Change in Intraocular Pressure According to Sleeping Posture in Normal People

Eung Lee; Jeong Do Kwon

doi:10.3341/jkos.2011.52.11.1318

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

Original Article

J Korean Ophthalmol Soc 2011;52(11):1318-1325.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.11.1318

Change in Intraocular Pressure According to Sleeping Posture in Normal People

Eung Lee, MD, Jeong Do Kwon, MD

Department of Ophthalmology, Wallace Memorial Baptist Hospital, Busan, Korea

Address reprint requests to Jeong Do Kwon, MD Department of Ophthalmology, Wallace Memorial Baptist Hospital #374-75 Namsan-dong, Geumjeong-gu, Busan 609-340, Korea Tel: 82-51-580-1359, Fax: 82-51-512-1354, E-mail: kjdeye@naver.com

Received 23 December 2010 Revised 25 April 2011 Accepted 30 August 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Glaucoma, Intraocular pressure, Normal people, Positional change, Sleeping posture

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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.

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.

Figure 3.

Linear graphs comparing intraocular pressure after 10 minutes in the sitting position, supine position, prone position, and lateral position.

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.

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.)
BMI^Π (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	0.43	Sitting (base)	10 min	12.93 ± 1.78	0.44
Supine	0 min	12.83 ± 1.51	<0.001	Supine	0 min	12.78 ± 1.56	<0.001
	10 min	15.36 ± 1.36	<0.001	Supine	10 min	15.21 ± 1.45	<0.001
Prone	0 min	13.16 ± 1.41	<0.001	Prone	0 min	13.13 ± 1.45	<0.001
	10 min	19.28 ± 1.72	<0.001	Prone	10 min	19.36 ± 1.57	<0.001
Lateral	0 min	12.70 ± 1.67	<0.001	Lateral	0 min	12.61 ± 1.61	<0.001
	10 min	16.56 ± 1.34	<0.001	Lateral	10 min	16.56 ± 1.35	<0.001

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 ratio^Π 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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