Sleep position and the ocular surface in a high airflow environment

Area of Science:

• Ophthalmology
• Dry Eye Disease Research
• Sleep Medicine

Background:

• Dry eye disease (DED) significantly impacts quality of life.
• Environmental factors, such as airflow, can exacerbate DED symptoms.
• The influence of sleep position on ocular surface health is an understudied area.

Purpose of the Study:

• To investigate the association between sleeping position and ocular surface symptoms and signs.
• To evaluate the role of high airflow environments in this relationship.
• To identify potential risk factors for DED exacerbation during sleep.

Main Methods:

• Prospective observational study of new dry eye clinic patients.
• Exclusion of patients with pre-existing ocular conditions or dry eye treatments.
• Data collection on dry eye symptoms, preferred sleeping side, and bedroom airflow.
• Clinical examination including Schirmer's test and slit lamp evaluation for lagophthalmos and corneal epitheliopathy.

Main Results:

• A strong association was found between preferred sleeping side and contralateral corneal epitheliopathy, especially with lagophthalmos.
• Dry eye symptoms were more severe on the contralateral side to the sleeping position.
• Tear production (Schirmer's scores) was lower on the contralateral side, particularly in high airflow environments.

Conclusions:

• Preferred sleep position is linked to increased dry eye symptoms and corneal epitheliopathy in the contralateral eye.
• Nocturnal lagophthalmos and high airflow environments amplify this effect.
• Findings suggest sleep position modification could be a consideration for managing DED.