Sleep is a crucial aspect of daily life, providing rest and rejuvenation for the body. However, certain physiological changes related to sleep can negatively affect eye health, particularly in people with glaucoma. Learn about the impacts of sleep on eye pressure, optic nerve health, and the progression of glaucoma.*

Intraocular Pressure Changes During Sleep

Eye pressure, or intraocular pressure (IOP), fluctuates based on the balance between the production and drainage of aqueous fluid within the eye. While fluid production decreases during sleep, research now shows that IOP tends to rise. 

This increase, typically ranging from 10-20%, is attributed to the positional effect of lying flat, which hinders drainage. Understanding these changes is essential for managing your eye health, especially when you have glaucoma.

Optic Nerve Blood Flow and Glaucoma

Blood pressure decreases during sleep and can lead to prolonged periods of low blood pressure (hypotension). While this can be beneficial for some cardiovascular conditions, it poses a risk for those with glaucoma. 

Prolonged hypotension can impair blood flow to the optic nerve, potentially worsening glaucoma damage. If your glaucoma progresses despite controlled IOP, you may need to consult with your healthcare provider about adjusting your blood pressure medication(s) to address nighttime hypotension.

The Role of Sleep Apnea in Glaucoma Progression

Sleep apnea, characterized by intermittent breathing interruptions during sleep, can further complicate glaucoma management. These episodes can reduce oxygen supply to the optic nerve, and aggravating glaucoma. 

People with sleep apnea are at higher risk of developing glaucoma, and glaucoma patients are more likely to suffer from sleep apnea compared to the general population. Recognizing and treating sleep apnea is crucial for preventing further optic nerve damage.

The Importance of Adequate Sleep

Besides these specific conditions, general sleep habits also influence glaucoma outcomes. Both insufficient and excessive sleep have been associated with worsened visual field defects in glaucoma patients. 

Ideas about ideal sleep duration vary, but typically fall between five to nine hours. Adequate sleep not only supports eye health but also benefits overall well-being, particularly in those with chronic conditions common among glaucoma patients, such as:

• Alzheimer’s disease, 
• Heart disease, and 
• Diabetes.

Maintaining optimal sleep and collaborative care between ophthalmologists and primary care doctors is vital for the health of both the eyes and the body.

*Bollinger, K. E. & Davanian, A. (2022, March 22). How Does Sleep Affect Glaucoma? Glaucoma Research Foundation. https://glaucoma.org/articles/how-does-sleep-affect-glaucoma 

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