Can you sleep with your eyes open?

Maybe we’ve seen someone like our children, partner, or friends sleep with their eyes open, or maybe we should sleep like this ourselves.

This is something that surprises us because we understand that you can only sleep by closing your eyes. We use our eyes to see and we cannot “turn off at will”, which is why we lower our eyelids and try to sleep.

Here we will answer the question of whether you can sleep with your eyes openIf this affects the quality of sleep, what problems may be causing it and if there is treatment.

    Can I sleep with my eyes open?

    Normally, in order to be able to sleep, we close our eyes, we join in the darkness and wait for Morpheus’ pleasant embrace.

    However, not everyone has their eyes completely closed while they sleep. Some keep them a bit open and others, oddly enough, keep them wide open. This is considered a medical problem and has a name: nocturnal lagophthalmos.

    Nocturnal lagophthalmos is a fairly common medical condition. It can be seen that around 20% of the population sleeps with their eyes open. This can lead to problems with sleep quality and eye health, Besides being a sign of an underlying medical condition.

    Although the person can sleep, keeping their eyes partially or fully open can damage them because they are not properly hydrated and are exposed to environmental agents.

    like that, eyes dry out, they can get infected, they can get scratched from strange objects such as dust and nocturnal insects, corneal damage, sores and ulcers, leading to eye disease and, in the worst case, loss of vision.

    Why do we close our eyes while sleeping?

    In normal sleep, closed eyelids prevent light from being absorbed by the eyes and thus prevent the brain from being stimulated.

    During the vigil light is absorbed by cells in the retina which contain the pigment melanopsin, A light sensitive protein. Its stimulation causes the transmission of information to the brain, in particular to the suprachiasmatic nucleus, a region that regulates circadian rhythms, the sleep-wake cycle and the schedules of bodily processes.

    In addition to preventing brain activation, closing the eyelids hydrates the eyes while we rest. When we are sleeping we cannot blink, which is why it is best to lower the blinds. By keeping the eyelids lowered on the one hand, good hydration is obtained, preventing the eyes from drying out, and on the other hand, they are protected from external agents swarming in the air.

    the causes

    There are several causes that can cause nocturnal lagophthalmos. Below we will see the main ones.

    paralytic injury

    In that case, the facial nerve responsible for transmitting nerve information to the muscle that closes the eyelids is paralyzed. This can be due to facial paralysis, tumors, trauma, or cerebrovascular pathology. It can also be due to Möbius syndrome, which damages the cranial nerves. The muscle loses its strength, which makes it impossible to completely close the eyelid.

    mechanical injury

    In case of mechanical injury, it may be due to external factors. Among them we can find scars on the eyelids or conjunctiva, laxity of the eyelids and exophthalmos. It could all be due to careless surgery on the face, a blow to the eyelid, or some disease that damaged it.

    Thyroid problems

    One of the medical problems associated with the thyroid is bulging eyes, a common symptom of Graves’ disease. This disease is a form of hyperthyroidism, i.e. have a very active thyroid, which may interfere with the ability to close your eyelids falling asleep.

    genetic

    Nocturnal lagophthalmos has been shown to be more common in those who have a parent who has it.

      treatment

      Depending on how nocturnal lagophthalmos occurs and the extent to which the person cannot completely close the eyelids, there are different treatment options for this condition. All must be supervised by an ophthalmologist and, preferably, follow up in a hospital or a place authorized to be able to observe the person while sleeping.

      The main therapeutic option is the use of artificial tears during the day.. This treatment creates a more robust moist film on the eyeball and thus keeps the eyes more hydrated for longer. This way, in case the patient has them opened at night, his eyes will be better prepared against environmental pathogens rather than preventing them from drying out even if they do not close the eyelids.

      Eye masks or face masks can protect them from damage and stimulation, acting as a physical barrier for pathogens, dust and light rays. There are glasses specially designed to generate moisture in open eyes during sleep.

      Another option in the same vein as the humidifying glasses of a room humidifier, making the room more humid and the eyes are not at too much risk of drying out. Also, this option is not fully recommended and should be closely monitored by a professional, because in the event that the humidifier is contaminated, eye damage will be severe.

      Finally, a curious but effective therapeutic option is quite simply close your eyes with surgical tape. This measurement should be closely supervised by a doctor, and it is best if it is done in a controlled place, to prevent the patient from placing it incorrectly or skipping the tape and its effect being null. In more severe cases, surgery will be needed to resolve nocturnal lagophthalmos.

      Bibliographical references:

      • Toledano-Fernández N, García-Sáenz S, Ortega-Gómez J, Sánchez Cruz J (2004): Ophthalmological evaluation of the patient with facial paralysis. Proceedings of the Spanish Society of Ophthalmic Nursing, vol. 1
      • Latkany RL, Lock B, Speaker M (2006). Nocturnal lagophthalmos: overview and classification. The ocular surface. 4 (1): 44-53. PMID 16671223.
      • Shorr, N; Goldberg, RA; McCann, JD; Hoenig, JA; Li, TG (2003). Upper eyelid transplant: an effective treatment for lagophthalmos after blepharoplasty. Plast Reconstr Surg. 112 (5): 1444-8. doi: 10.1097 / 01.PRS.0000081477.02812.C9. PMID 14504530
      • Nakazawa, H; Kikuchi, Y; Honda, T; Isago, T; Morioka, K; Yoshinaga, Y (2004). Treatment of paralytic lagophthalmos by loading the eyelid with a golden plate and lateral cantopexy. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. 38 (3): 140-4. PMID 15259671
      • Breus, MJ (2020). One in five people sleep with their eyes open. United States: Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/sleep-newzzz/202001/one-in-five-people-sleeps-their-eyes-open

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