Lax eyelid condition and floppy eyelid syndrome prevalence in obstructive sleep apnoea syndrome patients: A systematic review and meta‐analysis

Abstract

AbstractPurpose: The aim of this systematic review and meta‐analysis was to explore the available literature to estimate the prevalence rate of lax eyelid condition (LEC) and floppy eyelid syndrome (FES) in obstructive sleep apnoea (OSA).Methods: PRISMA guidelines were acknowledged in the conduction of this work, whose protocol has been registered in PROSPERO. Four electronic databases were searched from inception to December 24, 2020. A random intercept logistic regression model was carried out for the analysis of overall proportions, while mean difference was calculated as a measure of effect size to compare continuous variables. The estimated numbers of LEC/FES patients in OSA were calculated by multiplying the prevalence rate determined by our random‐effects model and the corresponding Benjafield's et al population prospect.1Results: We included 11 studies comprising 1225 OSA patients of whom 431 and 153 affected by LEC and FES, respectively. Our model estimated a pooled prevalence rate for LEC and FES in OSA patients of 40.2% (95%CI: 28.6–53.1%) and of 22.4% (95% CI: 13.8–34.2%), respectively. The number of LEC/FES affected individuals among OSA patients is expected to peak up to 376 and to 210 million, respectively. OSA patients appeared to have a 3.4 (95% CI: 2.2–5.2) and a 3.0 (95% CI: 1.7–5.5) increased risk of developing LEC and FES than the healthy counterpart.Conclusions: Given the strict association between LEC/FES and OSA both sleep physicians should consider the eventuality of ocular comorbidities in sleep apnoea patients and ophthalmologists should investigate the occurrence of sleep disturbances whenever any case of lid laxity is encountered.Reference1. Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, Nunez CM, Patel SR, Penzel T, Pepin JL, Peppard PE, Sinha S, Tufik S, Valentine K, Malhotra A. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature‐based analysis. Lancet Respir Med 2019; 7: 687–698.