MEDICAL EXPERTS: Snorers Far More likely To Go Blind!

Do you feel exhausted and sleepy even after a full night’s sleep? Do you snore all night, breathe through the mouth, and feel tired the next day? If you have an affirmative answer to these, then you are probably suffering from obstructive sleep apnea.
Though snoring while sleeping is not considered to be unusual, not many know that excessive snoring is a serious health problem that can lead to grave complications, including blindness, heart problems and high blood pressure, if not treated in time.
This noisy and laboured breathing, often interrupted by gasping and snorting, experts have linked with Obstructive sleep apnea (OSA,) a condition that causes interrupted breathing during sleep and found more predominant in individuals with glaucoma.
Researchers in Taiwan have discovered that obstructive sleep apnea is not simply a marker for poor health, it is actually an independent risk factor for open-angle glaucoma.
In a nationwide, population-based dataset to examine the prevalence and risk of the most common form of glaucoma among patients with the most common form of sleep apnea, they found that people with sleep apnea are far more likely to develop glaucoma compared to those without the sleep condition.
According to the study published in the August 2013 edition of the Journal of the American Academy of Ophthalmology, the risk of developing open-angle glaucoma within five years of an obstructive sleep apnea diagnosis was 1.67 times higher in those who had sleep apnea compared to the control subjects.
Glaucoma is the second-leading cause of blindness worldwide. It is a disease of the eye in which fluid pressure within the eye rises. If left untreated, the patient may lose vision, and even become blind. The disease generally affects both eyes, although one may have more severe signs and symptoms than the other.
There is a small space in the front of the eye called the “anterior chamber”. Clear liquid flows in-and-out of the anterior chamber. This fluid nourishes and bathes nearby tissues. If a patient has glaucoma, the fluid does not drain properly - it drains too slowly - out of the eye. This leads to fluid build-up, and pressure inside the eye rises. Unless this pressure is brought down and controlled, the optic nerve and other parts of the eye may become damaged, leading to loss of vision.
Dr Sola Olawoye, a consultant opthamologist, University College Hospital (UCH), Ibadan, Oyo State, affirmed that several studies have found out that glaucoma and sleep apoea are related considering that a lot of persons that snore also have glaucoma.
According to Dr Olawoye, as a result of insufficient oxygen to the optic nerve due to interrupted breathing during sleep, the optic nerve end is compromised. This is the nerve that carries images of what we see from the eye to the brain. Its damage results to vision loss and blindness.
“As a result, we are beginning to say that some glaucoma cases are not related to raised intra-ocular pressure in the eyes. This is because intra-ocular pressure in the eye oftentimes is within the normal range, which is within the statistically normal range, but they still have glaucoma and many of such cases may be related to sleep apnea.
There are different degrees of sleep apnea-mild, moderate and severe. The degree can be ascertained by using a Polysomnography.
Dr Olawoye, however, stated that for now the moderate and severe forms of sleep apnea are those to worry about when thinking about glaucoma.
“Usually, those with mild sleep apnea are asked to change their lifestyle, do more exercises, eat more green vegetables, stop smoking and lose weight to control it, but for the moderate and severe ones, aside these changes recommended for those with mild sleep apnea, they will also require therapy. They require using the continuous positive air pressure machine.
“What this does is to ensure that the person continues to take in enough oxygen through the night while sleeping. It has been found to be very valuable, especially in those who with normal tension glaucoma and who experience also severe or moderate sleep apnea.
In Nigeria, some centres exist in Lagos where Polysomnography can be done to ascertain the severity of sleep apnea.
Losing weight is of great importance in treatment of sleep apnea. “We know that the airway can get choked up because of the shortness of their neck, fat deposits in the neck region and so on,” she explained.
Can individuals know if they have glaucoma? “Diagnosis of glaucoma can only be done by an ophthalmologist or optician. Individuals cannot detect or know they have eye problem.”
Usually, glaucoma would have started for many years before it is detected by many individuals. The side vision is gradually lost and over time, the central vision is affected. It is only then that the patient knows something is wrong with the eye. Unfortunately, where just one eye is affected to start with, the patient might not realise the loss of vision since the unaffected eye would be trying to compensate.
Dr Olawoye declared: “What we usually advise is that individuals above the age of 30 years see an ophthalmologist at least once a year to have their eye check for the disease.  That the intraocular pressure is normal, however, does not mean a person does not have glaucoma. In people with a type of glaucoma called low pressure or normal tension glaucoma, the intraocular pressure is low.
“The high intraocular pressure is the one that is easy to detect by any trained person who has the machine to pick it, but those other ones who have statistically normal pressures need an ophthalmologist look at their optic nerve to ascertain if they have glaucoma.
“Important, that a person’s parents have glaucoma means  such should be more concerned about ensuring regular eye checks because they have a risk of developing the eye problem. Also, a person that wears prescription glasses needs regular eye checks for glaucoma.”
So, how many people in Nigeria have glaucoma? According to Dr Olawoye, between 7 and 8 per cent of Nigerians may have glaucoma.
“In a recent study that we did in Ibadan in Akinyele local government, about 7 in 100 people above the age of 40 years had glaucoma. Sadly, in many developing countries, including Nigeria, between 90 and 95 per cent of people affected by glaucoma are not aware they have this blinding disease and as such are not seeking medical care.”
While describing glaucoma as a silent epidemic, which is more severe in black people, Dr Olawoye said as people age. In people aged 60 years, about 20 percent have glaucoma. This is because the older people get, the more the risk of developing glaucoma. So, the older one becomes, the more the need to pay attention to one’s eyes.
But are children exempted from problem of glaucoma? “Unfortunately, Nigeria and other West African countries have the highest prevalence of juveniles with glaucoma and often times, the disease is worst in this age group. Often, glaucoma in juveniles is genetic but it does not follow the mendelian inheritance fashion as is the case in sickle cell disease.
“So, the fact that the father and the mother do not have glaucoma does not mean their child cannot develop glaucoma if the disease is in the family medical history, thus making it worse. “
To this end, she urged people with glaucoma to ensure people in their lineage also get tested because everyone is at risk of developing this blinding disease.