Sleeping with Eyes Open

Sleeping with your eyes open is more than just a metaphor for being observant. Some people really do sleep with their eyes open—and it can damage their eyes and vision.

Being unable to close the eyelids is called lagophthalmos. If this only happens during sleep, it's called nocturnal lagophthalmos. This doesn't mean the eyes are wide open, though. In most cases, the lids will close most of the way but not completely. Even a small opening in the eyelids can dry out the eyes overnight. Over time, the eyes can become chronically dry and uncomfortable, leading to exposure keratopathy, scratches on the eye, corneal abrasions and corneal ulcers.

As most people fall asleep, the eyelids naturally close completely when facial muscles relax. People might sleep with their eyes open if:

• They were born with eyelids that don't close completely
• The eyelid muscles are damaged by infection, inflammation or injury
• Bells' palsy, stroke, tumor or another condition has paralyzed some of the facial nerves
• Graves' disease or another condition is causing the eyes to bulge forward
• Blepharoplasty or other surgery has changed how the eyelids move

Nocturnal lagophthalmos usually won't keep someone from falling asleep. Sleeping with the eyes open may not affect the quality of sleep either. But the drying and irritation of the eyes could make sleep less restful. And that discomfort can continue after you wake up.

You may not know whether you're sleeping with your eyes open. You might need a partner, family member or friend to look or take a picture while you're sleeping. Your ophthalmologist also can check whether your lids are closing fully during an eye exam.

Symptoms of Sleeping with Your Eyes Open

If your eyes aren't closing all the way at night, you might experience some of these symptoms:

• Dryness
• Feeling like something is in your eye (foreign body sensation)
• Red eyes
• Blurry vision (especially after waking up)
• Sensitivity to light
• Not sleeping well

Treatment for Sleeping with Eyes Open

If you think you're sleeping with your eyes open, you should see an ophthalmologist to find out why. Treatments are available for many of the causes and symptoms of nocturnal lagophthalmos.

Treatments for sleeping with your eyes open may include:

• Taping the eyelids shut with medically-safe tape
  • Make sure to talk to your doctor about the best way to do this.
• Using eye wetting drops or ointments at night, with or without taping eyelids shut
• Treating the underlying condition that’s keeping the eyelids from closing completely
• Surgery to change how the eyelid moves
• Surgery to add weights to the eyelids to help them close