Why Do I Wake Up With Dry Eyes?

Many people have the unpleasant experience of waking up with dry eyes. Why is that, and what can be done about it?

Take the Dry Eye Quiz to find out if you suffer from dry eyes

Dry eye is a common issue which can have a wide range of causes. Why do people sometimes wake up with dry eye?

Why We Get Dry Eye

Dry eye is generally caused by either inadequate tear production, or a problem with the tear film that leads to it evaporating too quickly. So why would people get dry eye overnight?

Nighttime Dry Eye

Nocturnal Lagophthalmos

Nocturnal lagophthalmos is the condition where the eyelids don’t fully close while sleeping. It is thought to be caused by a weakness in the seventh cranial nerve (also known as the facial nerve), which can be caused by: injury to the cerebellar artery (which delivers blood to the face), jaw or skull trauma, or Bell’s Palsy (sudden but generally temporary weakness in facial muscles.)

The eyelids not closing while asleep can negatively impact the tear film (the layer of fluid which covers the eyes), and, if the eyes are exposed to air without the proper blinking, a process which reapplies tears to keep the eyes lubricated, they can become dry.

A 2020 study found that this condition, in addition to causing dry eye upon awakening, nocturnal lagophthalmos can worsen dry eye symptoms and reduce the quality of your sleep. This research also found that an overstimulation of the Muller’s muscle (one of the two muscles which keep the eye open while you are awake) can cause this condition.

Who is More Likely to Have Nocturnal Lagophthalmos?

Other risk factors for nocturnal lagophthalmos include younger age, and shift work.

What Can Be Done to Treat or Prevent Nocturnal Lagophthalmos?

There are few things you can do to deal with your NL. These include:

Aromatherapy
Using warm eye masks
Taking a warm bath
Taping the eyelids closed during sleep.

Relaxing activities, like the warm bath, can increase your parasympathetic activity, which regulates the “rest and digest” function and decreases sympathetic activity prior to falling asleep. This may also reduce the stimulation of the Muller’s muscle.

Taping the eyelids closed physically keeps your eyes covered, which should help keep them better lubricated.

Other standard treatments for dry eye can be effective at treating symptoms from nighttime dry eye, such as artificial tears.

Common Questions

Are some people more prone to having Dry Eyes than others?

Yes, typically older females going through menopause are more prone to having dry eyes than others. Also people taking certain medications such as anxiety medications, antidepressants, antihistamines, antipsychotics, anti-muscle spasm medications, Accutane, beta blockers, contraceptives, as well as certain diuretic medications, are more prone to have dry eyes. Also people who are contact lens wearers who don’t properly take care of their contacts or are wearing contacts with low oxygen permeability may be more prone to dry eyes. Additionally, people who tend to work on a digital screen for a prolonged period of time can increase their risk of dry eyes.

How do I know if I have Dry Eye?

You may have dry eyes if your eyes are feeling gritty, irritated, scratchy, foreign body sensation, burning, excessive watering/tearing, redness, or if you’re experiencing light sensitivity. Dry eyes can also cause blurred vision; you may notice you find yourself blinking more frequently in order for your vision to get cleared up after going in and out of focus due to an unstable ocular surface caused by dry eyes.

Summary

If you experience dry eye upon waking up, it is likely caused by nocturnal lagophthalmos. In addition to the suggestions listed above, a doctor can provide you with additional guidance on what to do to treat and resolve this issue. If you’d like to schedule an appointment for a consultation at American Family Vision Clinic, you can contact us at (360) 491-2121.