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Glaucoma: Best mask?
#11
(03-05-2015, 12:40 PM)justMongo Wrote: I think I understand the contraindication for the total face mask. IOP depends on the outflow of fluid from the eye through a set of micro slots in the edge of the cornea. Applying pressure to the external eye would impede that fluid flow.

Think of the eye as being a plastic soda bottle. Now, imagine CPAP air pressure squeezing on half of the bottle. The pressure inside the bottle would go up.

CPAP pressure can be up to 20 cmH2O, which is about 15 mmHg. They measure glaucoma in mmHg.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#12
(03-05-2015, 03:34 PM)Lukie Wrote: Well it can't get much worse than it already is. I have used nasal and full face masks for the past year and my eye pressures have gone from 20-30 in that period. So something relating to CPAP is driving up my pressures. I'll see what happens. If my pressures get even worse I'll stop using the fit life. If they get better I'll keep it. I don't think they have done enough research in this area.

I don't see any reason to think it will help, and several reasons to think it might hurt, including a direct warning from the manufacturer.

It's doubly bad because it could be increasing the pressure on your retina during your sleep and that wouldn't show up in glaucoma tests once you take the mask off.

If you want to experiment with masks for glaucoma, get an Oracle Oral mask, and learn to use it without the nose plugs. That way, there is only pressure in your mouth and throat, not in the nose, like other kinds of masks. There's some info on the mask in the useful links in my signature line at the bottom of this post.

Have you discussed CPAP vs. glaucoma with your doctors?
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#13
(03-05-2015, 04:16 PM)woozie38 Wrote:
(03-05-2015, 01:39 AM)Lukie Wrote: Since starting CPAP therapy my glaucoma pressures have gone from 21 in each eye to 30. Does anyone have an idea which mask would be better in this situation?

I am not inclined to think there is a relationship between CPAP and glaucoma. As I understand it, glaucoma is the increasing pressure of the inter-ocular fluid within the eyes. Can't see how CPAP air would affect it. Having said that, since "normal" pressure is somewhere between 9 & 14, a pressure of 30 would tend to crush the optic nerve resulting in loss of sight. I'd would advise you to see your ophthalmologist right away. Perhaps a change of eye drop is indicated. I lost the sight of one eye because of too high pressure.


Read this and comment please.
http://www.ncbi.nlm.nih.gov/pubmed/18326715


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#14
(03-05-2015, 08:32 PM)Lukie Wrote:
(03-05-2015, 04:16 PM)woozie38 Wrote: [quote='Lukie' pid='103207' dateline='1425537578']
Since starting CPAP therapy my glaucoma pressures have gone from 21 in each eye to 30. Does anyone have an idea which mask would be better in this situation?
Read this and comment please.
http://www.ncbi.nlm.nih.gov/pubmed/18326715

I have read this study and for me the sample was not big enough considering that world wide, 4% of men & 2% of women suffer from SDB. It was not a double blind study in the true sense of the word & where XPAP may contribute to high IOP in some people, it is a long bow to draw to say that a correlation exists exponentially.
[Image: signature.png]Keep on breathin'
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#15
I looked into this myself a few years ago as I have ocular hypertension although I'll probably get the glaucoma dx this year. I found the thread where we discussed it back then:
http://www.apneaboard.com/forums/Thread-...e-pressure

If I remember right, the pressure on the eye from the CPAP is minimal but the oxygen benefits is far better.

Have you ever tried an oral mask? I wonder if that would do you any good?
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#16
No, I hate a dry mouth. I am going to try the Fit Life anyway. The pressure is distributed over the whole face instead of pinching the tear ducts and nasal sinuses. I ordered a dry eye shield from the dry eye store. This will keep my eyes from getting dry.


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#17
(03-06-2015, 07:34 AM)Lukie Wrote: No, I hate a dry mouth. I am going to try the Fit Life anyway. The pressure is distributed over the whole face instead of pinching the tear ducts and nasal sinuses. I ordered a dry eye shield from the dry eye store. This will keep my eyes from getting dry.

Let's see: The mfg says don't use this mask if you have glaucoma? But you're going to do that anyway? Hmmm. Really?
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#18
There are several studies showing that CPAP can increase IOP, including the Loyola Study mentioned above. I just had this conversation today with my glaucoma doctor. There have been several studies with conflicting results. I tried CPAP and felt that the exertion required to exhale was uncomfortable, which made me wonder if that type of exertion could possibly increase IOP. I then found the studies. Variable PAP (also commonly called Bi-Pap) lowers the exhale pressure. I will be trying that shortly. It's a complex issue when you have both apnea and glaucoma. Lower oxygen saturation can also affect ocular perfusion pressure. AutoPap appears to be the therapy that does not increase IOP, but the Medicare coverage criteria is very explicit and does not take glaucoma into consideration, unfortunately. The other study (which you can find by doing a Google search) is "Evaluation of Intro-Ocular Pressure in Patients with Obstructive Sleep Apnea Syndrome Before and After One Month of CPAP Therapy -- s. Kiekens, et al. The best scenario would be measurement of 24-hr. IOP. My glaucoma doc said it's not generally available in the US unless you can find a clinical study. That's my next search. It seems outrageous to me that we don't yet have a reasonably priced way to measure our own IOP.
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#19
Don't hold your breath. I use an APAP and my pressures have gone from 20 to 30 in each eye with RESMED s9 autoset apap.
I read those articles. I don't know what to think. I guess I will just end up on drops soon.

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#20
(03-06-2015, 03:39 PM)retired_guy Wrote:
(03-06-2015, 07:34 AM)Lukie Wrote: No, I hate a dry mouth. I am going to try the Fit Life anyway. The pressure is distributed over the whole face instead of pinching the tear ducts and nasal sinuses. I ordered a dry eye shield from the dry eye store. This will keep my eyes from getting dry.

Let's see: The mfg says don't use this mask if you have glaucoma? But you're going to do that anyway? Hmmm. Really?

If the manufacturer does not recommend this mask for use when you have glaucoma, I just wonder: Are you looking forward to being blind?

Try wearing a sleep mask over your eyes all day long and get a feel for what blindness might be like. Good luck to you. If money spent is the issue, you might want to sell that mask on Ebay to recoup some of your investment and use the money towards a mask that is better suited for you.

Good luck to you.
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