CPAP Therapy and the Eye Irritation Problem

Last Updated on March 30, 2021

It is not uncommon to hear about eye irritation from those who use CPAP to treat sleep apnea. This side effect is not dangerous in the vast majority of cases, but can cause considerable discomfort. If not treated in time, it can lead to microtraumatization and inflammation – conjunctivitis. But if you understand the cause of the problem, it can be eliminated or at least significantly reduced.

In May 2020, a group of scientists from New Jersey (USA) published the results of their work, which confirmed the link between CPAP therapy and the possibility of chronic eye irritation. The researchers analyzed data from nearly 331,000 patients and found complaints of discomfort and signs of mucosal eye inflammation in more than 13,000 patients.

They found that the risk of developing eye problems increased with long-term use of the CPAP device. For example, after the first year of treatment, only 4% of patients showed side effects, and after 2 and 3 years, 7% and 10%, respectively.

Chronic Eye Irritation During CPAP Therapy

Eye discomfort occurs when the amount of tears produced is not enough to moisten the mucous membranes. The following discomfort is easy to suspect:

• Tingling, itching, and a desire to rub the eyes – they seem to “burn” and itch;
• Redness up to the development of inflammation – conjunctivitis;
• Increased sensitivity to light;
• A heavy eyelids and rapid eye fatigue;
• Deterioration of vision, especially at night;
• Feeling of a foreign body (“sand”) in the eyes;
• profuse tearing, but the tear fluid produced is of poor quality and therefore cannot moisten and protect the eyes.

The inability of the lacrimal glands to cope with their function can be related to a number of medical conditions. But in the case of CPAP therapy, it is most often due to external irritants.

Causes of Dry Eyes with CPAP Therapy

It is important to take into account all factors that can cause dryness and irritation of the mucous membranes of the eyes. The following are the causes caused by CPAP therapy. But if the problem was bothering you even before you started snoring treatment, and then it only got worse, you should definitely see an ophthalmologist.

Air leakage from under the mask

The main cause of dry eyes with CPAP therapy is air leakage from under the mask. The airflow partially enters the eye area and evaporates the tear fluid. As a result, the mucous membranes dry out and become inflamed.

Air may leak in the following cases:

• The mask does not fit the shape or size of the mask;
• The mask is not properly adjusted and does not fit snugly enough on the face;
• The mask is worn out and needs to be replaced;
• The therapeutic pressure required to relieve the apnea is very high.

Irritated eyes can be exacerbated by air conditioning in the bedroom, which lowers the humidity, as well as some chronic diseases, initially predispose to inflammation and dry eyes.

How to Solve the Problem of Dry Eyes

Dry and irritated mucous membranes are uncomfortable and reduce quality of life, especially if sharp vision is critical in your line of work. It can ultimately shake your commitment to this treatment. Here are some tips to help your eyes.

Tip 1 (the main one!). Make sure the mask is airtight

With CPAP therapy, dry eyes are most often a mucosal reaction to air leakage, so it’s important to deal with the mask first.

First, it must fit the size. When buying a product in an official regular (not online) store, you can always count on the help of an experienced consultant. But here it is like with buying shoes: you must try on, compare and listen not only to the seller’s advice, but also to your own feelings. Of course, leading manufacturers always offer a detailed table, based on which you can choose a mask remotely. But experience shows that personal presence is still preferable.

Secondly, the mask should be properly adjusted to your face with the help of adjustment straps. Only you should be able to find the tension of the straps that keeps the mask sealed without causing discomfort.

Third, even a good mask is a consumable accessory and usually lasts about a year or more. A mask’s tightness deteriorates when, due to natural wear, the silicone in contact with facial skin hardens, micro-cracks form in it, and the adjustment straps stretch and lose elasticity. In other words, don’t forget to buy a new mask periodically.

Fourthly, wash the CPAP mask daily. After all, a layer of skin secretions remains on the silicone, on which dust settles and adheres. Contamination prevents the contour from adhering tightly to the skin, breaks its tightness, and can provoke irritation and even inflammation. For added security, use a cpap cleaning machine, it will kill any remaining bacteria and reduce the chance of any infection reaching the skin.

If the size, adjustment, and hygiene are all right, but the air leaks haven’t disappeared, experiment again with a different type of mask. Keep in mind, the smaller the fit area of the model, the more closely it matches the contour of your nose, the less likely it is to leak.

In fact, if you end up doing it right, 99% of the time the problem of air leaks and eye irritation will be over for you.

Tip 2: Use artificial tears and moisturizing eye drops

Artificial tear eye drops make up for the lack of natural tears, moisturize the eyes, and reduce irritation. They are thicker than regular tears and therefore do not evaporate as quickly under the influence of air flow.

The drug is injected according to the instructions before bedtime. Side reactions are possible when using it, including temporary blurred vision, allergies to the active ingredient, etc. Always consult your ophthalmologist before using these or those drops!

Moisturizing drops will not fully solve the problem of irritation and dry eyes. It is better to use them as a prophylactic measure. But the drug will alleviate your condition until you detect and finally eliminate the underlying cause of the problem.

Tip 3. Talk to your doctor about reducing treatment pressure

The higher the treatment pressure, the more likely the mask will pull away from the face and leakage will occur. This not only reduces the effect of the treatment, but also dries out the mucous membranes of the eyes.

Talk to your doctor about the possibility of lowering the maximum treatment pressure for a while. This is not the best option, but it will give you extra time to decide on a more suitable mask model for you.