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Why Are Some People Sleeping With Eyes Open?

image of our writer Filip Maric

Written By Filip

Sleep Advisor

Featured image of sleeping with the eyes open.

29 April 2024 5 min read

Have you ever seen someone sleeping with his eyes open? This condition is called nocturnal lagophthalmos and it is not rare at all. Let’s find out together more about nocturnal lagophthalmos.

The first prerequisite for falling asleep is to close our eyes. That's why sleeping with your eyes open sounds surprising and contradictory. If we see a person sleeping with his eyes open or half open, we may even think he is dead.

Of course only if we have not encountered with nocturnal lagophthalmos several times before.
About 5 percent of the adult population is unable to close the eyelids during sleep. But even though the condition is frequent, it does not mean that it is harmless.

People who suffer from this may experience numerous sleep and other issues. We will first focus on the causes, before moving on to the symptoms and treatments.

What are the causes of sleeping with eyes open?

In more than 90% of cases nocturnal lagophthalmos has a clear cause and we know why people sleep with eyes open. Unlike many other sleep disorders such as sleep drunkenness and sleep inertia, where very often we cannot determine the cause, in this case we should pay attention to structural changes in the face. We will probably find the answer there.

Proptosis

Proptosis is a disorder that is very easy to notice, so making a diagnosis is simple. It is the bulging of one or both or eyes in relation to the natural position. The causes of proptosis can be many. These are most often thyroid disorders or tumors that push the eyes out of their natural position.

The cause may be somewhat less severe, such as an infection, but it must be treated. If underlying medical condition is left untreated, many other serious problems can occur and the appearance will also be affected. It is clear why proptosis affects sleep with open eyes – the eyelids should cover a larger area than they can.

Scarring

An image of a child having scars close to eyelids.

Scars are the result of various physical traumas or illnesses. Every blow you receive in the head and neck area is very dangerous and is more likely to leave a scar than on some other parts of the body. Physical trauma is just one of the many causes of scarring.

Chemical burns occur, especially in people working in hazardous industries involving chemicals. Doctors will certainly notice some very serious diseases such as ocular pemphigoid and Stevens-Johnson syndrome, although they are very rare. Any of these disorders, injuries or diseases can impair the functioning of the eyelid and thus lead to lagophthalmos.

Eyelid problems

An image of eye lid problems with eye redness.

The eyelids themselves can be the cause of the problem. As people get older, they lose muscle tone, so in elderly people, eyelids can become very weak. When they become too weak to perform their function, it will not only be a problem to open eyes fully, but also to close eyes completely. Eyelid problems also occur after cosmetic procedures and operations.

Blepharoplasty should repair eyelids, but like Botox and some other cosmetic surgeries it can compromise muscle tone in the area. So it is important that professionals perform eyelid tightening surgery and other similar procedures, not beauticians as more and more often is the case.

Problems with nerves

An image of a young man having pain due to nerve problems.

If we could see the nerves, we would notice that the whole face is covered with a network of facial nerves. Nerves are responsible for facial expressions, but also many other functions including eyelid function. If physical damage occurs as a result of trauma or stroke, lagophthalmos can be expected.

Facial paresis, also known as Bell's palsy, is a temporary weakness or paralysis of muscles and nerves, when there is stiffness or loss of function in the part of the face, including the eyelids. Cause of facial paresis is often unknown. Lyme disease transmitted by ticks sometimes has similar symptoms.

Sedatives

an image of drugs and medications

It has been observed that people who take larger amounts of sedatives on a daily basis are more likely to experience nocturnal lagophthalmos than others. The same is the case with alcohol and some types of sleeping pills.

Doctors and scientist have various theories about the connection between sedatives, alcohol and sleeping with open eyes, but no theory has been conclusively proven. So avoid excessive alcohol intake as well as higher dose of sedative than prescribed.

Idiopathic problem

Idiopathic is the umbrella term for all those diseases or conditions for which the cause is unknown. Remember that at the beginning of this part of the article we mentioned that the cause of nocturnal lagophthalmos is mostly known. When we do not know what is the cause of sleep with open eyes, then it is considered idiopathic.

What are the common symptoms of sleeping with eyes open?

Almost all common symptoms of nocturnal lagophthalmos are related to the eyes, because the eyes do not have the opportunity to refresh during sleep as they should. Symptoms can be noticed after the very first night, and if this becomes a chronic problem, you will have a constant feeling of fatigue in the eyes.

