29/08/2026
Glaucoma Physician Glaucoma Research Foundation EGS European Glaucoma Society Glaucoma and Sleep Position: Even Your Pillow May Affect Intraocular Pressure
A recent study published in the British Journal of Ophthalmology evaluated 144 patients with glaucoma.
The researchers compared the supine position with a sleeping posture using two pillows, resulting in head elevation of approximately 20–35°.
Contrary to expectations, the “high-pillow” position was associated with a significant increase in intraocular pressure (IOP).
Mean IOP increased from 16.62 to 17.42 mmHg, and 66.7% of patients experienced an increase in IOP when switching to the high-pillow position.
Greater fluctuations in IOP over 24 hours were also observed. At the same time, ocular perfusion pressure (OPP) decreased significantly.
Ultrasound assessment of the jugular veins, also performed in healthy volunteers, showed a reduction in their caliber in this position.
A possible explanation is that the high-pillow posture causes neck flexion and subsequent compression of the jugular veins. This may impair venous return and potentially affect aqueous humor outflow, ultimately contributing to an increase in IOP.
Importantly, however, the study does not demonstrate that elevating the upper body is harmful.
Previous research suggests that elevating the head and torso together, while keeping the neck in a more neutral position, may have different effects.
The practical message is therefore straightforward: in patients with glaucoma, it may be advisable to avoid sleeping positions that cause excessive neck flexion or jugular vein compression.
These findings provide further evidence that sleeping posture may play a role in intraocular pressure control.
Further studies are needed to determine whether these nocturnal postural effects have a meaningful long-term impact on the progression of glaucoma.