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NewsSleep is a blind spot in glaucoma care, and experts say it's time to change that. At the AAO meeting, Dr. Kaweh Mansouri highlighted how IOP, blood pressure, and other key factors shift dramatically during sleep — potentially stressing the optic nerve. He's calling for 24-hour at-home IOP monitoring to get the full picture of what's happening overnight.
Sleep isn't just rest — and for glaucoma patients, the nighttime hours may be doing real damage. At the American Academy of Ophthalmology's Glaucoma Subspecialty Day, Dr. Kaweh Mansouri made the case that sleep physiology deserves a central role in glaucoma management. "The nighttime period is our blind spot in glaucoma care," he said, noting that the optic nerve experiences no physiological reprieve during sleep.
During sleep, IOP, blood pressure, respiration, and intracranial pressure all shift rapidly. Aqueous humor production drops by half, yet IOP still peaks between 3–4 a.m. in most glaucoma patients — a window clinicians rarely monitor. Factors like body position, eye movements, pillow pressure, and hormonal cycles all play a role.
Key Takeaways:
Why it matters: Glaucoma management has long focused on daytime IOP control, but if the most damaging IOP spikes happen at 3 a.m., clinicians may be missing the most critical window for intervention.
