Dry eye is a common condition that happens when your eyes don’t produce enough tears or the tears evaporate too quickly. It can be uncomfortable, and cause some pain, redness, and a burning sensation in your eyes.
Some of the most common reasons for waking up with dry eyes are:
- your eyelids aren’t remaining tightly closed during sleep (nocturnal lagophthalmos)
- you aren’t producing high-quality tears to lubricate your eyes
- you aren’t producing enough tears to lubricate your eyes
Read on to learn about what might be causing your dry eyes, plus how to treat them.
Nocturnal lagophthalmos is the inability to fully close the eyelids when sleeping. It’s thought to be caused primarily by the weakness of the seventh cranial nerve, also known as the facial nerve.
There are various causes for facial nerve weakness, including:
- skull or jaw trauma
- injury to the cerebellar artery, which delivers the facial nerve’s blood supply
- Bell’s palsy, a sudden but temporary facial muscle weakness
To protect and nourish the front surface of the eye, tears have three layers. These include the water, mucus, and oil layers.
The water layer hydrates the eye, while the oil layer prevents the water layer from evaporating. The mucus layer spreads the tears evenly over the surface of the eyes.
All three of these layers are needed to produce tears. If any of these layers aren’t produced at a great enough volume, tear quality drops.
Keratoconjunctivitis sicca is the most common form of dry eyes. It’s caused by an inadequate amount of water in the tears.
Tears are produced by glands around and in the eyelids. According to the American Optometric Association, there are a number of reasons you might not be producing enough tears. These include:
- Age. Dry eyes are common with older age. Most people over age 65 encounter some dry eye symptoms.
- Medical conditions. Blepharitis (eyelid inflammation) can result in low tear production. Low tear production can also be the result of thyroid problems, diabetes, rheumatoid arthritis, or Sjögren’s syndrome.
- Medication side effects. Decongestants, antihistamines, antidepressants, and blood pressure medications can all negatively impact tear production.
The first step is to find out what’s causing your dry eyes. The best way to get that information is to visit your eye doctor for a comprehensive eye exam.
When discussing your dry eyes with your doctor, be sure to tell them about all medications and nutritional supplements you’re taking.
Depending on your specific situation, your doctor might recommend any of the following treatment options:
- Artificial tear drops. You can purchase over-the-counter eye drops that can add lubrication to your eyes. Your doctor might suggest a heavier ointment for use during sleep.
- Punctal occlusion. This is a procedure in which your doctor will close the duct that drains tears from your eyes (punctum).
- Thermal pulsation. If the glands that produce the oil in your tears (meibomian glands) are blocked and causing dry eyes, your doctor might suggest a thermal pulsation system (LipiFlow). This system heats and massages the blockage to remove it.
Your doctor also might recommend any of the following medications:
- cholinergics, or tear-stimulating drugs, such as cevimeline or pilocarpine
- eye inserts, such as hydroxypropyl cellulose ophthalmic insert (Lacrisert), which are inserted between your eyeball and your lower eyelid for lubrication
- antibiotics, which can reduce inflammation that might be interfering with oil-secreting glands.
- prescription eye drops, such as corticosteroids or cyclosporine (Restasis), can control inflammation of your cornea (surface of your eye)
There are many treatments for dry eyes that you can try at home. These include:
- Warm compresses. Applying a warm compress to the eyes can help unclog oil-producing glands. Soak a clean washcloth with warm water and then, with your eyes closed, gently press it against your eyelids. Consider doing this a number of times a day for a week or two.
- Washing eyelids. To help deal with eyelid inflammation, use warm water and a mild soap, such as baby shampoo, to gently massage near the base of your eyelashes on your closed eyes.
- Using a humidifier. Adding moisture to dry indoor air, especially during the winter, can help keep your eyes from drying out.
- Drinking water. Stay hydrated by consuming 8 to 10 glasses of water a day.
- The 20-20-20 rule. For every 20 minutes you spend viewing a screen, try to take a 20-second break and look at something 20 feet away, the American Optometric Association recommends.
- Wraparound sunglasses. Protect your eyes from the sun and drying winds be wearing wraparound sunglasses.
- Air filter. Filters can reduce the amount of dust and other airborne irritants that can promote dry eyes.
Waking up with dry eyes can lessen the positive feelings gained from a good night’s sleep. The itch, the gritty feeling, and the irritation can be annoying and frustrating.
There are some treatment options for dry eye discomfort you can try at home, such as applying a warm compress and washing your eyelids.
However, if your discomfort continues for a few days, make an appointment with your eye doctor. They can do a comprehensive eye exam and recommend a treatment plan.