It has been found that the incidence of dry eye disease (DED) is higher in patients with obstructive sleep apnoea which then has been treated utilizing a continuous positive airway pressure (CPAP) device or other nasal mask treatment devices.
There is also a gender factor to this enhanced incidence of DED, with women with rest apnoea having a greater incidence.
“As eye care providers and caregivers, and the first line of treatment in specialised eyecare, we need to begin by asking our patients whether they use a CPAP device for the simple reason that DED is more prevalent among this subgroup,” stated an ophthalmologist.
While the occurrence of Dry Eye Disease is considered to be approximately 6.8% in US adult citizens, the percentage of patients that have actually been diagnosed clinically with DED is much less than fifty percent of that, due to the low incidence of diagnosis.
The occurrence of DED amongst women is practically double that among men, i.e., 8.8% versus 4.5%, specifically. Normally, the frequency of prevalence rates changes with age, ranging from 2.7% persons aged from 18 to 34 years approximately to 18.6% in those 75 years and older, she explained.
Sleep apnoea affects both males and females. However, it is significantly higher amongst males at 13% to 14% compared to 5% to 6% amongst Females, as well as the prevalence rates have increased significantly over the last decade.
Interestingly, the preferred treatment for sleep apnoea is connected with ocular conditions, that is, ocular irritation caused by air flow from a leaky mask or retrograde nasolacrimal escape of air, she noted.
Retrospective descriptive analysis
In light of the stats, the doctor as well as colleagues analysed data to identify real-world associations between DED as well as sleep apnoea.
The investigators took a look at information between Jan. 1, 2013, to June 30, 2018, consisting of the inpatient/outpatient medication experience among several million people covered by a selection of insurance coverage strategies.
The research study, consisted of adults, if they had several cases of CPAP or other nasal mask device usage throughout the research study duration, one or more inpatient/outpatient diagnoses of sleep apnoea in the year prior to the onset of device usage, continual registration in a medical or pharmacy insurance policy program for one year or longer before and also after the first date of the study, as well as no diagnosis of DED in the twelve month before onset of device use.
A total amount of 330,926 individuals (median age, 53 years) were included in the study, 65% of whom were males. Overall, 13,176 patients had DED. The most frequent patient comorbidities were diabetic issues (22%) as well as chronic obstructive pulmonary disease (COPD) (18%). One of the most frequently utilized medicines were antihypertensives (58.2%), antidepressants (32.5%), and also anxiolytics (31.3%).
The doctor and colleagues found important associations with the raised incidence of DED in this patient population while studying the usage of CPAP devices over age, gender, time, specific comorbidities, and also duration of mask use.
According to the doctor, the one-, two-, and three-year DED incidence rates after starting use of CPAP or an additional nasal mask device were, respectively, 4.0%, 7.3%, and also 10.3%, which is an increasing prevalence with usage duration of the devices in question.
The occurrence of DED increased with age; the one-year occurrence rates ranged from 1.6% in patients 18 to 24 years old as well as 11.2% in those aged 75 years and older. The one-year occurrence rate in women was higher than in men, 5.8% compared with 3.0%.
The existence of specific comorbidities made a distinction, that is, the incidence of DED was greater in the existence of psoriasis, with an occurrence of DED of 9.1%; COPD, 5.4%; irritable bowel syndrome, 5.3%;. diabetes mellitus, 5.1%; as well as rheumatoid arthritis, 5.0%.
The findings were that the occurrence of DED was exacerbated both during the second year of use of a device compared with the general incidence of DED amongst the basic populace of US adults in addition to being based on the duration of time during which the device was utilized.
Users of the CPAP devices that were females, older, or had comorbid inflammatory or metabolic problems experienced a greater incidence of DED.