Exploring link between sleep habits, dry eye

Take-home message: Sleep position may be correlated with the severity of dry eye symptoms, suggests a new study.

Reviewed by David Alevi, MD

New York-A single-center study showed a strong correlation between sleep position and severity of dry eye symptoms, said David Alevi, MD.

Sponsored: Join us for dinner in Chicago during AAO!

The findings suggest that patients might see a reduction in dry eye if they slept on their backs, in addition to continuing other forms of treatment, said Dr. Alevi, a cornea and refractive surgery fellow, Ophthalmic Consultants of Long Island in New York.

Dr. Alevi’s colleague, Henry Perry, MD, had long suggested to patients with dry eye that sleeping on their backs might improve their symptoms and wanted to formally test that theory.

Related: Getting beyond the surface in ocular surface disease

Accordingly, a nonrandomized, double-masked study was performed, enrolling 130 patients. The patients were given a questionnaire to analyze their sleep habits and sleep positions and also underwent a standard dry eye evaluation.

Testing a theory

Testing a theory

The results seemed to confirm Dr. Perry’s informal observation.

“What we saw that was statistically significant was that patients who slept on either the left or the right sides tended to have had more symptoms of dry eye and meibomian gland disease than patients who slept on their backs,” Dr. Alevi said.

Recent: Portable device offers rapid high-definition meibomian gland imaging

The analysis showed that patients who slept on their backs had a statistically significant decrease in lissamine green staining compared with those who mainly slept on their right or left sides.

“We think that if we advise patients with severe dry eye to sleep on their backs, it could help them and provide them with another tool for dry eye relief,” Dr. Alevi added.

Recent news: Shire's FDA-approved dry eye drug available by prescription

Dr. Alevi and his colleagues speculated that when patients sleep on their sides, contact with either the hand or the pillow could be irritating their eye and aggravating dry eye symptoms.

“In future studies we might try to elaborate and find out the exact physiology of what’s causing it,” Dr. Alevi said.

More: Novel dry eye therapy shows increased efficacy, rapid onset of action

It also might be helpful to monitor patients in a sleep center where data could be obtained on patients’ sleep positions and and then analyzed for correlations with dry eye symptoms. While most patients know whether they primarily sleep on their backs or on their right or left sides, formal observation of sleep positions would produce more reliable data, according to Dr. Alevi.

David Alevi, MD

E: [email protected]

This article was adapted from Dr. Alevi’s presentation at the 2016 meeting of the American Society of Cataract and Refractive Surgery. He did not indicate any financial interest in the subject matter.