Some individuals sleep with their eyes partially or fully open. This phenomenon, while often surprising, is a recognized medical condition that can affect eye health. It involves the eyelids not closing completely during sleep, leaving the eyes exposed to the environment. This compromises the eyes’ natural protection and lubrication overnight.
Understanding Nocturnal Lagophthalmos
Sleeping with eyes open is medically termed nocturnal lagophthalmos, indicating the incomplete closure of the eyelids during sleep. This condition is typically an involuntary action, meaning individuals are not consciously aware their eyes are not fully shut. It can range from a slight gap in the eyelids to the eyes being noticeably open. Estimates suggest it affects up to 5% of the general population, with some sources even indicating it could be as high as 1 in 5 individuals.
Eyelids play a role in maintaining eye health by protecting the ocular surface and ensuring proper lubrication through the tear film. During normal sleep, the eyelids fully close, creating a protective barrier and allowing the eyes to remain moist. When nocturnal lagophthalmos occurs, this protective mechanism is compromised, leading to increased exposure of the eye’s surface. This lack of complete closure sets the stage for various ocular surface problems.
Common Causes of Sleeping with Eyes Open
Several factors can lead to nocturnal lagophthalmos, often involving facial muscles and nerves responsible for eyelid movement. Issues with the facial nerve (seventh cranial nerve) are frequently implicated. Conditions such as Bell’s Palsy, stroke, or tumors can cause weakness or paralysis of the orbicularis oculi muscle, responsible for closing the eyelids.
Anatomical differences or structural problems around the eyes can also contribute. For instance, exophthalmos, where the eyes bulge forward (often seen in Graves’ disease), can make it difficult for eyelids to cover the entire eye surface. Eyelid deformities like ectropion (lower eyelid turns outward) or unusually thick eyelashes can also impede full closure. Previous surgical procedures around the eyelids, such as blepharoplasty or Botox injections, might alter eyelid function and result in incomplete closure.
Genetics can play a role, indicating a predisposition in some individuals. Dry environmental conditions can exacerbate the problem. Less commonly, certain behavioral factors, such as heavy alcohol consumption or the use of some sedatives, have been associated with nocturnal lagophthalmos.
Potential Effects and When to Seek Medical Advice
When eyes remain open during sleep, they are continuously exposed to air, leading to tear film evaporation. This prolonged exposure can cause various uncomfortable symptoms upon waking, with dry eyes being the most common. Individuals often experience irritation, redness, a gritty sensation, and blurred vision, particularly in the morning. Some may also feel as if something is lodged in their eye or experience increased sensitivity to light.
Over time, chronic dryness and exposure can lead to significant ocular complications. The cornea, the clear outer layer of the eye, can become damaged, potentially resulting in corneal abrasions (scratches), corneal ulcers (open sores), or exposure keratopathy. These conditions can be painful and increase the risk of eye infections, which, if left untreated, could affect vision. While severe complications like vision loss are uncommon, the risk increases with prolonged and untreated nocturnal lagophthalmos.
If you suspect you are sleeping with your eyes open, or if you regularly wake up with symptoms like persistent dry, red, or irritated eyes, it is advisable to seek medical advice. An eye care professional can diagnose nocturnal lagophthalmos through an examination, sometimes involving observation of eyelid closure. Seeking timely consultation is important to address discomfort and rule out any underlying medical conditions. Early intervention can manage symptoms and prevent potential long-term eye damage.