Are the
facial wrinkles, lines and folds that happen with aging result purely from the
expressions we make? While skin distortion from facial expressions causes many,
if not most, of the wrinkles we see on our faces with age, a new study suggests
there’s a wrinkle (ahem) in that line of thinking. It turns out, as many
experts in facial aesthetics have long assumed, wrinkles also result from
"mechanical distortion" during sleep.
Plastic
surgeon and lead author Goesel Anson, M.D., clinical instructor of surgery at
the School of Medicine, University of Nevada, Las Vegas, and colleagues report
in the study published online June 21 in the Aesthetic Surgery Journal that
compression, shear and stress force factors result in facial distortion when
people sleep on their sides and stomach.
These
sleep wrinkles tend to be perpendicular to expression lines and they don’t
respond significantly to animation, according to Dr. Anson. Common sleep
wrinkles include the lateral oblique forehead crease, radial orbital crease,
lateral (vertical) malar crease, medial cheek crease, nasal/lip crease, corner
lip crease, oblique marionette crease, preauricular crease and inferior
vertical cheek crease, according to the study.
American
Society for Aesthetic Plastic Surgery President Daniel C. Mills, M.D., a
plastic surgeon in Laguna Beach, Calif., says he has long suggested to patients
that some of their facial wrinkles come from sleep positions, especially when
patients complain that they have more wrinkles on one side of the face than the
other. He’ll ask them how they sleep at night, and often the light goes off in
the patient’s mind that, yes, those wrinkles show up on the side of their
favorite sleeping position, he says.
“So,
these are things that we see on a daily basis, but it’s very nice for the
doctors to have written an article about this, quantifying it,” Dr. Mills says.
The
researchers not only looked at wrinkles from sleep, but also potential facial
skin expansion. Based on available studies, they didn’t find a direct
correlation between facial distortion during sleep and skin expansion, Dr.
Anson says. However, it’s a logical conclusion to draw from basic science
literature and more research needs to be done on the subject matter, she says.
The Science of Sleeping Positions
In order
to get a sleep wrinkle, you have to have contact with a surface, Dr. Anson
says.
“So, back
sleeping should not cause these wrinkles. But if you sleep in a side position
or on your stomach, then you likely cause compression, which will likely
increase your risk of having sleep wrinkles,” she says.
However,
physicians who recommend their patients sleep on their backs to avoid the
wrinkles might end up with frustrated patients. Dr. Anson and colleagues report
that while initial sleep positions tend to be conscious decisions, most people
unconsciously change positions throughout the night.
While
wrinkles from sleep tend to increase with age, they are also influenced by the
amount of time spent in various positions. Interestingly, the number of
position shifts per night decreases as we age — from 27 to 16 a night, with an
average of 20 nightly position shifts, according to the research. As a result,
the time spent in each position increases with age.
That’s
bad news for those who sleep predominately on their sides and stomachs, which
is most people. According to the study, the lateral sleep position is the most
common in studies, averaging 65%, while an average 30% of sleep is spent supine
and 5% prone.
Sleep Wrinkle Solutions
Neuromodulators,
the go-to wrinkle reducers that cosmetic surgeons use to treat
expression-caused facial wrinkles, don’t work on wrinkles that are due to
sleep, Dr. Anson says.
Fillers
might help temporarily. But if patients’ wrinkles are truly from compression
during sleep and the mechanical distortion continues after filler treatment,
the results are unlikely to last long at all, according to Dr. Anson.
Dr. Mills
says that it’s also possible that newer noninvasive cosmetic surgery treatments
designed to promote collagen formation, such as radiofrequency and ultrasound
devices, could help to make skin more resilient to wrinkles from sleep. And
microneedling, he says, could increase the penetration of newer products that
may also help with wrinkles.
“Even IPL
has been shown to add a little more collagen to the deep dermis,” Dr. Mills
says.
The
logical solution, Dr. Anson says, is to limit the cause — the mechanical
compression that comes from smashing our faces into fluffy pillows.
“There
are several specialty pillows available these days, which help to minimize
distortion during sleep,” says Dr. Anson, who has developed and patented such a
product, called the JuveRest pillow.
“We have
a small amount of unpublished data comparing a standard pillow to the JuveRest
pillow. We see a clear improvement in distortion and wrinkles immediately. How
that relates to long-term improvement is much more difficult to study due to
the length of time required for those studies and many variables in sleep
position,” she says.
Dr. Anson
says that while she can’t draw the conclusion that using the JuveRest or any
other specialty pillow designed to limit distortion will prevent or change
facial wrinkles in the long term, it seems logical that it would.
“The
argument is that this is all logical,” she says.
