Can Sleeping Worsen Your Dry Eye Symptoms?

by May 27, 2020

Many people assume that at night, when we are fast asleep and our eyes are closed, they are protected from symptoms of dry eye disease.  Unfortunately, this is not the case for many individuals who suffer from nighttime dryness.  For some people, overnight can be the most damaging and uncomfortable time for the surface of the eye.  There are several eye conditions that can increase the risk of overnight damage.  If you find yourself waking up with dry and uncomfortable eyes, continue reading to learn more about how to protect your eyes.  


What Causes Nighttime Dryness?

The main cause of nighttime dryness is an eyelid condition known as nocturnal lagophthalmos.  This is essentially a fancy term describing eyelids that do not completely shut overnight.  For some people, the eyelids never fully close.  For others, they slowly drift open throughout the night.  When this occurs the front of the eye is exposed for long periods of time without the eyelid or the tear film to protect it.  The portion of the cornea that is exposed overnight becomes damaged and symptoms such as dryness, irritation, or pain can arise.  Your optometrist can usually diagnose nocturnal lagophthalmos during a routine eye examination because of the distinct pattern of corneal irritation it causes.  The pattern of irritation can be very small, or can affect significant portions of the corneal surface, depending on how severe the condition is and how much the eyelid drifts open throughout the night. 


Sleep Apnea and Dry Eye Symptoms

Another condition that can cause or worsen overnight dryness is sleep apnea, which may come as a surprise.  Sleep apnea is a sleep disorder in which breathing is irregular; several nighttime factors associated with sleep apnea increase the risk of nighttime dryness and dry eye disease.  

Many cases of sleep apnea are treated with a medical devices known as a continuous positive airway pressure machine, or a CPAP machine.  This device uses a mask that fits over the nose and mouth and delivers a constant stream of oxygen throughout the night to alleviate the problems caused by irregular breathing.  If the CPAP mask is too large or has a tendency to slide off overnight, the airstream can bombard the front of the eye and exacerbate symptoms of dryness, especially if the eyelids are not properly closed.  In order to protect the cornea and prevent discomfort, those with a CPAP machine should ensure the device is properly fitted and secure. Sleep apnea is also associated with a condition called Floppy Eyelid Syndrome.  As the name suggests, this disorder causes the eyelids and the skin around the lids to be less taught than normal.  As a result, those with sleep apnea are at a greater risk for the eyelids to unknowingly flip open throughout the night.  Like in nocturnal lagophthalmos, this leaves the corneal surface exposed and can significantly increase the risk of irritation and nighttime dryness. 


Treating Overnight Dryness While Sleeping

If your doctor notices signs of nocturnal lagophthalmos or sleep apnea-related dryness, they may recommend several different treatment options.  For mild cases, gel-based artificial tears can provide some overnight protection and prevent irritation from exposure.  For those with moderate to severe cases, an overnight ophthalmic ointment may be necessary to completely protect the cornea.  The doctor may also recommend traditional artificial tears throughout the day to help the front of the eye heal and stay lubricated.  Additional methods to keep the eyelids closed overnight, such as taping the lids or using an eye mask, may be necessary to help prevent symptoms of nighttime dryness. 


Our eye doctors at EyeDocs Family Eye Care in Brookville, OH excel in prescription of glasses, contact lenses and the diagnosis of a variety of eye disese. Call our optometrists at 937-770-1265 or schedule an eye exam appointment online if you would like to be evaluated for dry eye symptoms such as dry eyes while sleeping. Our eye doctors, Dr. Kyle Maxam and Dr. Cara Wampler, provide the highest quality optometry services and eye exams in Brookville, Ohio.

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