High- pillow sleeping posture : significant constriction of internal and external jugular veins and increased intraocular pressure in those with glaucoma

General
,
1

Association of high-pillow sleeping posture with intraocular pressure in patients with glaucoma

Results:

Ultrasonography in healthy volunteers revealed significant constriction of both internal and external jugular venous lumen in the high-pillow position (all p<0.001), accompanied by an increase in maximum blood flow velocity of the internal jugular vein (p=0.013).

Compared with the supine position, the high-pillow position was associated with significantly elevated IOP, increased 24-hour IOP fluctuation and reduced ocular perfusion pressure (OPP) (all p<0.001) in those suffering from glaucoma in this study. Greater postural IOP fluctuation (ΔIOP) was observed in younger individuals (p=0.027) and patients with primary open-angle glaucoma (POAG) (p<0.001). Multiple regression analysis identified thicker central corneal thickness and the presence of POAG (vs normal-tension glaucoma) as positive predictors of larger ΔIOP changes (both p<0.05).

This emphasizes the importance for those among us who suffer from symptoms of internal jugular vein compression and glaucoma to elevate their bed mattress or to use a long wedge (from the head to at least the mid-thorax) to encourage cerebral venous drainage and not to add an extra cushion under their head which would cause excessive flexion of the neck and thus compression of the internal and external jugualr vein even further.

1 Like
2

That’s interesting…will have to try to remember that as a caution when we suggest sleeping raised to help with IJV compression…

2 Likes
ES Info: Alternative Treatments
3

The study only indicated that the volunteers were all healthy & elevated IOP was noted over the first 24 hrs of sleeping w/ head elevation. It didn’t note the time span of the study i.e. was it only done after 1 night of sleeping w/ head elevation or a week, month, etc.? If it was longer-term, it would be interesting to see if the body adjusts to sleeping w/ head elevation i.e. IOP doesn’t remain elevated & corneal changes reverse.

Since the people we suggest sleep w/ head elevation aren’t healthy & already have IJV & possible EJV stenosis, & sleeping w/ head elevation usually helps reduce their vascular symptoms, that conflicts with the results which indicated significant constriction of both internal and external jugular venous lumen (the hollow passageway through which the blood flows), which would in effect make vascular symptoms worse vs helping to provide some symptoms relief, as many of our members have noted.

I agree that if there are already ocular problems such as the open-angle glaucoma that was mentioned, sleeping with head elevation is not a good idea.

1 Like