Introduction

Floppy eyelid syndrome (FES) is an underdiagnosed condition stereotypically found in obese, middle-aged men, characterized by a lax eyelid tarsus which readily everts without excess mechanical manipulation. Obstructive sleep apnoea (OSA) is the most frequently reported comorbidity in patients suffering from FES. The aim of this study was to determine whether or not individuals with FES present with distinct anthropometric characteristics in comparison to patients without FES suspected of having OSA.

Methods

A retrospective case–control study in which FES patients and controls all referred for investigation of suspected OSA, matched for sex, ethnicity, residential location, age (± 2 years), date of sleep study (± 1 month), and type of sleep study were compared for anthropometric, comorbidity, and sleep data differences.

Results

OSA prevalence and severity, assessed by apnoea-hypopnea index (AHI), revealed no significant differences between patients with FES (n = 39) and those without (n = 75), (85% vs 88%, p = 0.91 and 31.9 ± 28.7 vs 28.5 ± 16.6, p = 0.81 respectively), despite patients with FES being more obese (p = 0.02). Patients with FES had significantly lower Epworth sleepiness scale (ESS) scores after treatment with CPAP (5.3 ± 4.1 vs 9.4 ± 5.0, p = 0.028). Patients with FES exhibited increased prevalence of hernias (15% vs 4%, p = 0.032), dermatological (41% vs 17%, p = 0.006) and rheumatological (15% vs 3%, p = 0.012) comorbidities.

Conclusion

FES patients appear to exhibit a distinct phenotype with increased prevalence of comorbidities related to matrix metalloproteinase dysfunction and significant improvement of daytime hypersomnolence with continuous positive airway pressure (CPAP) treatment.

中文翻译：

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眼睑松弛综合征和阻塞性睡眠呼吸暂停：一种独特的表型？

介绍

眼睑松弛综合征 (FES) 是一种诊断不足的病症，常见于肥胖的中年男性，其特征是眼睑睑板松弛，无需过度机械操作即可轻松外翻。阻塞性睡眠呼吸暂停 (OSA) 是 FES 患者最常报告的合并症。本研究的目的是确定与怀疑患有 OSA 的无 FES 患者相比，患有 FES 的个体是否具有明显的人体测量学特征。

方法

一项回顾性病例对照研究，其中 FES 患者和对照都被转诊以调查疑似 OSA，匹配性别、种族、居住地、年龄（± 2 岁）、睡眠研究日期（± 1 个月）和睡眠类型研究比较了人体测量学、合并症和睡眠数据的差异。

结果

通过呼吸暂停低通气指数 (AHI) 评估的 OSA 患病率和严重程度显示，有 FES 的患者 ( n = 39) 和没有 FES 的患者 ( n = 75) 之间没有显着差异，（85% 对 88%，p  = 0.91 和 31.9 ± 28.7 与 28.5 ± 16.6，分别为p  = 0.81），尽管 FES 患者更肥胖（p  = 0.02）。使用 CPAP 治疗后，FES 患者的 Epworth 嗜睡量表 (ESS) 评分显着降低（5.3 ± 4.1 vs 9.4 ± 5.0，p  = 0.028）。FES 患者的疝气患病率增加（15% 对 4%，p  = 0.032），皮肤病（41% 对 17%，p  = 0.006）和风湿病（15% 对 3%，p = 0.012) 合并症。

结论

FES 患者似乎表现出独特的表型，与基质金属蛋白酶功能障碍相关的合并症患病率增加，持续气道正压通气 (CPAP) 治疗显着改善日间嗜睡。