One of the first steps to falling asleep is to close your eyes. There’s no greater association to sleep than having your eyes closed. That, and snoring, but that’s for another article!
So it might be a bit unusual to see someone sleeping with their eyes open or to find out you’ve been sleeping that way. Imagine how you look when a family member stumbles on you, sleeping with open eyes!
You might think that sleeping with eyes open is out of the ordinary, but the National Sleep Foundation estimates that the phenomenon actually occurs in one in every five people.
In this article, we take a look at why some people sleep with their eyes open, what it means, possible side effects, and what it does to your sleep and eye health.
What is Nocturnal Lagophthalmos?
Nocturnal lagophthalmos is a common eye and sleep disorder where the eyes remain open even when a person is sleeping.
The inability to close your eyes during sleep can cause pain and discomfort throughout the night, which leads to disrupted sleep, as well as being more exposed to bright light in the mornings and waking up earlier.
Eyes should normally stay shut when sleeping. This is because eyelids block light that causes you to wake up before you may need to, and to protect your eyes from irritation, blurred vision, dryness, dust and debris.
What Causes You to Sleep with Your Eyes Open?
Your Eyelid Structure
For some people who sleep with their eyes open, the shape of their upper eyelids causes nocturnal lagophthalmos.
One treatment option that eye doctors suggest is reconstructive cosmetic surgery to help fix your eyelids and facilitate easier opening and closing.
Not all people who have issues with their eyelid structure are required to undergo surgery, as this appears to be limited to the more severe cases. Still, if eye infections and other problems occur frequently, then that’s one reason to consider having a procedure done.
You Might Have a Problem with Your Facial Nerves
Facial nerves surrounding your lids control them, so any weakness in those facial nerves may lead to less control of your eyelid movement.
The weakness in your facial nerves may be caused by various factors such as injury, stroke, the presence of a tumour, or other systemic diseases.
One of the most common associated conditions is Bell’s Palsy, which is a condition that causes temporary paralysis or weakness of your facial muscles.
Nocturnal lagophthalmos is also evident in certain autoimmune diseases like Lyme disease, Guillain-Barre syndrome, mumps, and other infections.
In rare cases, it can also be caused by Moebius Syndrome, an uncommon condition that badly affects the cranial nerves.
Whatever the case, if you suspect it’s an issue with your facial nerves, it’s best to consult a physician or a neurologist for medical advice.
We mentioned earlier that eyelid surgery could help alleviate nocturnal lagophthalmos, but at the same time, a procedure can also cause it.
Blepharoplasty is a surgical procedure wherein some excess skin on the upper eyelids is removed to appear younger and, in some cases, helps patients see better. Ophthalmology and eye care experts use this procedure in cases of sagging in the area.
Not all cosmetic surgeries are entirely successful. When too much of the skin is removed, lagophthalmos may develop. It’s essential to do your research and go with a reputable surgeon you trust if you’re considering this procedure.
It Might Be Thyroid-Related
People suffering from thyroid-related conditions such as hypothyroidism or Graves’ disease may experience bulging eyes, which is a common symptom.
Due to the thyroid imbalance, one or both eyes may protrude forward of the socket; this condition is called Graves’ ophthalmopathy.
Because of the extra bulge from the eye, the eyelids can’t close properly, leading to added pain and discomfort for the eyes and may also cause sleep problems.
Is It Safe to Sleep with Your Eyes Open?
Your eyelids play an essential role in your general eye health – whether sleeping or awake. Eyelids protect your iris from debris and foreign bodies you generally don’t want to be anywhere near your eyeballs.
More than protecting your eyes, the eyelids also spread tears on the corneal surface of your eyes, lubricating them and keeping them healthy every time you blink or close your eyes.
When you take away that protection, you subject your eyes to diseases and other underlying conditions that might affect your eyesight, including blurry vision and even nerve damage.
Exposure keratopathy and corneal ulcers can occur among people with nocturnal lagophthalmos due to foreign bodies and debris reaching the corneal surface while sleeping.
Likewise, dry eyes are familiar in people sleeping with open eyes as tears can evaporate quickly since the eyelids do not cover them.
When the tear film isn’t spread and appropriately distributed, it opens the eyes to vulnerabilities and infections.
How can I treat nocturnal lagophthalmos?
Apart from treating pre-existing medical conditions or undergoing surgical procedures, there are many ways to manage the symptoms of nocturnal lagophthalmos. We’ve listed some of the most common methods, but check with your doctor before starting anything new.
Use Artificial Tears
Pay a visit to a doctor or ophthalmologist and inform them of your condition. They would usually prescribe artificial tears that are most suited to your needs.
Artificial tears, also known as eye drops, can be used throughout your wakeful hours to ensure that you have a healthy tear film and enough moisture in your eyes to protect them at night.
The eye drops are also best used right before bed to give your eyes sufficient lubrication and nourishment right before sleep.
It might sound funny, but it’s common to manually use surgical tape to give yourself some shut-eye (no pun intended). The tape would prevent your eye from opening up when you sleep, providing your corneas with the protection they need.
Wear an Eye Mask or Goggles
Wearing eye protection during sleep allows you to know that no foreign bodies or debris can enter your eye when you sleep.
People who sleep with their eyes open can use specialised goggles to prevent their eyes from drying up throughout the night.
Turn Your Humidifier On
Although a humidifier won’t directly moisturise your eyes, having one in your room would create a moisture-rich environment.
Having enough moisture in the air lessens the likelihood of suffering from dry eye symptoms affecting your much-needed sleep.
To sum things up, it’s pretty common to sleep with your eyes open, with one in five people experiencing it. But, this doesn’t mean you should do nothing about the problem.
Your eye health is essential, and it’s best to seek medical advice and take action as soon as possible to ensure that you maintain the safety of your eyes.