Could your sleep position make your dry eyes worse?

A recent study in Cornea 2017 by Alevi et al. have suggested that patient with dry eyes and meibomian gland dysfunction have fewer symptoms if they are back sleepers, face up towards the ceiling.
The US study assessed whether a patient’s sleep position had an impact on their dry eyes and meibomian gland dysfunction (MGD). Researchers looked at 100 patients who had ocular symptoms related to dry eye disease and compared them with a control group of 25 age-matched and asymptomatic patients.
They used questionnaires relating to sleeping habit and to dry eyes (the ocular surface disease index, OSDI). They also assessed the severity of the dry eye clinically by looking at the stage of the meibomian gland dysfunction and other parameters such as corneal fluorescein staining, Schirmer’s I test, tear osmolarity levels etc.
The researcher’s results showed a significant difference between those people sleeping on their backs compared to those sleeping on their left side regarding staining with lissamine green drops which shows up dry areas. They also had higher ocular surface disease index (OSDI) scores in those patients who slept on their sides, whether it was the right or the left side, compared to back sleepers.
However, they did not find a significant degree of association between the sleep position and the degree of meibomian gland dysfunction, where the oily secretions are deficient or abnormal.
They concluded that as well as the patient being on their treatment for dry eyes and meibomian gland dysfunction, they could find an improvement of their dry eye symptoms if they are side-sleepers or sleep facedown, and change to their sleeping position to be on their backs. This sleeping position is medically called “supine”.
It is worth trying this out yourself if you have dry eyes and see whether your eyes do feel more comfortable in the morning after sleeping on your back.
Reference for this blog post on sleep position is Alevi et al, Cornea 2017; 36 (5:567-571).