Sleep Apnea Found to Increase Retinal Macular Damage in Diabetic Patients

Diabetic macular edema a complication of the eye that affects the part of the retina that controls sharp vision, which can lead to vision loss. A new study has identified that this conditions appears to occur more often in diabetic patients who also have severe sleep apnea.  

It is a unique discovery, to say the least, but it is not exactly all that new.  Existing evidence has long suggested that sleep apnea is a major risk factor for aggravating present eye disease.  

Damage to the retina caused by eye disease(s) is typically a result of microvascular injury—injury to the tiny blood vessels which supply the retina.  Studies show that high blood-sugar levels cause the blood vessel walls to bulge, which in turn affects the retinal capillaries smooth inner lining, the endothelial cells.  When these cells are pushed outward, connections between adjacent cells are compromised by fluid and blood leaking out  into the retinal tissue.  This is what causes the inflammation associated with eventual diabetic retinopathy. 

Concurrently, sleep apnea is a sleep-related breathing disorder categorized by a sleeping person have sudden and repeated bouts of temporary stoppage of breathing during the night. This causes transient waking out of a need to breathe.  Theories suggest this stoppage might be caused by repeated blockage of the upper portion of the airway out of reduced muscle tone during deep sleep cycles.  This causes obstructive sleep apnea, and is totally reversible. 

Now, the study advises the patterns observed in obstructive sleep apnea causes poor-quality sleep, of course, as deep sleep is continually disrupted.  This can lead to loud snoring or gasping during sleeping periods, even without waking up.  This irregular respiration pattern causes hpoxia—oxygen deprivation—which then causes damage to the blood vessels. 

The study, then, says that sleep apnea’s association with blood vessel damage indicates that this exacerbates complications for the diabetic retina that can surely lead to diabetic macular edema. 

Lead study author Juifan Chiang describes, “Based on these results, we hope that more medical professionals will approach sleep apnea as a risk for diabetic macular edema.  This could allow for earlier medical intervention so patients can keep more of their vision and preserve their overall health as much as possible.”

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