Pillow Use Associated with IOP Elevation

Head position and elevation affect IOP levels via constriction of veins in the neck. Photo: Getty Images. Intraocular pressure (IOP) fluctuates with postural changes, and sleeping with the head at an upward, elevated position may raise IOP, thereby contributing to glaucoma risk, reports a study from China. “By using a wedge-shaped pillow or raising the bedhead, previous studies have reported a reduction in IOP in a semireclined position,” wrote the researchers in a paper for British Journal of Ophthalmology, but such equipment is “generally unavailable in domestic settings.” As such, they instead had participants sleep with their heads at an elevated 20° to 35° angle using “two regular-sized pillows.”While the researchers hypothesized that an elevated head position would reduce IOP, they found the opposite to be true: out of the 144 examined patients—all diagnosed with glaucoma—66.7% ended with a higher measurement of IOP when they switched to a head-elevated position. The average IOP in patients when they slept in a supine position was about 16.62mm Hg, whereas when they slept with their heads elevated on pillows, it increased to about 17.42mm Hg. The study’s authors attributed this to neck flexion, which compresses veins in the neck and restricts blood drainage from the head and aqueous humor outflow.Patients were split into three groups based on age, with people 44 or younger considered young adults, subjects between 45 and 59 middle-aged adults and those over 60 considered older adults. Patients in the young adult group “exhibited a significantly greater ΔIOP” of 2.09mm Hg “compared with the elders,” who came out at an average difference of about 1.48mm Hg, indicating that the risk of dangerously elevated IOP is greater in younger populations than in older ones, the researchers wrote in their paper.“Given the well-documented influence of postural changes” and the results of their study, the authors concluded that “non-pharmacological adjunctive approaches” may be supplementary to, if not as useful as, pharmacological interventions in tackling IOP-related issues before they affect patients’ lives.Click here for the journal source. Liu T, Hu M, Liu X, et al. Association of high-pillow sleeping posture with intraocular pressure in patients with glaucoma. Br Journal Ophthalmol. January 27, 2026. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.