It’s good to face new challenges with your eyes wide open. But sleeping with your eyes open? That’s not so good.
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Maybe your bed partner has mentioned your eyelids don’t fully shut when you snooze or that you sleep with one eye open. Or you might find yourself waking up with dry, irritated eyes. The culprit could be nocturnal lagophthalmos, a condition that prevents one or both eyes from shutting during sleep.
“In severe cases, it can lead to pain and cause permanent eye damage,” says sleep medicine specialist Andres Santiago Endara-Bravo, MD. But treatments are available to protect your peepers while you sleep.
Experts aren’t entirely sure how many people have nocturnal lagophthalmos, Dr. Endara-Bravo says. “But we think it’s underdiagnosed.”
Most people find out they have it when someone tells them their eyes stay slightly open during the night. But others are diagnosed after experiencing eye symptoms:
Those symptoms are caused by the surface of your eye drying out during the night. When the outer layer of your eye doesn’t stay moist with tears, your eye may be scratched or damaged.
Lagophthalmos rarely strikes out of the blue. It’s usually caused by damaged nerves or muscles in your face. The condition may be related to:
Nighttime lagophthalmos can affect one eye or both. And if it goes untreated, it can lead to serious vision problems. “If the dryness becomes severe, it can damage the cornea and impair vision,” Dr. Endara-Bravo says. “It can also cause significant pain.”
Nocturnal lagophthalmos can be treated in several ways.
First, your doctor may ask you about your lifestyle habits. Sleeping pills or alcohol use can make lagophthalmos worse. In some people, sleeping pills may even be the primary cause of the condition, Dr. Endara-Bravo says.
Poor quality sleep can also worsen the condition. He recommends that patients with lagophthalmos avoid sleeping pills and alcohol and take steps to prioritize healthy sleep.
Two treatment methods can help keep your eyelids closed:
These treatments can help keep your eyes moist:
If other treatments don’t work, you might benefit from surgery to expand your eyelids so they’ll fully close when you doze.
Nocturnal lagophthalmos is not the only cause of sleeping with your eyes open. People who experience parasomnias — abnormal sleep behaviors — may sit up, talk or walk in their sleep. And they may open their eyes while it’s happening.
In those cases, though, the eyelids close when the person isn’t experiencing parasomnia symptoms. “People with parasomnias don’t experience symptoms like dry eyes, redness or irritation,” Dr. Endara-Bravo says.
If you suspect lagophthalmos, talk to your doctor. “We can find a solution — but the earlier, the better,” he says.