Written by: Mallorie Stallings
Updated March 3, 2021
The idea of “sleeping with one eye open” is a metaphor for being alert. But, you might wonder if people can really sleep with their eyes open.
A portion of people (1) don’t fully close their eyes when they sleep. This tendency is called nocturnal lagophthalmos. It’s difficult to estimate exactly how many people are affected by nocturnal lagophthalmos, but some research shows that it may be relatively common (2), affecting anywhere from 5% to 50% of people (3). It most often affects adults, but can also be found in children in rare cases.
Why Do Most People Close Their Eyes During Sleep?
Closing our eyes during sleep helps to keep the eyes moist and protects the surface of the eye (4). Additionally, our eyelids block light. This is important because when our eyes are exposed to light at night (5), the brain triggers us to wake up and feel more alert.
How Do I Know if I’m Sleeping With My Eyes Open?
The easiest way to determine whether you are sleeping with your eyes open or not is to have someone else check your eyes while you are asleep. It could also help to consider if you have any of the signs of nocturnal lagophthalmos. Some people with this condition don’t have any symptoms. However, possible signs include:
- Sore or painful eyes
- Feeling like you have something in your eye
- Dry eyes
- Watery eyes
- Blurred vision
- Eye redness
In people who sleep with their eyes open, these symptoms are often most severe in the morning after waking up from sleep and tend to get better during the day. Nocturnal lagophthalmos isn’t the only possible cause for these symptoms, though. For example, sleeping with contacts can also cause eye irritation at night.
It’s important to speak with a doctor if you are concerned about your eyes or about how much sleep you are getting. A doctor will examine your eyes as you open and close them to look for any signs of lagophthalmos. They may also check for signs of dry eye.
Why Do Some People Sleep With Their Eyes Open?
Some people with nocturnal lagophthalmos have eye or facial characteristics that make it difficult to close their eyes completely. Sometimes, there is a known cause. For example, nocturnal lagophthalmos often occurs due to paralysis of facial nerves. Scarring of the eyelids can also cause you to sleep with your eyes open. Examples of other specific factors that may lead to nocturnal lagophthalmos include:
- Injury to the face or skull
- Viral or bacterial infection
- Thyroid disease
- Certain surgical procedures
- High alcohol consumption
- Chemical burns
In some cases, it isn’t possible to identify a specific cause of nocturnal lagophthalmos.
Do Sleepwalkers Sleep With Their Eyes Open?
Sleepwalking is another situation in which someone might have their eyes open (7) during sleep, though it’s not related to nocturnal lagophthalmos.
The cause of sleepwalking is not clear. When we sleep, we cycle through a series of stages of sleep. Sleepwalking often occurs during deep sleep early in the night. People who sleepwalk may sit up, walk around, and even talk in their sleep, appearing awake although they are not. Most people who sleepwalk don’t need treatment. However, since sleepwalking can cause someone to trip and fall, it may be appropriate to wake them up or take other precautions to prevent injury.
What Are The Treatment Options?
Some people who sleep with their eyes open don’t have any symptoms and don’t need treatment. Others may experience complications such as dry eyes, pain, or discomfort, and seek help. People with nocturnal lagophthalmos may benefit from one or more of the following treatments:
- Using a Humidifier: A humidifier in the bedroom can help to counteract eye dryness from sleeping with your eyes open.
- Hypnosis: Hypnotherapy aims to create a state of intense concentration and may help some people sleep with their eyes closed.
- Taping the Eyelids Closed: Some people who sleep with their eyes open benefit from using medical tape to keep the eyes closed at night. However, this approach should only be used under the guidance of a medical professional.
- Applying Eyelid Weights: A doctor may also be able to help you explore using small eyelid weights at night to encourage keeping your eyes closed.
- Eye Ointments: Eye ointments are designed to keep the eyes moist at night and may be used in combination with other approaches, such as taping the eyelids closed, to reduce discomfort from nocturnal lagophthalmos.
- Artificial Tears: Another approach to counteracting dry eye symptoms is to use eye drops in the morning and throughout the day as needed.
- Avoiding Alcohol: Drinking a lot of alcohol and then going to sleep can lead to sleeping with your eyes open, so avoiding overconsumption might help.
- Surgery: Surgery, such as to remove a tumor that is causing symptoms or to lengthen the eyelids, may be appropriate. Additionally, surgery to implant a gold weight in the eyelids has been shown to be effective for some patients.
With the help of a doctor, you may be able to safely and effectively reduce symptoms of nocturnal lagophthalmos and get your best night’s sleep.
- https://pubmed.ncbi.nlm.nih.gov/2076287/ Accessed February 26, 2021.
- https://www.sciencedirect.com/science/article/pii/S1873959809700274 Accessed February 26, 2021.
- https://pubmed.ncbi.nlm.nih.gov/32635438/ Accessed March 1, 2021.
- https://www.ncbi.nlm.nih.gov/books/NBK560661/ Accessed March 1, 2021.
- https://pubmed.ncbi.nlm.nih.gov/28214594/ Accessed March 1, 2021.
- https://pubmed.ncbi.nlm.nih.gov/32635438/ Accessed February 26, 2021.
- https://medlineplus.gov/ency/article/000808.htm Accessed February 26, 2021.