When most people go to sleep, they close their eyes and doze off with little effort. But there are many people who cannot close their eyes while sleeping.
Your eyes have eyelids attached to protect your eyes from irritants like dust and bright light, both when you’re awake and sleeping. Each time you blink, your eyes are coated by oils and mucous. This help keep your eyes healthy and moist.
During sleep, eyelids keep your eyes dark and moist to maintain eye health and help you sleep more deeply. You should not attempt to sleep with your eyes open.
There are several possible reasons that a person may not be able to sleep with his or her eyes open. These might be related to neurological problems, physical abnormalities, or other medical conditions.
Here are some of the most common reasons for sleeping with your eyes open:
Nocturnal lagophthalmos
Most people who cannot close their eyes while sleeping have a condition called nocturnal lagophthalmos. Most with this condition have eyelids that cannot close enough to cover the eye partly or completely.
Nocturnal lagophthalmos is associated with physical abnormalities of the eyes, face, or eyelids, or eyelashes that grow into the eyes.
Ptosis surgery
Some people have a drooping upper eyelid. This condition, called ptosis, is associated with the weakening or injury to the muscle that lifts the eyelid.
While surgery can help correct this condition, a common complication during surgery could keep the eyelid from shutting completely. This results in sleeping with eyes partially open.
Bell’s palsy
Bell’s palsy is a condition that causes temporary weakness or paralysis of the nerves that control movements in the face, eyelids, forehead, and neck. A person with Bell’s palsy may not be able to close their eyes during sleep.
Eighty percent of people with Bell’s palsy recover within six months, but without proper eye care and injury prevention, it’s possible to permanently injure your eyes.
Trauma or injury
Trauma or injury to the face, eyes, or nerves that control eyelid movement could affect your ability to shut your eyes. Injuries that result from cosmetic surgery, such as eyelifts, may also cause damage to the nerves that control movement in the eyelids.
Stroke
During a stroke, the blood supply to your brain gets reduced or cut off. This prevents oxygen from getting to the brain, causing brain cells to die within minutes.
Sometimes brain cells controlling nerve function and basic movements of the face are killed, causing paralysis of the face. Seek immediate medical assistance if someone has drooping on one side of their face.
Tumor, or tumor surgery near the facial nerve
A tumor near the nerves that control facial movements can reduce the face’s ability to move, or even paralyze the face. Sometimes when surgery is done to remove these tumors, parts of the nerves are damaged.
Both of these conditions can cause a loss of control over the eyelids, causing them to stay open at night.
Autoimmune conditions, such as Guillain-Barré syndrome
Some autoimmune conditions, such as Guillain-Barré syndrome, attack the body’s own nerves. When this happens, a person can lose control of the muscles on their face, including in their eyelids.
Moebius syndrome
Moebius syndrome is a rare disorder causing weakness or paralysis of the facial nerves. It’s inherited and apparent at birth. Those with this disorder are unable to pucker their lips, smile, frown, raise their eyebrows, or close their eyelids.
If there’s a reason you’re sleeping with your eyes open, you should address it. Sleeping with your eyes open over the long term can damage your eye health. It can also cause major disruption to your sleep and you may be trapped in a cycle of fatigue.
According to one estimate, 1.4 percent of the population sleeps with their eyes open, and up to 13 percent have a family history of nocturnal lagophthalmos. Many people who sleep with their eyes open are unaware, since they can’t see themselves when they sleep.
There’s a good chance that you are sleeping with your eyes open if you continuously wake up with eyes that feel dry, tired, or itchy.
If you’re concerned, ask someone to check on you while you sleep, or see a sleep specialist to understand what’s going on while you sleep.
The type of treatment a person needs for eyes that won’t close during sleep depends on the cause. In some cases, all that’s needed is eye lubricant. In other cases, surgery is necessary.
- eye lubricants, such as artificial tears and ointments, which can be applied during the day and or at night
- eye patches or eye mask to be worn during sleep to keep eyes covered and dark
- surgery to correct physical causes, repair nerves, or remove a tumor on the nerves
- gold weight implants to help close the eye
If you suspect that you are sleeping with your eyes open, it’s important to see a doctor for an examination. A doctor will look at your eyes and eyelids, and may run imaging or neurological tests to better understand how your eyes are working.
Treatment can greatly improve the quality of your sleep and your overall eye health.
