When Sleeping Beauty emerged from her long slumber, she
appeared to be rested, radiant, and beautiful. She didn’t even have a single
sleep line on her face. Had she been a real flesh and blood woman, would she
have had cause to worry about sleep wrinkles?
What are Sleep
Wrinkles?
Wrinkles are lines that appear in the skin when the skin’s
elasticity isn’t as spry as it once was, and the skin doesn’t snap back when it
is stretched or compressed. It’s a normal part of aging. Several factors are
known to promote wrinkles; chief among them is the accumulation of sun damage that
leads to our cells’ declining ability to produce collagen that keeps our skin stretchable.
You can look in the mirror as you smile, or frown, or do any of expressions you
commonly do in a day, and catch a glimpse of where your wrinkles will appear. By
contracting our facial muscles to show our emotions, we repeatedly pull and
pull on our skin, and this wear and tear eventually leads to permanent furrows in the
skin. The process is similar to the creases that appear in a well-worn pair of
leather gloves. Botox works by paralyzing specific facial muscles, thereby
removing the stress on the skin, and reducing the appearance of wrinkles.
But not every wrinkle can be explained by the wear and tear
of facial expressions. Some wrinkles appear in places that don’t match smiling
or frowning. In fact, while many wrinkles caused by facial expressions run
horizontally (think of the frowning lines on the forehead and the crow’s feet
at the tips of the eyes), these other wrinkles are oriented in a vertical
direction. In the late 1980s, researchers proposed that they were caused by the
pressure exerted by our pillow on our skin during sleep. That seems plausible
enough; after all, the head is heavy and we spend a third of our life with our face
buried in a pillow. It makes sense that, over time, the places where pressure
folds our skin develop into more permanent wrinkles. If you want to get a sense
of where these “sleep wrinkles” are likely to develop on your skin, look in the
mirror while you press your flat palms against the sides of your head. In some
people, it will create lines running parallel to the nose; in others, vertical
lines around the sides of the eyes or the chin; or diagonal lines on the
forehead. Botox isn’t helpful in these cases because the lines aren’t caused by
the muscle contractions that a drug can reduce. So what can we do about them?
Do Sleep Wrinkles
Exist?
Before we tackle that question, we should first tackle
whether sleep wrinkles actually exist; that is, whether burying our head in a
pillow at night actually leads to the production of wrinkles. Certainly the mechanism
proposed to their development is plausible. But what I like about science is
that it gives us a means of assessing whether something works the way we think –
and that step is important because sometimes we are wildly wrong!
One study (1) asked volunteers to describe their sleep
position: did they sleep on their left, or on their right? Pictures of these
volunteers were assessed by a dermatologist who determined whether the volunteer
had more sleep wrinkles on the left or right side of the face. The rationale
was that someone who sleeps with the right side would exert more pressure on
the skin on that side of the face, and therefore sleep wrinkles are more likely
to develop on the right. The researchers failed to find that people who slept
on the right had more sleep wrinkles on the right side of the face, and the
same result was found for people who slept on the left side.
We might conclude from this that sleep wrinkles are a myth
and don’t exist, but I’m not so inclined to believe this study because people
seldom stay in one position during the night. People might think they sleep on the left because that’s where they start the
night, but inevitably they will move. In fact, we know from another study (2) that
young adults change sleep positions at least four times every hour, whereas
older adults shift less regularly, typically settling on only two positions per
hour. If anything, this would support the creation of sleep wrinkles, because
the older you are, the longer you stay in a position at night, and the more
pressure you apply to a specific fold in the skin which eventually becomes a permanent
wrinkle. The study provided other interesting tidbits; during a typical night,
people tend to shift their head from left to right, on average turning their
head right 47% of the time, left 45% of the time, and upward 8% of the time. Irrespective
of the position the volunteers adopt when they fall asleep, they spend about
the same amount of time sleeping on the right and the left during the night, and
I would therefore expect sleep wrinkles, if they do form, to appear
symmetrically on the face.
So what’s the take away message about sleep wrinkles? We don’t
know that they exist! We have a plausible mechanism to account for the creation
of some wrinkles that facial expression and gravity cannot explain, but we are
still waiting for confirmation that what we think is causing them really is
sleep. For now, it’s the best guess we have. I make this point so that you will
take the next section with a grain of salt…
How Can You Prevent
Sleep Wrinkles?
Let’s assume for a second that sleeping wrinkles are a real
thing. What can we do to slow down their appearance?
The first measure of protection applies to all wrinkles:
avoid sun damage. Over time, sun damage destroys your skin’s ability to produce
collagen and other chemicals that maintain the skin’s elasticity. Protect your
skin from the harmful effects of UV light with a good sunscreen.
The next bit of advice is to try to sleep on your back.
