Dry eye disease (DED) is more than just an uncomfortable condition. It can significantly impact various aspects of life, including work productivity, physical health, and mental well-being. One of the lesser-known but critical aspects of DED is its relationship with sleep. Research has shown that sleep disorders are notably common in patients with dry eye syndrome, leading to further health complications and a decline in overall well-being.
Understanding the connection between dry eyes and sleep
Dry eye disease (DED) is when the eyes don’t produce enough tears or tear evaporation too quickly, disrupting your eyes’ aqueous tear film. Causes of dry eye syndrome include medical conditions, medication, allergens, environmental factors like dry air, or prolonged contact lens use. Symptoms of dry eye often include burning, itching, redness, and a gritty sensation, making it uncomfortable and affecting vision. But another potentially overlooked symptom of dry eye could be poor sleep.
A significant study involving over 71,000 participants revealed that individuals with dry eye experience notably poor sleep quality. This correlation appeared across all age groups and genders. Patients with dry eye are 1.5 times more likely to suffer from poor sleep than those without the condition. Moreover, the eye condition ranks among the top five conditions significantly reducing sleep quality, with an impact comparable to sleep apnea.
Patients with autoimmune health conditions that are associated with dry eyes, like Sjögren’s syndrome, have an even higher prevalence of sleep disorders, too, with 81.7% of these patients experiencing sleep issues.
Poor sleep and dry eye disease, which came first?
The relationship between dry eyes when sleeping and poor sleep is complex and bidirectional. Each condition can exacerbate the other, creating a vicious cycle. Poor sleep can cause dry eyes, but the symptoms can also contribute to poor sleep.
How does poor sleep affect your eyes?
Not surprisingly, poor sleep is one of the risk factors for developing a dry eye condition. Individuals with poor sleep quality are 50% more likely to suffer from dry eye than those with better sleep habits. When you don’t sleep enough, your eyes don’t have time to rest and regenerate, leading to a lack of tear production or poor-quality tears.
But there are other ways sleep quality can affect your eyes and the tears that lubricate them. Studies have shown poor sleep results in saltier tears (tear hyperosmolarity), reduced time between blinking and breaking the tear film, and increased eye pain. Sleep deprivation may increase stress hormones such as cortisol, epinephrine, and norepinephrine, reducing tear production and resulting in lower-quality tears.
How can dry eye disease affect sleep?
Dry eye disease symptoms can cause your sleep to deteriorate, especially if you experience severe dry eye disease.
Dry eyes cause discomfort and irritation, making it difficult to fall asleep or causing you to wake up several times throughout the night. This discomfort can also lead to psychological distress, further complicating sleep patterns. Patients with dry eyes may also experience incomplete eyelid closure, called nocturnal lagophthalmos. This can lead to air and light exposure of the ocular surface during sleep, which can cause inflammation that contributes to nighttime dry eyes and disrupted sleep.
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A complex relationship
While dry eye disease and sleep quality affect one another, it can be challenging to determine their exact relationship. That is because other factors can contribute to both conditions. For example, sleep apnea is associated with dry eye disease and low-quality sleep. Depression is also linked with poor sleep, and those with depression are at higher risk of developing dry eye syndrome. Even something as mundane as digital screen use is linked to disrupted sleep and dry eye. These confounding variables make it challenging to pinpoint whether dry eye syndrome causes poor sleep or vice versa.
How can sleep and dry eye be managed?
The bottom line is that addressing both sleep and symptoms of dry eye can significantly improve overall quality of life. Here are some strategies to consider:
Lifestyle changes
Sometimes, simple lifestyle changes and home remedies can improve dry eye and reduce sleep disturbances.
- Consistent sleep schedule: Getting enough sleep and maintaining a regular sleep routine is crucial.
- Relaxing bedtime routine: Before bed, engage in calming activities such as taking a bath, reading a book, or meditating.
- Avoid screens: Reduce screen time and dim lights two hours before bedtime to reduce eye strain.
- Humidify the bedroom: Adding moisture to the air via a humidifier can alleviate dryness.
- Avoid irritants: Minimize exposure to smoke, fans, and other irritants.
- Use a sleeping eye mask for dry eyes: Using sleep goggles or taping the eyelids closed can prevent excessive drying during sleep. A dry eye sleep mask may also reduce eye exposure while sleeping.
Medical interventions
If you experience dry eyes after sleeping that don’t improve with at-home care, it’s recommended to seek the help of a professional. Our doctors can perform an eye exam to assess your eye health and help treat underlying conditions contributing to dry eye and poor sleep. They may recommend the following treatment options:
- Topical medications: Treatments such as prescription steroid eye drops can improve dry eye symptoms and sleep quality.
- Eye ointments: Nighttime eye ointments provide additional moisture.
- Referral for CPAP therapy: Continuous positive airway pressure therapy (CPAP) can help improve sleep quality for those with sleep apnea.
- Punctal plugs: Using punctual plugs can increase tear volume and reduce dependency on over-the-counter artificial tears.
- Treat eyelid conditions: Address issues like blepharitis or meibomian gland dysfunction that affect tear quality.
Consider AGEI for your dry eye symptoms
Assil Gaur Eye Institute remains laser-focused on our founding mission of providing exceptional health care in a compassionate and caring environment. We understand that the relationship between sleep and dry eye disease is complex and intertwined, and both conditions must be addressed to improve eye health and overall health.
Please call (866) 945-2745 or make an appointment online.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
FAQs on Dry Eye Disease
Does dry eye ever go away?
Dry eye can be temporary or chronic; our eye doctor can help determine your dry eye type. While artificial tears may help with temporary dry eyes, chronic dry eye often requires treatment.
Is dry eye caused by lack of sleep?
Dry eye may be one of the side effects of lack of sleep. Studies show that individuals with poor sleep habits are more likely to suffer from dry eye, though the link between dry eye disease and poor sleep isn’t straightforward.
Does drinking water help dry eyes?
Staying hydrated can help with adequate tear production, but drinking water alone is often not enough to remedy dry eyes.
Sources:
Ayaki M, Toda I, Tachi N, et al. Preliminary report of improved sleep quality in patients with dry eye disease after initiation of topical therapy. Neuropsychiatr Dis Treat. 2016; 12: 329–337. https://pubmed.ncbi.nlm.nih.gov/26937189/
Ayoubi M, Cabrera K, Mangwani S, et al. Associations between dry eye disease and sleep quality: a cross-sectional analysis. BMJ Open Ophthalmol. 2024 Jan 4;9(1)
. https://pubmed.ncbi.nlm.nih.gov/38177080/
Lee YB, Koh JW, Hyon JY, et al. Sleep deprivation reduces tear secretion and impairs the tear film. Invest Ophthalmol Vis Sci. 2014;55(6):3525-3531. Published 2014 May 15. doi:10.1167/iovs.14-13881. https://pubmed.ncbi.nlm.nih.gov/24833736/
Li A, Zhang X, Guo Y, et al. The Association Between Dry Eye and Sleep Disorders: The Evidence and Possible Mechanisms. Nat Sci Sleep. 2022 Dec 15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762265/
Magno MS, Utheim TP, Snieder H, et al. The relationship between dry eye and sleep quality. Ocul Surf. 2021 Apr;20:13-19. https://pubmed.ncbi.nlm.nih.gov/33421635/
Wu M, Liu X, Han J, et al. Association Between Sleep Quality, Mood Status, and Ocular Surface Characteristics in Patients With Dry Eye Disease. Cornea. 2019;38(3):311-317. doi:10.1097/ICO.0000000000001854. https://pubmed.ncbi.nlm.nih.gov/30614900/
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