A simple change before bedtime may help slow the progression of glaucoma, according to a new study published in the British Journal of Ophthalmology. Researchers found that sleeping without a pillow helps reduce intraocular pressure — a key risk factor for optic nerve damage and irreversible vision loss.

The study involved 144 people with glaucoma. Participants were asked to sleep either with two standard pillows, raising the head by 20–35 degrees, or without any pillows. In both groups, researchers regularly measured intraocular pressure during sleep and found a significant increase in the elevated position. In contrast, intraocular pressure was lower when participants slept without a pillow.

The researchers explained that a high pillow changes the position of the neck and may compress the jugular vein. This impedes the outflow of intraocular fluid and leads to increased eye pressure. Additionally, an elevated head position reduces ocular perfusion pressure — a measure of how effectively blood reaches the eye tissues. Lower perfusion pressure is considered a negative factor in glaucoma.

The authors note that traditional nighttime intraocular pressure management usually involves increasing medication doses or using laser therapy. Against this backdrop, avoiding a pillow could be a simple, non-pharmacological measure, useful in the early stages of the disease or as a supplement to treatment.

Glaucoma remains one of the leading causes of blindness in people over 60. Researchers believe that adjusting sleep posture may be an accessible and potentially effective way to improve long-term intraocular pressure control in patients with the condition.