Swollen eyelids from CPAP are very common because the mask often leaks, so you don’t get as much air pressure as you need, and the mask can push air into your eyes, making your eyes puffy, dry, and swollen.
If you are searching for answers about CPAP machines and potential dry eye. You are in the right place for those who don’t know a continuous positive airway pressure machine or CPAP is a device that is frequently prescribed for treating sleep apnea. A CPAP can be very effective at helping people get more oxygen while they sleep.
Dry Eyes from CPAP
Those using this type of machine also have a much higher rate of dry eye, which is where I commit, so if you have a CPAP and feel worried, don’t worry. There are ways to help prevent dry eye and treat it if it does occur and we will talk about all of that in this article.
We know that the prevalence of dry eye disease has been estimated to from like you know 6% up to more than 20% among adults in the United States. However many patients are not diagnosed with dry eye disease clinically because they assume their eye irritation could be related to allergies or exposure or just some type of irritant.
In other words, we normalize our symptoms of dry eye and then patients will oftentimes try to treat dry eyes at home with little to no improvement.
But If you have sleep apnea and you are sleeping with CPAP and you are noticing that in the morning you have symptoms of dry eye disease which can range from redness of your eyes, irritation feeling like something in the eye we call that foreign body sensation. It could even be watering your eyes that you notice in the morning then you very well could have a dry eye disease that’s related to the use of a CPAP machine for sleep apnea.
Dry Eye Causes
So if you are new to the world of dry eye disease you may not know the symptoms to be looking for or what dry eye is so we are going to go over that in this article.
Dry eye is a common condition it occurs when your eyes either don’t make enough tears or for some reason you are unable to maintain a layer of tears to protect and coat your eyes. When there is a lack of tears it results in inflammation of your ocular surface and damage over time.
Other Dry Eye Causes
Airborne Environmental Factors
There are other causes of dry eyes so we know that the prevalence increases with age. We know that there are airborne environmental factors like dust, smoke, wind, and irritants that can cause dry eyes.
Contact Lenses
You can also have dry eyes from wearing contact lenses or improperly cleaning your contact lenses. You can have dryness from allergies I always say that allergies and dryness tend to live in the same house. So if you have always had eye allergies you may be more at risk for dry eye and vice versa.
Medications
If your dry eye is flaring up you might notice that you are more susceptible to allergy season you can also have dry eye from medications like antihistamines, antihypertensive, and hormonal medications can cause dry eyes.
Autoimmune Conditions
Autoimmune conditions such as Sjogren’s syndrome, rheumatoid arthritis, or lupus are all connected with dry eye and even other health conditions like diabetes, psoriasis, rosacea, irritable bowel syndrome (IBS), or vitamin A deficiency.
Blepharitis
Then we have some eye conditions we know that there is a higher rate of dry eye in patients who have lash margin issues like blepharitis which is an inflammation at the base of the eyelashes and the lid margin and meibomian gland dysfunction. When the oil glands along the eyelid rim become clogged, blocking the tear supply.
Floppy Eyelid Syndrome
There is also floppy eyelid syndrome which is linked to both dry eye and sleep apnea. So floppy eyelid syndrome is when your eyelids don’t close completely during sleep. The lid gets floppy. The ocular surface is exposed to air and dries out. This makes the eyes particularly irritable when the patient awakens.
Other Factors
You can also develop dry eyes from a combination of these factors plus cold weather or excessive screen time. Sometimes it’s like an inciting event. You just have a long workweek. You have been on the screens a lot and it incites this dry eye that you tend to not be able to get rid of.
Dry Eye Symptoms from CPAP
Here are dry eyes symptoms:
- Watery eyes
- Red eyes
- Eye itching
- Burning sensation in the eye
- The sense of dust or grit in the eye
- Blurry Vision
- Feeling as if eyes are heavy or tired
- Extra discharge in and around the eyes
So we have talked about dry eye and some of the symptoms, and you might at this point think okay. I might have some of those symptoms maybe I have dry eye. I know I have sleep apnea. I know I have a CPAP machine I use. I think this is but let’s talk about the CPAP machine just a little bit first and how it works, and then we will talk about how they are linked.
So CPAP machines provide steady consistent air pressure so oxygen will travel through your airways. However, many CPAP users will experience air leaks from their machines which can cause a constant airflow over their eyes.
There is a larger problem if your mask is either too big or too small, incorrectly shaped, and doesn’t fit well. Some of my patients will notice this after they have gained a lot of weight or lost a lot of weight, and they haven’t gotten their CPAP readjusted.
So if it’s something like that you may just need to go in and have your doctor adjust your CPAP. So it fits you right so you don’t have that extra airflow going over your eyes because that constant airflow is what leads to eye irritation, swelling, and dryness.
If you don’t address this issue it can become a chronic issue, and you may have dry eye all the time not just in the mornings. specifically, from the flow of oxygen often individuals who use a CPAP have other medical conditions like high blood pressure and diabetes.
These conditions are independently associated with dry eye as well so they may be also contributing to your dry eye. So if you are feeling pretty sure that your CPAP is contributing to your dry eyes.
How to keep your eyes from drying out from CPAP?
You are probably wondering how then prevent that from happening because you need your CPAP so there are a few things you can do to ensure that you are treating your sleep apnea properly and also minimizing that risk of developing or worsening your dry eye disease.
- Make sure you are wearing your CPAP properly and that all parts are in good condition.
- Ensure a proper fit the absolute biggest culprit of dry eyes related to CPAP use is an improperly fitting mask.
- If it’s too big, too small, or the incorrect shape, there could be air leaks around that seal and this air is usually blowing directly into your eyes causing dryness, to fix this issue have a technician work with you at your doctor’s office.
- And make sure that you are wearing a prescribed fit.
- You may also benefit from replacing a full face mask with nasal pillows. they leak a little bit less.
- You can also check your pressure settings. They might not be set right. To fix this check your settings, and relay them to your technician or healthcare provider. If those are not correct get help adjusting them to the correct setting.
- Clean your machine regularly on the manufacturer’s suggested schedule.
- Avoid applying oily moisturizers at night around the mouth and nose where the mask attaches.
- Use a humidifier to add heated moisture into the air circulating through the machine.
- Check that everything is working perfectly to make sure you don’t need to replace something.
- Wear a rubber mask while using the CPAP machine to create a nice seal around your eyes.
- Use an ointment before going to bed. It will stay longer on the eyes.
It helps your eyes if you are struggling with dry eye. We know that studies have found the incidence of dry eye disease is higher in patients who have a CPAP and even if you didn’t have dry eye disease before.
As an eye specialist, I can tell you that sometimes patients it’s like an inciting event you know you start using a CPAP to treat your sleep apnea and it sort of kicks things off.
It kicks off this inflammatory cascade and maybe you have diabetes as well COPD (Chronic Obstructive Pulmonary Disease), or hypertension, or something and so it’s just sort of this straw that broke the camel’s back and the CPAP pushes you over the edge and now you have a dry eye so it can be just a very you know day to day thing maybe sometimes the air flows weird and your eyes get dry and it’s just once in a while but a CPAP certainly can cause.
You sort of push yourself over the edge into having dry eye every day and if that’s the case I would recommend talking to your eye doctor because you may have floppy eyelids that can affect all of this, and your eye care provider can help.
