05 February 2026
A new study published in the British Journal of Ophthalmology has examined the effect of head position during sleep on intraocular pressure (IOP) among a group of 144 glaucoma patients.
IOP was measured and compared between lying flat and lying with two pillows under the head.
The scientists found that the two-pillow head position was associated with significantly elevated IOP, increased 24-hour IOP fluctuation and reduced ocular perfusion pressure when compared with lying flat.
The researchers also explored the effect of head posture on the jugular venous lumen by using ultrasonography in 20 healthy volunteers.
They found that there was significant constriction of both internal and external jugular venous lumen in the two-pillow position. This was accompanied by an increase in the maximum blood flow velocity of the internal jugular vein.
“Preliminary evidence suggests patients with glaucoma may benefit from avoiding postures inducing jugular venous compression to mitigate postural IOP elevation,” the authors shared.
“Such behavioural adjustments represent a simple yet potentially effective adjunctive strategy for optimising long-term IOP management in clinical practice,” they noted.
The scientists added that further studies are needed to validate these preliminary associations between head posture during sleep and IOP.
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andyoptom05 February 2026
I have glaucoma and I obsessively measure my IOP through the night using an icare home tonometer…. Then plot the diurnal variation on a graph. In my case it peaks at about 6am (at around 28mm) and goes as low as 16 in the daytime. I do have some glaucomatous damage in my left eye and I might require MIGs soon. In terms of posture, after sleeping on my side, the lowest eye is about 4 to 5 mm higher IOP than the other eye. I was under the impression that more pillows would reduce the IOP so this study is quite useful for me to take on board.
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