Wouldn’t raising your head while sleeping diminish blood flow to the eyes if you have low tension glaucoma and low blood pressure?

[LowpressureG]

I know that it’s often recommended to sleep with a wedge under your mattress to raise your head and lower your IOP overnight. However, I understand that low blood pressure is believed to be a significant cause of normal tension or low tension glaucoma. It seems logical to me that raising your head in that circumstance would be counterproductive. Am I looking at this wrong?

[Trish_GlaucomaUK Partner]

Hello LowpressureG. This is a very interesting question which, to be truthful, I don't have an answer too.

Sleeping in an elevated position is a personal preference.

Many people say they find the benefits of sleeping slightly elevated and feel it helps with their glaucoma, whereas other sleep in the position they have always slept in, and their glaucoma is maintained and well controlled.

I have just checked with a consultant on your behalf and they have advised they don’t know of any evidence that suggests sleeping in a particular position would be detrimental to your type of glaucoma.

[LowpressureG in reply to Trish_GlaucomaUK]

Thank you, Trish

[muddledme]

Hello LowpressureG,

Yes, I agree it does seem a bit odd to sleep slightly raised, but I found I soon got used to it ( when advised by the consultant ) I put several pillows under the head of the mattress until it felt comfortable.

There are quite a few explanations and research studies on line, I looked up intraocular pressure, glaucoma and head elevation. One research study seemed to suggest that sleeping with a graded wedge under the mattress was better than multiple pillows to lower the eye pressure.

I suppose everyone is different but if I can do anything to help stop nocturnal raised pressures then it is worth it . I also have Normal Tension and very variable pressures.

Best wishes

[Beecalmed]

Hi! This is best explanation I could find in a simple to understand format. There are various fairly recent research papers around too though if you google.

healio.com/news/optometry/2...

I have low blood pressure and I’m suspect NTG. Spiking IOPs at night is thought to be a pattern for those of us with fairly low IOP but glaucoma progression. Often we have low blood pressure which drops even lower at night. Low blood pressure can equate to higher eye pressure. This article explains that the best I think.

I have a raised bed head about 6-8 inches with books under the feet. I tried wedge pillows and extra pillows but felt I’d prefer to sleep with my back straighter fit my back health, but body slightly elevated at the head.

My consultant said he wasn’t sure it would help significantly but didn’t think it would harm me either. My NHS consultant is focussed on the NICE guidelines for treatment which recommend: SLT, medication and then operations. I’m trying other things only if my consultant thinks it won’t do more harm.

[LowpressureG in reply to Beecalmed]

Thank you, Beecalmed. And I like your user name!

[Peg99]

I have NTG and I have slept with the head of the bed raised for many years initially, at the suggestion of a consultant. It suits me particularly as my husband has digestive problems and he needs to sleep with his upper body raised.

However, because of very low blood pressure, on the advice of my GP, I raise the foot of my bed which I find helps with the morning wobbles caused by low BP. It all sounds weird but it surprisingly comfortable. To make it easier, we changed to an electric bed some years ago and now wouldn't be without it.

It's very interesting that there is very little concrete evidence about the benefits of sleeping on an acute angle. With quite a few things about glaucoma, you just have to do what works for you.

[LowpressureG in reply to Peg99]

That’s very interesting. If I understand correctly, you raise the head for high IOP and you also raise the foot for low BP? I slept that way during a recent hospital stay and it was very comfortable

[Peg99 in reply to LowpressureG]

Yes, you understand correctly. I find that raising both ends of the mattress has the effect of cradling my body and I find I can sleep on either of my sides or on my back so it isn't as restricting as it sounds.

[Jbar24]

this is what I think as well - it seems it would reduce blood flow to the head even more