Sleeping with eyes open: what is nocturnal lagophthalmos?

Have you ever entered your bedroom late at night and started talking to your partner who was chilling out on the bed, just to hear them snore loudly in response? While lying there with their eyes open? No, they are not faking it, they really are sleeping. Can you sleep with your eyes open? Yes. And it is more common than you think. This condition is called nocturnal lagophthalmos and it affects about 1 in 5 people!

Sleeping with eyes open: what causes nocturnal lagophthalmos?

The most common causes of nocturnal lagophthalmos are problems with facial muscles, nerves or skin around the eyes. These problems can come as a result of injury or illness, such as stroke, Bell’s palsy (a condition that causes temporary paralysis or weakness in facial muscles), a disorder Moebius syndrome, which causes problems with cranial nerves, or autoimmune disorders such as Graves’ disease which causes bulging eyes.

But sometimes, there is no clear cause or underlying medical problem. Nocturnal lagophthalmos can also be simply due to genetics.

How do you know if you have nocturnal lagophthalmos? Unless you have a partner who will be properly freaked out witnessing you snore with your eyes half open, you won’t know it with any certainty.

But there are some common symptoms that might point to this condition. People who sleep with their eyes open often wake up with red eyes or blurry vision, or eyes that feel dry or irritated.

Is nocturnal lagophthalmos bad?

If your eyes are not fully closed that means they’re not properly lubricated. While nocturnal lagophthalmos is generally a dangerous condition, it can lead to eye problems down the road, such as eye infections or exposure keratopathy (damage to the cornea). It also negatively affects the quality of your sleep. Both the light that is not properly blocked by your eyelids, and the irritated eyes will not let you sleep as soundly as you could have otherwise.

As treatment, your doctor may prescribe eye drops, moisture goggles or medical-grade hypoallergenic tape that is gently applied to keep the eyelids closed.

It may help to sleep with a humidifier in your bedroom to keep the air moist.

In more severe cases, surgery may be performed, when a gold weight is implanted into the eyelid to help keep it closed at night.