Can CPAP therapy alter nasolacrimal duct drainage in patients with obstructive sleep apnea?

Abstract

Purpose To investigate whether the use of continuous positive airway pressure (CPAP) therapy due to obstructive sleep apnea (OSA) affects the nasolacrimal duct (NLD) drainage. Methods In this prospective study, group 1 included 82 NLDs from 41patients with OSA who were treated with CPAP at least 6 months to 2 years. Group 2 included 68 NLDs from 34 patients with OSA who received no CPAP therapy. Group 3 included 70 NLDs from 35 healthy volunteers, with no nasal/paranasal or nasolacrimal system problems. Nasolacrimal drainage times of participants in all groups were measured by observing the fluorescein-containing eye drops administered into the eye via endoscopic visualization of Hasner’s valve area. The time of nasolacrimal drainage was compared between the three groups. The correlation of NLD drainage time with PAP pressure and CPAP usage was investigated. Results The NLD drainage time of group 1 was significantly shorter compared both to the group 2 (p=0.001) and group 3 (p<0.001). Correlation analysis revealed a statistically significant negative correlation between NLD drainage time and CPAP pressure (p<0.01, r=−0.305) and no correlation between NLD drainage time and CPAP treatment duration (p=0.304, r=0.115). Conclusion CPAP usage changes NLD drainage time in patients with OSA who regularly use CPAP.