Relationship Between Sleep Position and Glaucoma Progression

Kevin Kaplowitz; Justin Dredge; Robert Honkanen


Curr Opin Ophthalmol. 2019;30(6):484-490. 

In This Article


As we spend considerable time in the horizontal position, it is very important to better understand the effect of body position on glaucoma. Data so far suggests that the right LDP may be the most common favored sleeping position. The positional increase from the supine position to the LDP averages less than 2 mmHg in the dependent position and less than 1 mmHg in the nondependent position. There is sparse data for the prone sleeping position.

Although some studies suggest that the positional increase may be persistent overnight and could potentially lead to worse glaucomatous loss in the dependent eye, preliminary data is conflicting and multiple studies failed to find a strong association. The evaluation of treatment options suggests that medications and argon laser trabeculoplasty are ineffective in blunting the positional increase, but trabeculectomy has been demonstrated to diminish the rise. Also, raising the head of the bed may reduce the positional increase in many patients. Controlled studies with continuous IOP monitoring will help further elucidate the relationship between sleep position and glaucoma.