Effect of Sleep Position on the Development of Ectropion or Entropion

Background: Most subjects, specifically adults, favor sleeping while lying in a lateral position rather than supine. Remaining on one side for prolonged periods may increase potential for developing pathologies related to changes in mechanical pressure, relative hypoxia and tissues stretch. Head sleep positions are known to be associated with several pathologies including floppy eyelid syndrome, dry eye and mybomian gland dysfunction. However, the role of sleep head positioning in the development of involutional entropion and ectropion has yet to be explored.

Objective: To explore a potential correlation between head sleep positioning and the development of a unilateral ectropion or entropion.

Method: A retrospective case series. Data was collected of all patients who had undergone repair of an involutional ectropion or entropion between 2004 and 2017 at the Soroka University Medical Center. Data included medical records and personal questionnaire regrading sleep habits.

Results: Thirty-six patients participated agreed to partake in the study.

A statistically significant positive association was found between the head posture preference during sleep and development of a unilateral ectropion (chi-square=6.11, p = 0.04) among 16 ectropion patients. No statistically significant correlation between head position preference and entropion occurrence was observed.

Conclusions: In this study, the occurrence of unilateral ectropion, but not entropion, has been associated with preference of head sleep position throughout the night. Further studies are needed to confirm these findings and to examine possible pathogenesis for this association.