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    How sleep patterns may affect MGD, dry eye

    Speaking at ASCRS 2016, Dr. Alevi said meibomian gland dysfunction (MGD) is thought to be a leading cause of dry eye, and often presents with similar symptoms.

    Related: In-office treatments for MGD may provide relief

    But in his practice in New York, Dr. Alevi and his colleagues began to notice a difference among the patient complaints—and that people who were side sleepers tended to have more symptoms in the morning than people who slept on their backs.

    “We wanted to examine the correlation between sleep position with the symptoms of dry eye, MGD, and irritation,” said Dr. Alevi, of Ophthalmic Consultants of Long Island, Rockville Centre, NY. “As clinicians, we already know how MGD is defined and how it can help characterize changes in the tear film. But it’s unclear what effect some non-obvious habits may have.”

    Changing sleep position

    They informally began to suggest side sleepers attempt to sleep on their backs, and while patients said it was difficult to make that sleep habit change, their eyes felt better in the morning and were not as symptomatic.

    Related: How punctal plugs may influence tear osmolarity and aid in dry eye therapies

    Dr. Alevi recruited 130 patients (and enrolled 125) who had been previously identified and were being treated for MGD and/or dry eye, using the American Academy of Ophthalmology’s definitions for the diseases.

    “Eyelids and meibomian glands were evaluated for expressibiity,” he said. “We initially used the Ocular Surface Disease Index (OSDI) questionnaire to qualify how serious subjects viewed their disease.”

    The group also queried subjects about sleep habits, how often they awoke during the night, and how their lids felt in the morning.

    More: Exploring ocular demodicosis in chronic blepharitis

    “Dry eye severity was graded based on MGD stage, lissamine green staining, Schirmer testing, treat osmolarity levels, and clinical exam,” he said. “Select patients also underwent meibomography.

    They then compared their findings with published estimates of disease severity.

    As might be expected, there were more women than men in the group, and subjects covered a wide range of ages.

    “On OSDI, patients who slept on their back had much better scores than those who slept on their sides,” Dr. Alevi said. “Lissamine green staining was heavy for those who slept on their sides and not as severe for the back sleepers.”

    Dr. Alevi said something as “simple” as trying to have patients change how they sleep may result in improved symptoms.

    More: Is it allergy or dry eye?


    Dr. Alevi has no financial disclosures.

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