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Posture can have a profound effect on intraocular pressure for glaucoma patients. I have even found that lying down, which is something we all do almost every day, can elevate my intraocular pressure from normal to high levels.
Some studies have found that intraocular pressure increases in proportion to the angle of the body away from upright (such as standing or sitting). The highest intraocular pressure is found 180 degrees from upright in the yoga headstand posture. Almost everyone will experience a near doubling of their eye pressure while in the headstand. However, many normal (non-glaucomatous) individuals are able to lie in the horizontal position (90 degrees from upright) with minimal impact on their eye pressure. Glaucoma patients, on the other hand, do need to be concerned about the intraocular pressure increases that can accompany lying down and sleeping.
In the past, here on FitEyes.com, we have discussed the idea of sleeping with one's head elevated to reduce intraocular pressure. Dr. Robert Ritch, a leading glaucoma specialist, mentioned in those discussions that he sometimes recommends (to some patients) using a wedge pillow to elevate the head of one's bed. The decision has to take into consideration blood pressure as well as eye pressure, and I'll comment more on that below.
As with most therapies, there are potential side effects from elevating the head while sleeping (see below). With that in mind, I want to mention a book I chanced across on Amazon.com today. It doesn't sound like a very scientific book, and I have not read it yet, but it did catch my attention. In this book, they tout sleeping with the head elevated as a cure-all for many common conditions. Here's the info:
Get It Up! Revealing the Simple Surprising Lifestyle that Causes Migraines, Alzheimer's, Stroke, Glaucoma, Sleep Apnea, Impotence,...and More! (Paperback)
by Sydney Ross Singer (Author), Soma Grismaijer (Author)
http://www.amazon.com/gp/product/1930858000/
One of the reviews on Amazon states:
"I have had high eye pressures for my whole life. Having high eye pressure can contibute to glacoma. My eye doctor has suggested laser eye surgery more than once (not the fun kind either!). I had searched the internet for anything that could help me out and this was the only reference that came up. I bought the book 6 months ago and worked the simple "solution" to my eye issues. My pressures were close to 30(29.5) after 4 months the left is down to 20 and the right 26.I am extremly happy to avoid and surgery or medication. Its also helped me with another problem listed in the book."
In regard to potential side effects, Dr. Ritch has previously commented that sleeping with the head elevated might reduce blood flow to the optic nerve. As I mentioned, eye pressure is elevated with any posture other than an upright posture. However, the critical factor in glaucoma (particularly normal tension glaucoma) seems to be retinal perfusion, which is based on the relationship between blood pressure and intraocular pressure. Therefore, it is possible to make the wrong decision if only intraocular pressure is considered. For example, if elevating the head reduces both intraocular pressure and blood flow, it may hurt more than it helps in the long run. In my own case I have been striving for moderation. I make sure I use a fairly tall pillow but I stay within the range of a normal horizontal sleeping position (and I definitely do not elevate the head of my bed).
In a previous article I went into quite a lot of detail about various things I'm experimenting with to keep my blood pressure higher and my intraocular pressurelower while sleeping. Those experiements are still a work in progress.
UPDATE: I have finally found some solutions that dramatically reduce my intraocular pressure while sleeping! This progress has come out of the eye pressure and consciousness research I have been doing in 2008. In simple terms, stress during the day has a huge impact on my eye pressure while sleeping. The full story of how to deal with this is presented in several different posts on my blog here at FitEyes.com, but this forum post gives a good summary of how consciousness and intraocular pressure are intimately connected.
