Effect of Sleep Position on the Ocular Surface

Alevi, David; Perry, Henry D.; Wedel, Alexander; Rosenberg, Eric D.; Alevi, Limor; Donnenfeld, Eric D.

doi:10.1097/ico.0000000000001167

Cited by 13 publications

(11 citation statements)

References 16 publications

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“…54,55 Patients with DED have a high prevalence of obstructive sleep apnea, [56][57][58][59] and its therapy, continuous positive airway pressure, may worsen DED. 60 Air conditioning and sleep position 61,62 also may worsen DED. Asplund 63 reported that nocturia is more prevalent in people with ocular and oral dryness than in those without, according to the survey results of 6103 elderly participants.…”

Section: Eyes Are Disturbed At Night With Dedmentioning

confidence: 99%

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Ayaki

Ohta

Kawashima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Sleep is an essential life habit and closely associated with lifespan, diabetes, hypertension, and mental health. Sleep disorders are a prominent, but overlooked problem in patients with dry eye disease (DED), characterized by a poor sleep index, short sleep duration, long sleep latency, and poor subjective sleep. DED and sleep disorders are more prevalent in women than men. Moreover, sleep quality in DED is worse than in other eye diseases, including glaucoma, retinal diseases, cataract, and allergic and chronic conjunctivitis. METHODS. We reviewed the literature for studies investigating sleep and health, eyes and sleep, and DED and sleep, in terms of systemic and eye health, especially in women. RESULTS. Two studies reported that approximately half of patients with DED suffer from poor sleep. The severity of mood disorders, including anxiety and depression, is correlated strongly with sleep disorders in DED, and the symptoms and signs of DED, especially pain, also are correlated with sleep quality. Sleep disorders are documented in primary Sjögren's syndrome and an association with sleep apnea and depression is suggested. Primary Sjögren's syndrome includes arthritis and other rheumatic disease causing pain and fatigue; however, how sicca contributes to sleep disorders is not known. CONCLUSIONS. Possible explanations for sleep disorders in DED may be depression, pain, and eye exposure at night. Reciprocal effects may be expected and consultation-liaison psychiatry is recommended for the management of sleep disorders in DED. Topical medication and lid heating also may be advantageous for sleep quality in DED.

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Section: Eyes Are Disturbed At Night With Dedmentioning

confidence: 99%

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Ayaki

Ohta

Kawashima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Similar to the pathogenesis of mechanical ectropion [25], the constant mechanical pressure exerted on the eyelid during the sleep time can produce prolonged micro-trauma to the eyelid, and eventually, change in shape and features of the eyelid. Alevi et al found a correlation between preferable sleep side and the development of dry eye syndrome and meibomian gland disorder [6]. They propose that during sleep time the eyelid everts, resulting in continuous rubbing between the eye surface and the pillow.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation is that this is a subjective study based on questionnaires. Even though a selfassessment questionnaire is not the golden standard for assessment of the sleeping position, it is widely used and is an acceptable and useful method [2,3,6,27,28]. Another issue is the retrospective nature of the study, which has its own limitations, including relying on patient recall.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, recently, there is evidence indicating that the link between sleeping position and morbidity may be much more extensive, affecting many systems in the body. Several papers have shown a correlation between different morbidities and sleeping postures [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Sleep position of the head has been associated with several ophthalmic pathologies; primarily the floppy eyelid syndrome (FES), the dry eye and meibomian gland dysfunction, keratoconus, and primary open-angle glaucoma may also be related [6][7][8][9]. Various mechanisms have been suggested, among them that prolonged mechanical pressure causes hypoxia and therefore continual and cumulative damage to the tissues [10].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Sleep Position on the Development of Ectropion or Entropion in Aged Population

Hayat¹,

Hadad²,

Lior³

et al. 2019

J Sleep Disord Ther

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Purpose: To explore a potential correlation between the position of the head of a sleeping individual and the (presence) of a unilateral ectropion or entropion. Method: A retrospective case series. Data were collected from all patients who had undergone repair of an involutional ectropion or entropion between 2004 and 2017 from all causes at the Soroka University Medical Center. Results: Thirty-six patients were available for participation in the survey received a telephone questionnaire regarding their sleep position and preference. The questionnaire was aimed to determine the patient's quality of sleep, position, and side preference while asleep. The ectropion group includes 16 patients who have had a statistically significant positive association between the preference of a head posture during sleep and the development of a unilateral ectropion (χ=6.11, p<0.05). There was no statistically significant correlation between head position preference and entropion occurrence. Conclusions: This study firstly demonstrates the correlation between sleep position preference and the risk of developing an involutional ectropion.

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Hue and Cry

Prashar¹

2019

Shed Tears for Diagnostics

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Effect of Sleep Position on the Ocular Surface

Abstract: In addition to current treatment, patients who sleep on their side or face down might see a reduction in dry eye and MGD if they change their sleep pattern to the supine position.

Cited by 13 publications

References 16 publications

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Effect of Sleep Position on the Development of Ectropion or Entropion in Aged Population

Hue and Cry

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