Simple Sleep Change Could Support Glaucoma Care

Sleeping without pillows may lower eye pressure in people living with glaucoma, according to new early research. Since high internal eye pressure is a major cause of optic nerve damage, these findings may point to a simple nighttime habit that could help protect vision alongside standard treatment.
One of the main causes of permanent blindness in the world is glaucoma. While medications and laser therapy remain the main ways to control the disease, researchers are now exploring whether sleeping posture could also play a role.

Why Eye Pressure Rises During Sleep

Eye pressure, known medically as intraocular pressure (IOP), naturally changes throughout the day. However, it often increases at night when people lie down.

Researchers explain that stacked pillows can bend the neck forward. This position may squeeze the jugular veins, which are responsible for draining blood from the head. When these veins are compressed, fluid inside the eye may not drain efficiently, allowing eye pressure to rise.

Over time, repeated nighttime pressure increases may contribute to optic nerve damage in people with glaucoma.

How the Study Was Conducted

To better understand this effect, researchers studied 144 adults diagnosed with glaucoma between October 2023 and April 2024. Participants ranged from young adults to those over 60 years old and included people with:

Normal-tension glaucoma
Elevated eye pressure without nerve damage
Primary open-angle glaucoma (the most common form)

Each participant underwent a full eye examination and shared details about their medical history, medications, and lifestyle habits.

Comparing Eye Pressure With and Without Pillows

Eye pressure in the right eye was measured every two hours over a full 24-hour period. Measurements were taken while participants were:

Sitting upright
Lying flat on their backs
Lying on their backs with two pillows, lifting the head by 20–35 degrees

After each pillow-elevated position, participants returned to lying flat until the next reading. This allowed researchers to directly compare pressure changes caused by head elevation.

Key Findings

The results showed a clear pattern:

Two-thirds of participants experienced a rise in eye pressure when pillows were used
On average, eye pressure increased by about 1.6 mm Hg
Overall, eye pressure was higher with pillows than when lying flat
Eye pressure also fluctuated more throughout the day when pillows were used

Notably, younger adults and those with primary open-angle glaucoma showed the largest pressure increases.

Reduced Blood Flow to the Eye Was Also Observed

In addition to higher eye pressure, researchers measured ocular perfusion pressure (OPP), a marker of how well blood flows to the eye.

When pillows were used:

OPP dropped significantly
Lower OPP suggests reduced delivery of oxygen and nutrients to the eye tissues

Since healthy blood flow is essential for optic nerve function, this finding raises further concern for people with glaucoma.

Evidence of Jugular Vein Compression

To support their theory, researchers also examined jugular vein blood flow in 20 healthy volunteers. When pillows were used:

The veins became narrower
Blood flow speed increased

These changes indicate compression of the jugular veins, which may explain why eye pressure rises when the head is elevated during sleep.

What This Means for People With Glaucoma

Current nighttime eye-pressure management mainly relies on medications or laser treatments. However, this study suggests that sleeping without pillows may lower eye pressure by avoiding neck positions that interfere with normal blood and fluid drainage.
While the study does not prove cause and effect, it highlights posture as a potential supportive strategy that deserves more research.

Important Limitations to Keep in Mind

The researchers stress that this was an observational study with relatively small groups in each glaucoma category. As a result, firm conclusions cannot yet be drawn.
Larger and longer studies are needed to confirm whether changing sleeping posture leads to lasting improvements in eye pressure and vision outcomes.

Conclusion

Even with these limitations, the findings suggest that sleeping without pillows may lower eye pressure by reducing vein compression in the neck. For people with glaucoma, avoiding sleep positions that strain blood flow could become a helpful addition to standard care.
Anyone considering changes to their sleep habits should first discuss them with their eye specialist to ensure safety and comfort.

This research highlights how everyday behaviours, like how we sleep, may influence long-term eye health and opens the door to new, non-invasive ways of supporting glaucoma management.

Source: Inputs from various media Sources

Priya Bairagi

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I’m a pharmacist with a strong background in health sciences. I hold a BSc from Delhi University and a pharmacy degree from PDM University. I write articles and daily health news while interviewing doctors to bring you the latest insights. In my free time, you’ll find me at the gym or lost in a sci-fi novel.