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Head-up sleeping position lowers IOP compared with flat position

Ophthalmology. 2010;117(7):1348-1351.

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A majority of glaucoma patients in a sleep study had lower IOP when sleeping in a 30° head-up position than lying flat, the study found.

Approximately 94% of patients who slept in 30° head-up position had lower IOP than when lying flat. In addition, mean IOP was "3.2 mm Hg lower in the 30° head-up position compared with the flat position."

"The 30° head-up sleeping position lowers IOP compared with the flat position. Although this effect varies between individual patients, mean IOP was 20% lower in one-third of patients in this series," the study authors said.

The prospective, nonrandomized comparative case series looked at 17 eyes of 17 glaucoma patients who had controlled IOP and recent disc hemorrhage. Patients were measured in a sleep laboratory for two nights, first lying flat, followed by the second evening lying in a 30° head-up position.

Patients were seated upright for the 6 p.m., 8 p.m., 10 p.m. and 8 a.m. measurements, called the "awake period." The "sleep period" was midnight, 2 a.m., 4 a.m. and 6 a.m. measurements, when patients were either supine (the first night) or had their head raised by 30° (second night).

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