These authors contributed equally to the work.
Floppy eyelid syndrome is associated with obstructive sleep apnoea: a prospective study on 127 patients
Article first published online: 11 OCT 2011
© 2011 European Sleep Research Society
Journal of Sleep Research
Volume 21, Issue 3, pages 308–315, June 2012
How to Cite
CHAMBE, J., LAIB, S., HUBBARD, J., ERHARDT, C., RUPPERT, E., SCHRODER, C., MALAN, A., BOURCIER, T. and BOURGIN, P. (2012), Floppy eyelid syndrome is associated with obstructive sleep apnoea: a prospective study on 127 patients. Journal of Sleep Research, 21: 308–315. doi: 10.1111/j.1365-2869.2011.00968.x
- Issue published online: 19 MAY 2012
- Article first published online: 11 OCT 2011
- Accepted in revised form 21 August 2011; received 28 February 2011
- palpebral laxity;
- sleep apnoea
A few investigations have raised the question of a possible relationship between obstructive sleep apnoea syndrome (OSAS) and floppy eyelid syndrome (FES). FES is an easily inverted floppy eyelid with papillary conjunctivis, and is a subset of the general pathology, lax eyelid syndrome. The aim of the current study is to determine whether OSAS severity is associated with FES. One hundred and 27 consecutive subjects (aged 25–75 years) referred to the Strasbourg University Sleep Clinic with suspicion of OSAS were included. All patients underwent overnight ambulatory respiratory polygraphy, comprehensive ophthalmological examination and completed standard sleep questionnaires. OSAS severity was defined based on the patient’s obstructive apnoea–hypopnoea index (AHI). As expected, age, body mass index (BMI) and the proportion of males increased with OSAS severity. FES was observed in 15.8% of the subjects without OSAS, 25.8% of the total OSAS population and the frequency was significantly increased (40%) in patients with severe OSAS (AHI > 30 h−1). A significant correlation between OSAS severity and FES was found after adjustment for age, sex and BMI, using a principal component analysis (PCA). The multivariate analysis included clinical, polygraphic and comorbidity data and was followed by logistic regressions for the main components extracted from the PCA. In summary, our findings show an association between OSAS severity and FES and suggest that severe OSAS might be an independent risk factor for FES. These two disorders may share common biological determinants, such as tissue elasticity. Finally, clinicians should be aware of this association so that underlying OSAS or FES can be detected.