Is it possible to sleep with your eyes open?

Is it normal, or even possible, to sleep with your eyes wide open? Let's look at it.

We may have seen someone like our children, partner or friends sleep with their eyes open, or we may sleep this way 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 them off at will", which is why we lower our eyelids and try to sleep.

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

Is it possible to sleep with your eyes open?

The normal thing is that, in order to be able to sleep, we close our eyes, we plunge into the darkness and wait for the pleasant embrace of Morpheus.

However, not everyone's eyes are completely closed during sleep. Some people keep them slightly open and others, strangely enough, keep them wide open. This is considered a medical problem and it has a name: nocturnal lagophthalmos..

Nocturnal lagophthalmos is a fairly common medical condition. Apparently, about 20% of the population sleeps with their eyes open. This can pose problems for both the quality of sleep and eye health.It is also a sign of an underlying medical condition.

Although the person can sleep, keeping the eyes partially or completely open can damage them, since they are not adequately hydrated and are exposed to environmental agents.

Thus, the eyes become dry, can become infected, can be scratched by foreign objects, and can become infected. such as dust and nocturnal insects, corneal damage, sores and ulcers, leading to ocular pathologies and, in the worst cases, loss of vision.

Why do we close our eyes during sleep?

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

During wakefulness light is absorbed through cells located in the retina that contain the pigment melanopsina light-sensitive protein. Its stimulation causes information to be transmitted to the brain, specifically to the suprachiasmatic nucleus, a region that regulates circadian rhythms, the sleep-wake cycle and the schedules of body processes.

In addition to preventing brain activation, closing the eyelids moisturizes the eyes while we rest. while we rest. When we are asleep, we cannot blink, which is why it is better to keep the blinds down. On the one hand, having the eyelids lowered provides proper hydration, preventing the eyes from drying out, and on the other hand, it protects them from external agents that swarm in the air.

Causes

There are several causes that may be behind nocturnal lagophthalmos. Here are the main ones.

Paralytic lesion

In this case, the facial nerve in charge of transmitting the nerve information to the Muscle that closes the eyelids is paralyzed.. This may be due to facial paralysis, tumors, trauma or cerebrovascular pathology. It may also be due to Möbius syndrome, which causes damage to the cranial nerves. The muscle loses strength, making it impossible to close the eyelid completely.

Mechanical injury

In the case of mechanical injury, this may be due to external factors. Among them we can find scarring of the eyelids or conjunctiva, eyelid laxity and exophthalmos.. All this may be due to a negligent surgical intervention on the face, a blow to the eyelid or a disease that has 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, ie, having an overactive thyroid, which can interfere with the ability to close the eyelids while asleep. while asleep.

Genetics

It has been seen that nocturnal lagophthalmos is more frequent in those who have a relative who has it.

• You may be interested in "The 5 phases of sleep: from slow waves to REM".

Treatment

Depending on how nocturnal lagophthalmos is occurring and to what extent the person cannot completely close their eyelids, there are different therapeutic options for this condition. All of them should be supervised by an eye care professional. and, preferably, follow up in a hospital or a place where the person can be observed while asleep.

The main therapeutic option is the use of artificial tears during the daytime.. This treatment helps to create a more robust moist film on the eyeball and thus keep the eyes more hydrated for a longer period of time. In this way, in case the patient keeps them open during the night, his eyes will be better prepared to environmental pathogens and prevent them from drying out even if he does not close his eyelids.

Eye masks or eye masks can protect the eyes from damage and stimulation, acting as a physical barrier pathogens, dust and light rays. There are goggles specifically designed to generate moisture in open eyes while sleeping.

Another option along the same lines as the humidifying glasses is to use a room humidifier, making the room more humid and the eyes are not at too much risk of drying out. However, this option is not entirely advisable and should be closely monitored by a professional, since, if the humidifier is contaminated, the damage to the eyes will be serious.

Finally, a curious yet effective therapeutic option is to simply close the eyes using surgical tape. This measure must be closely supervised by a physician, and it is preferable that it be performed in a controlled place, to prevent the patient from putting it on inappropriately or jumping off the tape and its effect being null. In the most severe cases, surgical intervention will be necessary to solve nocturnal lagophthalmos.

Bibliographic references:

• Toledano-Fernández N, García-Sáenz S, Ortega-Gómez J, Sánchez Cruz J (2004): Valoración oftalmológica del enfermo con parálisis facial. Actas de la Sociedad Española de Enfermería Oftalmológica, vol. 1
• Latkany RL, Lock B, Speaker M (2006). Nocturnal lagophthalmos: an 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 skin grafting: an effective treatment for lagophthalmos following 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 lid with a gold plate and lateral canthopexy. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. 38 (3): 140–4. PMID 15259671
• Breus, M. J. (2020). One in Five People Sleeps With Their Eyes Open. United States: Psychology Today. Retrieved from https: