Journal List > J Korean Ophthalmol Soc > v.52(11) > 1008925

Lee and Kwon: Change in Intraocular Pressure According to Sleeping Posture in Normal People

Abstract

Purpose

The present study examined how intraocular pressure is affected by changes in sleeping posture (22–2400 hours) from the sitting position to the supine, prone, and lateral positions in normal subjects.

Methods

Ophthalmological examination was performed on 140 eyes of 70 healthy adult men, and changes in the intraocular pressure were measured according to posture during sleep. The subject was initially relaxed and the base intraocular pressure was measured in the sitting position. In order to reduce the influence of intraocular pressure among the positions, namely, the supine, the prone, and the lateral recumbent positions, the subject was seated for ten minutes before assuming each position. Intraocular pressure was measured twice at 0 and 10 minutes in each position, and the mean of the two values was used for comparison.

Results

Compared to the intraocular pressure in the sitting position, intraocular pressure increased significantly in the supine, prone, and lateral positions (p < 0.05). Compared to the base intraocular pressure, the intraocular pressure measured in the prone position showed the largest difference, increasing 6.34 mm Hg in the right eye and 6.43 mm Hg in the left eye. The intraocular pressure measured in the lateral position was 3.62 mm Hg higher in the right eye and 3.63 mm Hg higher in the left eye, and that in the supine position was 2.42 mm Hg and 2.28 mm Hg higher in the right and left eyes, respectively.

Conclusions

The change in posture during sleeping from the sitting position to the supine, prone, and lateral positions caused increases in intraocular pressure in normal subjects. The results show that the change in sleeping posture induced by sleeping habits may raise intraocular pressure.

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Figure 1.
In order to measure intraocular pressure, we used a specially designed bed. The bed was designed so that the intraocular pressure can be measured while the subject maintains the prone position or the lateral position.
jkos-52-1318f1.tif
Figure 2.
Intraocular pressure was measured by a tester using a Perkins' handheld tonometer HA-2 (KOWA, Japan) in the sitting position (A), supine position (B), prone position (C), and lateral position (D) on a specially designed bed.
jkos-52-1318f2.tif
Figure 3.
Linear graphs comparing intraocular pressure after 10 minutes in the sitting position, supine position, prone position, and lateral position.
jkos-52-1318f3.tif
Figure 4.
Linear graphs comparing intraocular pressure just after the change of posture to the sitting position, supine position, and prone position at 0 and 10 minutes.
jkos-52-1318f4.tif
Table 1.
Mean values of age and ophthalmic parameters
Variables Mean ± SD*
Age (yr) 34.00 ± 8.19
C/D ratio 0.41 ± 0.37 (Rt.)
0.43 ± 0.51 (Lt.)
BCVA (log MAR) 0.03 ± 0.12 (Rt.)
0.04 ± 0.64 (Lt.)
PAC§ 0.92 ± 0.23 (Rt.)
0.91 ± 0.47 (Lt.)
BMIΠ (kg/m2) 24.54 ± 3.94

* Values are given as a mean ± standard deviation

Cup to disc ratio

Best correction visual acuity

§ Peripheral anterior chamber

Π Body mass index = weight (kg) divided by height (m) square.

Table 2.
Comparison of IOP after 10 minutes of sitting, supine, prone and lateral position
IOP Sitting Supine Prone Lateral p-value
Mean ± SD* (Rt.) 12.94 ± 1.58 15.36 ± 1.36 19.28 ± 1.72 16.56 ± 1.34 <0.001
Mean ± SD* (Lt.) 12.93 ± 1.78 15.21 ± 1.45 19.36 ± 1.57 16.56 ± 1.35 <0.001

* Values are given as a mean ± standard deviation

Intraocular pressure

p-value was determined by one-way ANOVA.

Table 3.
Comparison of IOP & p-value on sitting, supine, prone, lateral position
Rt.
Lt.
Position Time Mean ± SD* p-value Position Time Mean ± SD* p-value
Sitting (base) 0 min 12.95 ± 1.41 0.43 Sitting (base) 0 min 12.94 ± 1.63 0.44
10 min 12.94 ± 1.58 10 min 12.93 ± 1.78
Supine 0 min 12.83 ± 1.51 <0.001 Supine 0 min 12.78 ± 1.56 <0.001
10 min 15.36 ± 1.36 10 min 15.21 ± 1.45
Prone 0 min 13.16 ± 1.41 <0.001 Prone 0 min 13.13 ± 1.45 <0.001
10 min 19.28 ± 1.72 10 min 19.36 ± 1.57
Lateral 0 min 12.70 ± 1.67 <0.001 Lateral 0 min 12.61 ± 1.61 <0.001
10 min 16.56 ± 1.34 10 min 16.56 ± 1.35

Intraocular pressure was measured twice at 0 and 10 minutes in each position.

* Values are given as a mean ± standard deviation

Intraocular pressure

p-value was determined by Paired T-test.

Table 4.
Correlation between BMI, peripheral anterior chamber, C/D ratio parameters, and intraocular pressure (IOP) after 10 minutes in the 4 positions
IOP in 4 position BMI p-value (R)* Age p-value (R)* PAC§ p-value (R)* C/D ratioΠ p-value (R)*
Rt. Sitting (base) 0.333 (−0.117) 0.769 (0.036) 0.879 (0.028) 0.082 (−0.242)
Supine 0.136 (−0.180) 0.927 (0.011) 0.711 (−0.471) 0.218 (−0.167)
Prone 0.091 (−0.203) 0.859 (−0.022) 0.368 (−0.107) 0.858 (−0.239)
Lateral 0.104 (−0.196) 0.374 (−0.005) 0.377 (−0.116) 0.869 (−0.248)
Lt. Sitting (base) 0.501 (−0.082) 0.475 (0.087) 0.789 (0.138) 0.202 (−0.332)
Supine 0.101 (−0.198) 0.474 (0.087) 0.531 (−0.381) 0.158 (−0.347)
Prone 0.538 (−0.075) 0.736 (0.041) 0.518 (−0.327) 0.648 (−0.339)
Lateral 0.087 (−0.206) 0.739 (−0.041) 0.497 (−0.236) 0.759 (−0.338)

* Values are number of p-value (R). p = Pearson's correlation; R = Pearson's correlation coefficient; Correlation analysis

IOP = intraocular pressure

Body mass index = weight (kg) divided by height (m) square

§ Peripheral anterior chamber

Π Cup to disc ratio.

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