Papilledema and Obstructive Sleep Apnea Syndrome

Open Access
Publisher Website
Google Scholar
Abstract
OBSTRUCTIVE sleep apnea syndrome (SAS) is characterized by recurrent interruption of normal breathing during sleep owing to upper airway obstruction.1 Patients are typically obese, middle-aged men who have a history of loud snoring and excessive daytime somnolence. In addition to the hypoxia and hypercarbia caused by inadequate respiration, repetitive sympathetic activation during arousal from sleep may cause arterial hypertension, cardiac arrhythmias, and epinephrine-induced platelet activation.2 These metabolic changes may have several cardiovascular and neurologic consequences. Sleep apnea syndrome has been implicated as a cause of myocardial infarction,3,4 stroke,5,6 chronic headache,7 and cognitive dysfunction.7 Neuro-ophthalmic manifestations include visual field defects,8 ischemic optic neuropathy,9 glaucoma,10 and optic disc edema.11 The mechanism for the optic disc swelling associated with SAS has not been fully elucidated. We describe 4 patients with disc edema and SAS to better characterize the pathogenesis and the clinical features of this syndrome.