Br J Ophthalmol
Glaucoma: Sleeping without pillows may reduce intraocular pressure
An observational study of 144 glaucoma patients found that sleeping with a high pillow (head elevated 20–35°) increased intraocular pressure (IOP) compared with the supine position, raising mean IOP by ~1.6 mm Hg and increasing 24‑hour IOP fluctuation. Ocular perfusion pressure also declined in the elevated‑pillow posture. Ultrasound in healthy volunteers showed that head elevation caused jugular venous constriction, suggesting a mechanism for impaired aqueous outflow and IOP rise. Younger patients and those with primary open‑angle glaucoma showed greater posture‑related IOP shifts.
Clinical takeaway: Advise glaucoma patients to avoid high‑pillow sleeping positions, which may worsen nocturnal IOP control.
Source:
Liu, T, et al. (2026, January 27). Br J Ophthalmol. Association of high- pillow sleeping posture with intraocular pressure in patients with glaucoma. https://pubmed.ncbi.nlm.nih.gov/41592946/