Apnea·

The Link between Age Related Macular Degeneration (AMD) and Sleep Apnea

AMD is an eye disease that affects people over 50, causing vision problems and possible blindness. In this article you will discover the link between AMD and sleep apnea. Sleep apnea is a common condition where breathing stops during sleep.

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Introduction to AMD

AMD is a chronic, progressive, multifactorial disease that mainly affects people over the age of 50. It is an incurable disease in which vision deteriorates, leading to blindness. During normal vision, light enters the eye through the cornea, passes through the pupil and lens, and converges on the macula at the center of the retina (see Figure 1). When the macula is affected, the individual loses central vision, as illustrated in Figure 2. This loss of vision is often accompanied by difficulties in carrying out activities of daily living, and therefore influences the quality of life not only of those affected, but also of their loved ones.

Figure 1. Anatomy of the human eye

Figure 1. Anatomy of the human eye

Figure 2. Illustration of central vision loss in people with AMD

Figure 2. Illustration of central vision loss in people with AMD

Exploring Sleep Apnea

Sleep apnea is a prevalent condition characterized by frequent interruptions in breathing during sleep, leading to insufficient oxygen intake by the body. If you exhibit symptoms like snoring, gasping, or other signs of poor-quality sleep such as excessive daytime sleepiness, it is advisable to consult your healthcare provider regarding sleep apnea.

There are two distinct types of sleep apnea:

  1. Obstructive sleep apnea (OSA) occurs when the upper airway experiences repeated blockages during sleep, resulting in decreased or complete cessation of airflow. ( Figure 3) This form of sleep apnea is the most commonly observed. Risk factors for obstructive sleep apnea include obesity, enlarged tonsils, hormonal changes, or anything that may narrow the airway.
  2. Central sleep apnea (CSA)arises when the brain fails to transmit the necessary signals for breathing. Underlying health conditions affecting the brain's control over the airway and chest muscles can lead to central sleep apnea.

Figure 3. Illustration of obstructive sleep apnea

Figure 3. Illustration of obstructive sleep apnea

The Link between AMD and Sleep Apnea

There is a potential link between AMD and sleep apnea. Several mechanisms have been proposed to explain this connection:

  • Oxygen Deprivation: Sleep apnea episodes can lead to intermittent drops in blood oxygen levels (hypoxia) due to reduced airflow. This hypoxia may contribute to retinal damage and the development or progression of AMD.
  • Systemic Inflammation: Sleep apnea has been linked to chronic systemic inflammation. Inflammation plays a significant role in the pathogenesis of AMD, and the systemic inflammation associated with sleep apnea could potentially exacerbate retinal inflammation.
  • Vascular Factors: Sleep apnea can cause vascular changes, including endothelial dysfunction and increased oxidative stress. These factors may impair blood flow to the retina, leading to the development of AMD.

Management and treatment methods

Continuous positive airway pressure (CPAP) is the main treatment for sleep apnea. Its use has been associated with improved visual acuity and reduced risk of progression in AMD patients with sleep apnea. Patients are encouraged to adopt a healthy lifestyle, including weight control, regular exercise and smoking cessation, can help mitigate the risks associated with AMD and sleep apnea. In addition, close cooperation between ophthalmologists, sleep medicine specialists and other healthcare providers is essential to ensure comprehensive care for patients suffering from both conditions.

Conclusion

AMD is a progressive disease that affects vision, while sleep apnea is a condition characterized by interrupted breathing during sleep. There is a potential link between AMD and sleep apnea due to factors such as oxygen deprivation, systemic inflammation, and vascular changes. Treatment for sleep apnea involves using continuous positive airway pressure (CPAP), which can benefit AMD patients. Adopting a healthy lifestyle and interdisciplinary collaboration among healthcare providers are essential for managing both conditions effectively.

Bibliography

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