Waking Up With Dry Eyes: Causes And What To Do

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Symptoms of dry eyes

A person in bed looking at their phone and rubbing their eye. — FG Trade/Getty Images

A person with dry eyes upon waking may experience the following symptoms:

redness on the whites of the eye
stinging
burning sensations
scratching
sensitivity to light
blurring vision
stringy mucus near their eye

Nocturnal lagophthalmos

Nocturnal lagophthalmos (NL) may cause people to have dry eyes upon waking.

NL is a condition where individuals are unable to close their eyelids during sleep. This can impair the functioning of the tear film, a layer of fluid that covers the surface of the eye.

A 2020 study found that NL may worsen symptoms of dry eyes and reduce the quality of sleep. The research suggests that overstimulation of the Muller’s muscle — one of two muscles that help keep the eye open during waking hours — could cause this condition.

The sympathetic nervous system triggers the Muller’s muscle. The sympathetic nervous system acts as the “fight or flight” response in the body, sending extra blood supply to muscles to prepare for physical activity.

The study also reported that risk factors for NL included younger age and shift work.

Tear quality

A reduction in tear quality may be causing people to wake up with dry eyes.

The lacrimal glands sit above each eye and help produce tears. Tears cover the surface of the eye to protect it and keep it lubricated before draining out through the tear ducts in the corners of the eye.

Tears consist of three layers, which all help protect the front of the eye:

Water layer: The thickest layer that helps protect the eye from bacteria and keeps the surface of the eye hydrated.
Oil layer: The meibomian glands that line the upper and lower eyelids secrete this layer. The oil layer helps prevent the water layer from evaporating and keeps tears smooth for the eye to see clearly through.
Mucous layer: Goblet cells in the conjunctiva — the transparent layer covering the white of the eye — help create this layer. The layer helps spread tears over the eye evenly and keeps them attached to the surface of the eye.

If there is an issue with any of these layers, it can cause the tears to evaporate too fast or not cover the surface of the eye evenly enough, which can lead to dry eyes.

Inadequate tear production

If tear glands do not produce enough tears, it can lead to dry eyes. Certain factors may reduce tear production, including:

being over the age of 65 years, as tear production reduces as people age
certain medical conditions, such as diabetes, thyroid conditions, or autoimmune conditions
certain medications, such as antihistamines, decongestants, antidepressants, and blood pressure medications
dry or windy environments, which can lead to quicker tear evaporation
not blinking as much due to looking at a screen for long periods of time
refractive eye surgery
hormonal changes, such as menopause, pregnancy, or taking oral contraceptives

Treatment

According to a 2020 study, the simplest and most effective treatment for NL is to use an ophthalmic ointment before going to sleep. People can also use artificial tears to treat any symptoms of dry eyes.

The research also suggests the following treatments for NL:

taping the eyelid closed during sleep
using warm eye masks
aromatherapy
taking a warm bath

Performing relaxing activities, such as taking a warm bath, may help increase parasympathetic activity — which helps regulate the body’s “rest and digest function” — and decrease sympathetic activity before sleeping. This may reduce stimulation of the Muller’s muscle above the eyelid. Using warm compresses could also help, which increases lipid secretion from the meibomian glands, according to an older study.

To treat reduced tear quality, people may use artificial tears. Individuals may find they can treat dry eyes with over-the-counter (OTC) artificial tears. The American Optometric Association (AOA) recommends using preservative-free artificial tears, as these may cause less irritation.

Treatments to increase tear production include:

using artificial tears or eyedrops
using prescription eyedrops, which help the eye create more tears
taking an omega-3 fatty acid supplement

Treatments that block the tear ducts can help keep tears in the eye for longer. People may use punctal plugs, small silicone or gel plugs that insert into the tear ducts. In some cases, individuals may have a surgical procedure to block the tear ducts permanently.

Home remedies

People could treat dry eyes upon waking with the following home remedies:

using a humidifier if they live in a dry environment
using a high-quality air filter if they live in a city or area with high levels of air pollution
limiting the use of fans or hair dryers, which can dry the eyes
wearing wraparound sunglasses in wind or sun
avoiding cigarette smoke, which can irritate and dry the eyes
taking regular breaks and blink more often if looking at a screen for long periods
using lubricating eye gels, which may temporarily blur vision, so a person should use this before sleeping or resting
gently pressing a warm compress over closed eyes
gently washing eyelids with warm water and mild soap before rinsing thoroughly
drinking 8–10 glasses of water each day to stay well hydrated

Outlook

Using an ophthalmic ointment before sleeping is generally an effective treatment method for NL.

According to the AOA, people can usually treat mild cases of dry eyes with OTC artificial tears.

Contacting a doctor

If people find that OTC treatments and home remedies are not effective in treating dry eyes, they can talk with a doctor.

A healthcare professional will be able to treat dry eyes to relieve uncomfortable symptoms and prevent any negative effects on eye health or vision.

Summary

A person may experience dry eyes when they wake due to a medical condition called NL, reduced tear quality, or low tear production.

Medical treatments for dry eyes will depend on the cause. However, people can try a variety of home methods to help relieve or prevent symptoms. They include using a humidifier or warm compresses, applying eye drops, and drinking plenty of water.

If home treatments are not effective, individuals can talk with their doctor to explore other suitable treatment options.

Read this article in Spanish.

Dry Eye
Eye Health / Blindness

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Abdelhady, A., et al. (2020). Anatomy, head and neck, eye superior tarsal muscle (Mullers muscle). https://www.ncbi.nlm.nih.gov/books/NBK540964/
Alshak, M. N., et al. (2020). Neuroanatomy, sympathetic nervous system. https://www.ncbi.nlm.nih.gov/books/NBK542195/
Boyd, K. (2018). Remedies to reduce dry eye symptoms. https://www.aao.org/eye-health/tips-prevention/dry-eye-tips
Boyd, K. (2021). What is dry eye? Dry eye. (n.d.).https://www.aao.org/eye-health/diseases/what-is-dry-eye
Dartt, D. A. (1998). Physiology of tear production. The Dry Eye. Berlin: Springer.https://link.springer.com/chapter/10.1007/978-3-642-58130-4_4
Mukamal, R. (2016). Facts about tears. https://www.aao.org/eye-health/tips-prevention/facts-about-tears
Olson, M. C., et al. (2003). Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction. https://pubmed.ncbi.nlm.nih.gov/12695712/
Takahashi, A., et al. (2020). Nocturnal lagophthalmos and sleep quality in patients with dry eye disease.https://www.mdpi.com/2075-1729/10/7/105/htm

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Medically reviewed by Jenna Stoddard, OD, FAAO — Written by Beth Sissons on June 30, 2021

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Symptoms of dry eyes

Nocturnal lagophthalmos

Tear quality

Inadequate tear production

Treatment

Home remedies

Outlook

Contacting a doctor

Summary

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