Adopting this position means that your face will not be buried in a pillow and
therefore that the skin will not be compressed. That might be difficult to do,
given that we have control of where we start out in the night, but once we are
asleep, the body acquires a mind of its own. And this approach may not be ideal
given that people who sleep on their back have a greater tendency to snore. (So
you’ll look great, but no one will want to sleep next to you!)
Some manufacturers sell pillows covered in a slippery fabric
like silk and they claim that their product reduces the appearance of wrinkles.
I couldn’t find any evidence for or against this in the scientific literature,
but I am very skeptical. When you rest your face sideways on a pillow, there
are two forces that conspire to exert stress on your skin. There is the weight of
the head, which causes compression of the skin, as we have been discussing, and
there is also friction between your skin and the fabric of the pillow. That
second type is a considerably smaller contributor to the stress on your skin;
how often do you rub your face up and down the pillow?
Another type of “anti-wrinkle pillow” that you might
encounter online is one that is designed to remove the pressure on the face
when your head is resting on it. All of the scientific papers on this tested a
doughnut-shaped pillow where the chin and forehead rest on the pillow but the
cheek and eye areas are suspended above the “doughnut hole” and therefore do not
exert pressure on the skin. The papers report moderate improvement in the appearance
of wrinkles after using the pillow for a month (3). I’m cautiously optimistic
about this study, in part because it did show that there was less pressure
exerted on the cheek area. However, I remain skeptical, because at least one of
the researchers had ties to a company that manufactures and sells these pillows,
so there is a possibility for conflict of interest.
In fact, most research done on marketable products suffer
from this type of conflict of interest. The next one is another such example,
and the company fabricates copper
oxide-containing pillowcases. Here’s the idea behind it. Copper is an element that
is absorbed through the skin and that can stimulate skin regeneration, possibly
by stimulating the production of collagen. Previous work had shown that copper
oxide-impregnated socks could treat athlete’s foot (copper is known to kill
bacteria and fungus). The researchers of that study noted that in addition to
curing the infection, the volunteers reported that the skin on their feet felt
and looked great. So another study was performed with copper oxide socks, but
this time the researchers investigated the elasticity of the skin on the feet.
Lo and behold, copper oxide worked in this capacity as well. Researchers
interested in cosmetology took these results to the next level and investigated
whether a pillowcase containing fabric impregnated with copper oxide
could improve the appearance of wrinkles (4). They randomly assigned 30 volunteers
to sleep on a normal pillowcase and 30 others to sleep on the copper-containing
one. After two months, the volunteers’ “before and after” pictures were
compared by skin experts who did not know which pillowcase the volunteers had
slept on. They evaluated the appearance of wrinkles and determined that
sleeping on a copper-containing pillowcase resulted in better skin. In case you
are wondering, the volunteers were told to wash their pillowcase as they
normally would wash one, so I have to presume that copper doesn’t leach out of
the fibres during the wash cycle.
I have some reservations about this study because the
researchers are working for the company that markets this product, but the
results are thought-provoking and I look forward to other researchers
confirming these results.
So after all that research, we can guess that Sleeping
Beauty was resting her head on a specially shaped pillow, or perhaps one infused
with copper oxide, or perhaps she was sleeping with her head facing up. Or, you
know, maybe she didn’t wake up from her prolonged slumber with any sleeping
wrinkle because there is no such thing. The fairy tale doesn’t say. And only
more research will tell….
Cited Research
(1) Kotlus BC (2013). Effect of sleep position on perceived facial
aging. Dermatol Surg. 39(9):1360-2.
doi: 10.1111/dsu.12266. PMID: 23865987
(2) De Koninck J, Lorrain D, Gagnon D (1992).Sleep positions
and position shifts in five age groups: an ontogenetic picture. Sleep 15(2): 143-9. PMID: 1579788
(3) Poljsak B, Godic A, Fink R, Oder M, Lampe T, Dahmane R,
(2015). Sleeping on an anti-wrinkle pillow reduces facial wrinkles: Results
from an anatomical study. Forensic
Medicine and Anatomy Research, 3, 48-56. doi: 10.4236/fmar.2015.32010.
(4) Baek JH, Yoo MA, Kohn JS, Borkow G (2012). Reduction of
facial wrinkles depth by sleeping on copper oxide-containing pillowcases: a
double blind, placebo controlled, parallel, randomized clinical study. J Cosmet Dermatol. 11(3):193-200. doi:
10.1111/j.1473-2165.2012.00624.x. PMID: 22938003
Images
Baby Sleeping
License image obtained from Jim Champion (Love 2 Sleep) on
Flickr.
Woman who earned her wrinkles
License image obtained from Mario Popova (Age of Sad) on
Flickr.
