You know, first impressions are usually an indicator of the kind of service you might expect. And the first impression with that neurologist office is not good.
Good luck in finding a solution,

Ernesto

[hairnet]

I too have had a twitch in my right eye for several years. The eye doctor kept saying it would go away but after about a year I went to see a neurologist and was diagnosed with something called hemifacial spasm. That will not go away on its own. Botox is one solution for short term relief, however, I have not chosen that as it has to be repeated every few months and is quite expensive. You might want to Google Hemifacial Spasm and read more. Don't think there is any connection to my OSA.

[geoDoug]

Please take anything involving the brain seriously. As others have said, an ongoing twitch of any kind can be a lot of things. It could also be a mild partial seizure. (Epileptic seizures take many forms.)

I'd search out another neuro who will really listen to you and if they feel it's warranted (and you agree) order a comprehensive exam. (including an EEG possibly?) Your initial contact with that first one would be enough to make me look for somebody else. It sounds like they're not terribly interested in listening to your concerns, despite the fact that you know your body better than anybody else ever well.

Doug.

[Julie]

Hairnet - I think you might have hit it on the nose - ain't botox great?

[papoose]

Hairnet: Your post reminded me that I, too, was diagnosed with hemifacial spasm at least 3 years ago by an ophthalmologist. For years prior to that, I experienced occasional eye (and mouth) twitching after periods of sleep deprivation. (As a writer, I had a habit of working all-nighters, and after such sessions, I twitched all over.) But when the eye twitch became almost ever-present, I sought the advice of an ophthalmologist. She asked me if I had ever experienced mouth twitching on the same side of the face as the eye twitch. When I said yes, she said I had hemifacial spasm and gave me a brochure. I read that there is a nerve running vertically from the lower corner of the eye to the upper corner of the lip. When inflamed, this nerve twitches both the eye and the mouth at once. This was never the case with me. I had always experienced lip and eye twitching as separate events. And unlike hemifacial spasm, my twitching occurred on both sides of the face. After reading this, I figured that this was yet another wrong diagnosis. I forgot about it until your post. I would hate to tell you how many other wrong diagnoses I’ve collected in my lifetime with sleep apnea.