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CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0043-1777784
Case Report

Looking beyond in Sleep Medicine Practice: Effect of OSA Management in Floppy Eyelid Syndrome – A Case Report

Helya Bolouki-Azari 
1   School of Medicine, Tehran University of Medical Sciences, Tehran, Tehran, Iran
2   Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Arman Soleimani
1   School of Medicine, Tehran University of Medical Sciences, Tehran, Tehran, Iran
2   Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
,
Arezu Najafi 
2   Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
3   Sleep-Disordered Breathing Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
,
Hamed Amirifard
4   Department of Neurology, The Iranian Center of Neurological Research, Department of Neurology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
› Author Affiliations Funding The authors declare that the present research received no specific grants from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Obstructive Sleep Apnea Syndrome (OSA) is a common sleep disorder characterized by recurrent episodes of partial or complete upper airway obstruction during sleep. Floppy Eye Syndrome (FES) is a condition in which the upper eyelids easily evert with upward traction due to underlying tarsal plate laxity and is associated with chronic, reactive papillary conjunctivitis; this causes the eye to be vulnerable to discomfort and visual symptoms. A 49-year-old man with an 8-year history of snoring, sleep fragmentation, and daytime sleepiness was admitted as an outpatient in our sleep clinic. The patient had complied ocular symptoms such as burning eyes, redness, and irritative ocular symptoms in the past five years, arising upon waking up. The symptoms did not regress with the use of artificial tears and proper ointment. The patient was diagnosed with OSA and began using continuous positive airway pressure (CPAP). CPAP therapy significantly corrected the symptoms of FES associated with OSA . This would help to sensibilize ocular findings in patients with OSA and identify hidden sleeping diseases needing a more appropriate investigation and possible treatment. We must look beyond our approach to sleep clinic patients and avoid being kept to the common symptoms patients represent.

Keywords

Obstructive sleep apnea syndrome - OSA - Floppy eyelid syndrome - FES - sleep - CPAP

Ethical Considerations

Informed consent was obtained from the patient for the inclusion in the study.


Authors' Contributions

HBA: literature review, data collection, and writing and editing of the manuscript draft; AS: literature review, data collection, and writing of the manuscript draft; HA: patient management and follow-up, and review and editing of the manuscript. AN patient visit, management, and follow-up, and writing, review, and editing of the manuscript draft.




Publication History

Received: 14 March 2023

Accepted: 25 August 2023

Article published online:
20 February 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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