Compression, tension, and shear forces applied to the face during sleep cause facial distortion when people sleep on their sides and stomach, leading to the development of sleep wrinkles over time, according to a study. The study is published in the Aesthetic Surgery Journal, the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS).
“Sleep wrinkles form in response to distortion created when the face is pressed against any sleep surface. They tend to worsen over time due to repetition combined with thinning of the skin and decreased elasticity as we age,” says ASAPS member and lead author, Goesel Anson, MD, FACS, in a release.
Sleep wrinkles are also influenced by the amount of time spent in various positions. While our initial sleep position is a conscious decision, we change positions throughout the night unconsciously. The number of shifts decreases as we age from 27 to 16 per night, with an average of about 20 position shifts. The lateral (side) sleep position is the most common in studies averaging 65%, with the remaining 30% in the supine (back) position, and 5% in the prone (stomach) position. While some sleep wrinkle patterns can reinforce facial expression lines, most sleep wrinkles tend to be perpendicular to expression wrinkles. Most sleep wrinkles can be seen on the forehead, lips, and cheeks. Unlike facial expression wrinkles caused by muscle contractions, sleep wrinkles that are formed because of mechanical compression during sleep can’t be eliminated using Botulinum Toxin.
Anson notes, “One way to minimize sleep wrinkles is to limit facial distortion during sleep. If you can stay on your back, that’s ideal. There are several specialty pillows available to help achieve that. Dermal fillers can temporarily improve wrinkles of any type; however, neurotoxins won’t have much effect on these wrinkles since they are not caused by muscle contractions.”
Patients are advised to use sunscreen, quit smoking, optimize nutrition, and maximize topical skin care to control at least some of the variables that influence aging. While plastic surgeons also advise patients to avoid sleeping in the lateral and prone positions, it is extremely difficult to consciously change sleep patterns. Noninvasive aesthetic treatments that promote collagen production could decrease sleep wrinkles.