Sleeping posture and intraocular pressure

Wong, Melissa H.; Lai, Annie Hiu On; Singh, Mandeep S.; Chew, Peter

doi:10.11622/smedj.2013050

Cited by 14 publications

(8 citation statements)

References 7 publications

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“…In previous studies, several types of tonometers, such as a handheld tonopen (Wong et al. ) or a rebound tonometer (Kim et al. ,b, ), were used to measure the IOP in varying body positions.…”

Section: Discussionmentioning

confidence: 99%

Is a pillow a risk factor for glaucoma?

Meurs

Thepass

Stuij

et al. 2018

Acta Ophthalmologica

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Purpose To study whether a clinically significant increase in intraocular pressure (IOP) occurs during simulated sleep conditions with the subject's head turned comfortably into a pillow (the simulated sleep position) and the effect of protective glasses on any such IOP rise. Methods A specially developed electronic epipalpebral pressure (EPP) sensor was attached to an eyelid of the right eye of all participants: 11 patients with primary open‐angle glaucoma and 11 healthy volunteers. During calibration, mechanical pressure was applied to the EPP sensor taped to the lower eyelid and the IOP was measured simultaneously at the slit lamp by Goldmann applanation tonometry. The EPP was increased in a stepwise fashion to assess the relationship between EPP and IOP for each individual eye. Thereafter, EPP (with the sensor now taped to the upper eyelid) measurements were performed in the simulated sleep position, both with and without protective glasses. The EPP was determined in each individual eye, and the estimated IOP was then inferred from the established EPP/IOP relationship. Results In the simulated sleep position, the mean IOP increased by an estimated 19.6 mmHg (SD: 7.5; range 11.6–32.8; p < 0.0001) in the patient group and 28.0 mmHg (SD: 9.6; range 12.3–41.1); p < 0.0001) in the control group. When the subjects wore protective glasses, the mean estimated IOP decreased again by 16.3 mmHg (SD: 5.6; range 9.8–28.1; p < 0.0001) in the patient group and 25.1 mmHg (SD: 8.2; range 11.7–38.3; p = <0.0001) in the control group. Conclusion Turning the head into a pillow gave a large and clinically significant increase in the estimated IOP in the simulated sleep position. With protective glasses, however, the increase in estimated IOP was almost absent. Therefore, protective shielding of the eyes during sleep may be a treatment option in glaucoma.

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Section: Discussionmentioning

confidence: 99%

Is a pillow a risk factor for glaucoma?

Meurs

Thepass

Stuij

et al. 2018

Acta Ophthalmologica

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“…10 Compared with the upright posture, IOP has been shown to increase in the horizontal postures (supine, [11][12][13][14][15][16][17] prone, or lateral decubitus [18][19][20][21][22][23][24] ) in healthy and glaucomatous eyes. Such posture-induced IOP rise has been associated with progression of glaucomatous damage.…”

Section: Introductionmentioning

confidence: 99%

Effects of head elevation on intraocular pressure in healthy subjects: raising bed head vs using multiple pillows

et al. 2014

Eye

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Purpose To evaluate the effects of different methods of head elevation on intraocular pressure (IOP) in healthy young subjects. Methods Twenty-four healthy young Korean subjects were included in this prospective observational study. The IOP measurements were taken with the subjects in the sitting position and in the supine positions with the head flat and 301 up using two different methods: (1) raising the bed head and (2) using multiple pillows. IOP was measured using Tonopen AVIA in both eyes 10 min after assuming each position in a randomized sequence. The Wilcoxon signed-rank test was used to compare the IOP by changing the methods of head elevation. Results Mean IOP of both eyes when sitting was lower than that measured in the supine position with head flat (P ¼ 0.001). Compared with that measured in the supine position with head flat, the mean IOP was lower when measured in the supine position with the head kept 30 1 up by bed head elevation (P ¼ 0.001), whereas the mean IOP was not significantly different when measured in the supine position with the head elevated using multiple pillows (right eye, P ¼ 0.061; left eye, P ¼ 0.089). Conclusion In normal subjects, IOP was lower when measured in the supine position with the head kept up by the bed head elevation compared with that measured when lying flat. However, such head-up positioninduced IOP reduction was not found when the head was kept up using multiple pillows. These findings suggest that elevating the head using multiple pillows may not help to reduce IOP in the supine posture.

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“…Hard vs soft pillows were not found to have a difference in the IOP increase in normal subjects between supine and lateral decubitus positioning. 50 A Reliance ophthalmic chair was fully extended parallel to the floor for all recumbent positions. Care was taken to ensure that the patient was as comfortable as possible before any IOP measurements were obtained.…”

Section: Methodsmentioning

confidence: 99%

Effects of different sleeping positions on intraocular pressure in secondary open-angle glaucoma and glaucoma suspect patients

Sedgewick

et al. 2018

OPTH

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PurposeThe aim of this study was to investigate the effects of different recumbent sleeping positions of the head and body on intraocular pressure (IOP) in secondary open-angle glaucoma and glaucoma suspect patients, specifically pigmentary dispersion (PD) as measured using the ICare rebound tonometer.Patients and methodsA total of 44 eyes of 24 patients with PD were selected in this study. The IOP of 44 eyes was measured in the initial seated position, in the 4 recumbent positions, and again in the sitting position between each of the recumbent positions.ResultsThe IOP of the right eyes and left eyes was higher in each of the 4 recumbent positions compared to its initial sitting position (all P<0.001). Dependent (D) vs nondependent (ND) comparisons failed to show a significant difference. All lateral vs prone comparisons showed a higher average IOP in the prone position than in the lateral position regardless of D vs ND status. The range of recumbent IOP changes was −4 to +17 mmHg or −17% to +142%. A total of 64% had at least a ≥33% IOP increase with 43% having a ≥50% increase.ConclusionLateral and prone sleeping positions usually do result in significant elevations of IOP in PD patients. Dependency status did not make a difference. A significantly larger IOP increase was seen in the prone position than in the lateral position. The presence of 3 clinical variables (disk hemorrhage [DH], notches, and BV changes) might increase the chances of developing a large recumbent increase in IOP. These patients and possibly all PD syndrome (PDS) or PD glaucoma (PDG) patients should consider sleeping in a bed that allows a head elevation of 30°.

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Sleeping posture and intraocular pressure

Cited by 14 publications

References 7 publications

Is a pillow a risk factor for glaucoma?

Is a pillow a risk factor for glaucoma?

Effects of head elevation on intraocular pressure in healthy subjects: raising bed head vs using multiple pillows

Effects of different sleeping positions on intraocular pressure in secondary open-angle glaucoma and glaucoma suspect patients

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