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What happens to glaucoma patients during sleep?
1University of Illinois Eye and Ear Infirmary, Chicago, IL, USA. ahmadaref@gmail.com
Current Opinion in Ophthalmology
|December 25, 2012
Summary
Nighttime events like increased intraocular pressure (IOP) and decreased ocular perfusion pressure (OPP) can advance glaucoma. Understanding these nocturnal factors is crucial for managing glaucomatous optic neuropathy effectively.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Glaucomatous optic neuropathy can progress despite controlled office-measured intraocular pressure (IOP).
- Nocturnal physiological changes may significantly impact glaucoma development and progression.
Purpose of the Study:
- To review recent findings on nighttime events contributing to glaucomatous optic neuropathy.
- To elucidate the role of nocturnal intraocular pressure (IOP) and ocular perfusion pressure (OPP) in glaucoma.
Main Methods:
- Literature review of recent reports on nighttime events and glaucoma.
- Analysis of studies investigating IOP fluctuations during sleep.
- Examination of the association between obstructive sleep apnea (OSA) and glaucoma.
Main Results:
- Peak intraocular pressure (IOP) often occurs during sleep due to body positioning.
- A 30° head-up sleeping position effectively lowers nocturnal IOP.
- Nocturnal IOP elevation and decreased blood pressure reduce ocular perfusion pressure (OPP), increasing glaucoma risk.
- Conflicting evidence exists regarding obstructive sleep apnea (OSA) and glaucoma association.
Conclusions:
- Increased nocturnal IOP, decreased OPP, and potentially OSA are implicated in glaucoma progression.
- These nighttime factors may explain disease progression despite seemingly controlled daytime IOP.
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