Dry eyes

An image of a sad woman with green eyes crying.

After many hours of looking at the screen, dry eyes are a common thing. You know that feeling like you have dust or sand in your eyes. But it should not be experienced in the morning, because then the eyes should be rested after a good night's sleep.

However, if they are half open most of the night, it will be dry in the morning as well.

Blurry vision

An image of a blurry vision.

Blurred vision that occurs as a consequence of nocturnal lagophthalmos is not as pronounced as when you have a migraine attack or suffer from diplopia, but it is certainly noticeable.

If you conclude that there is no other reason for blurry vision, you should tell your partner to pay attention to your eyelids during the night.

Watery eyes

Watery eyes are especially common in the spring when there are the most allergens in the air. So we can't say that watery eyes are something you will immediately associate with lagophthalmos. But if you have never suffered from an allergy and have no other allergy symptoms, then it is possible that there is another cause of water eyes that should be investigated.

Eye irritation

Blue lights are the main culprit for eye irritation, as well as for dry eyes, so you should avoid them in the hours before bedtime. After you inadvertently get dirt in your eye, eye irritation is normal. Nevertheless, eye irritation after waking is not natural. If you notice irritation every morning, try to find cause.

Eye redness

Like all previous symptoms, eye redness can be associated with hours of staring at the screen, eye injuries, infection or consumption of various substances. You may need to wear glasses too. And maybe, just maybe you sleep with your eyes open which provokes redness.

Treatment of sleeping with eyes open

The treatment that your doctor will recommend depends on the severity of the symptoms, but also on the cause. If the cause is, for example, Lyme disease, then the cause will be treated while at the same time efforts will be made to alleviate the symptoms of nocturnal lagophthalmos so you can have normal night’s sleep.

Eye drops for Keratitis prevention

An image of a person dropping eye drops into their eye

When bacterial inflammation of the cornea occurs, there is a drastic reduction in vision, pain and abundant secretion. Those who have dry eyes are more susceptible to keratitis, so the goal is to use eye drops to prevent keratitis.

There are many different types of eye drops, and since the eyes are very sensitive, drops that do not contain or contain minimal amount of chemicals are recommended.

Special tapes

When eye drops cannot help, then tapes are used which should keep the eyes shut at night, because they do not mechanically allow the eyelids to open. As sleeping with these tapes is not very comfortable, many choose an eye mask instead. But sometimes mask won’t help and special tapes are the only solution.

Optimal (night) sleep environment

It is definitely necessary to create an optimal sleep environment. This is important for everyone, but especially for those who sleep with their eyes open. Use blackout curtains to make the room completely dark even in the morning. It should be so dark that you don't even know what time it is. It's the only way to prevent bright light from waking you up. The air should be moist, to alleviate dry eye symptoms.

Alcohol & drug limitation

The question is not whether alcohol and drugs will cause health problems, but when and which ones. Therefore, they should not be consumed at all or the intake should be very moderate. In particular, avoid consuming an hour or two before bedtime. Although you feel that alcohol helps you fall asleep easier, it is only temporary, and night's sleep will not be good.

Surgical procedure

An image of surgeons getting ready for a surgical procedure.

Those suffering from most severe forms may require surgery. There are several techniques used to sleep with your eyes open. Skin grafting is a well-known technique that is used in many cases. There are also some less conventional techniques such as sewing the upper eyelids closer together, and implanting tiny external eyelid weight.

You should not worry about gold surgical implant nor sewing technique, because both are effective and safe according to the peer reviewed studies.

When is the time to visit a doctor?

A man sitting in an ordination and talking to a doctor

If your eyes are so open that your partner can clearly notice that, then it's time to see a doctor right away. But there is a possibility that your eyes are open very little and you may not be able to diagnose lagophthalmos yourself. You will have eye problems, eyes must be completely shut.

After noticing all the symptoms we talked about for a few days, visit a doctor. Even if you do not suffer from nocturnal lagophthalmos you probably have another eye problem that needs to be addressed as soon as possible to maintain eye health.

Conclusion

And that's all you need to know about sleeping with eyes open. Have you ever experienced something like this? If so, make sure to go to a proper clinic and get it checked out sooner rather than later! And if you want to share your experience of sleeping with eyes open, you can do so in the comment section.

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