By Neelam Gor, MD, Chief Clinical Officer and Robin Boltz, RN, Medical & Clinical Policy Analyst

Sleep apnea is often thought of as a condition that only affects breathing during sleep, but its impact reaches far beyond the airway. It effects 26% of adults aged 30-70 in the U.S. and contributes to our risk for:

• high blood pressure
• heart disease
• stroke 

Research has also shown a surprising connection between sleep apnea and eye health, with several common eye conditions linked to this sleep disorder. Understanding this connection can help us take proactive steps to protect both your overall health and your eyesight.

How does obstructive sleep apnea (OSA) effect your eyes?

OSA disrupts breathing during sleep—reducing blood flow and oxygen levels throughout the body. Exactly how sleep apnea causes damage to the eye is still under investigation but there is evidence of a strong association between sleep apnea and eye related conditions. The following eye health conditions are related to lower oxygen levels and changes in blood flow and intracranial pressure

• Dry eye disease (DED) – poor sleep quality increases the risk of DED as well as poorly fitted sleep apnea treatment equipment which can leak and expose eye surfaces to more air flow.
• Floppy eyelid syndrome – loose, poorly working upper eyelids are often seen in patients with sleep apnea. The eyelids become loose and flip outward allowing them to rub against pillows, causing irritation, and tearing. In addition, lower oxygen levels, common during sleep apnea, have been linked to weakened eyelid tissue.
• Glaucoma – a condition where high levels of pressure inside the eye can lead to irreversible optic nerve damage leading to permanent vision loss. Obstructed breathing can drop the oxygen levels in the blood, cause changes in blood flow, and increase the pressure of fluid in the brain. All of these can decrease blood supply to the optic nerve and increase pressure in the eye, causing or worsening glaucoma.
• Optic nerve and retina damage – sleep apnea can cause repeated low levels of oxygen and poor blood flow to the optic nerve. The optic nerve may suffer damage or an “eye stroke” called non arteritic anterior ischemic optic neuropathy (NAION).  
• Other conditions – Sleep apnea complicates the treatment and control of other common vision threatening conditions including diabetic retinopathy and macular edema.

What steps can you take to protect your vision health?

1. Pay attention to your sleep quality and take note of recurring disruptions like loud snoring or breathing pauses.
2. Inform your doctor of any sleep related issues.
3. If you have any level of sleep apnea, get regular eye exams to detect and manage any associated conditions.
4. Sleep apnea equipment, such as continuous-positive-air-pressure (CPAP) should be fitted and cleaned regularly to reduce air flow leaks and bacterial contamination to your eyes.
5. Get regular eye exams!

In summary, the link between sleep apnea and eye health is more significant than many realize. By addressing sleep apnea proactively, we not only improve overall health and quality of life but also help protect our vision for the long term. If you or someone you know experiences symptoms of sleep apnea such as loud snoring, daytime fatigue, or interrupted breathing during sleep, consider discussing it with a healthcare provider. Your eyes will thank you.

Sources

1. American Academy of Sleep Medicine, “Rising Prevalence of sleep apnea in U.S. …“ Accessed 11/2025.
2. Journal of Clinical Sleep Medicine. “Sleep apnea and eye diseases: evidence of association and potential pathogenic mechanisms.” 2022.
3. National Science on Sleep. “Impact of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Treatment on Dry Eye Disease . . . ” 2024.
4. Survey of Ophthalmology. “Association between obstructive sleep apnea and floppy eyelid syndrome.” 2023.
5. Eye. “Obstructive sleep apnea and glaucoma.” 2023.
6. Front Medicine. “Risk Factors for Non-arteritic Anterior Ischemic Optic Neuropathy.” 2021.
7. American Journal of Ophthalmology. “Impact of Obstructive Sleep Apnea on Diabetic Retinopathy Progression and Systemic Complications.” 2025.