(I-MED Pharma)
Whether you regularly wake up with dry eyes or experience dry or gritty eyes at night, we’re here to shed some light on why your eyes may be dry at different times of day – specifically before or after sleeping!
Getting the right amount, and the right quality, of sleep is critical to your overall health, and it’s also important in maintaining the health of your eyes. This article will explore the role of sleep in managing dry eye disease, along with a multi-step approach that can include such things as warm compresses and daily ocular hygiene for optimal results.
The Relationship Between Dry Eyes and Sleep
Dry eye disease is a multifactorial disease that occurs when natural tears are unable to keep the surface of the eye sufficiently lubricated. It can be caused by a range of factors, including aging, hormonal changes including those associated with menopause and pregnancy, surgery, certain medications, excessive screen time, environmental conditions, and some autoimmune conditions like Sjögren’s syndrome.
Sleep is essential for your overall health, supporting your brain and heart health[1], as well as your eyes. Lack of sleep can lead to dry eyes, with one study demonstrating that one night of sleep deprivation had measurable effects on the tear film[2], the protective coating that keeps the eyes hydrated.
Dry eyes themselves can impact the ability of some to fall asleep or to sleep restfully, leading to a vicious cycle. Many people with dry eye disease also suffer from sleep disorders[3]. Sleep deprivation in those who suffer from insomnia, anxiety, or depression can be a cause of dry eye, while in other instances, those who experience anxiety or depression may also experience dry eye as a side effect of their medication.
The impacts of dry eyes on sleep and vice versa can be complicated by the presence of other conditions. For example, sleep apnea may negatively impact sleep quality without the aid of a device like a CPAP machine or other Nasal Mask Therapy (NMT) device, but simultaneously, the use of these devices themselves and the air that they generate can also lead to dry eyes, particularly in those who are female, are older, or have inflammatory or metabolic conditions[4].
Another condition that impacts the eyes during sleep is nocturnal lagophthalmos, or the inability to fully close the eyelids while sleeping. This leaves the surface of the eye exposed to the air and causes it to dry out.
Getting enough good quality sleep is essential for the health of the tear film that protects your eyes and ensures they stay lubricated. Being well rested also improves your mental health, which is beneficial when it comes to dealing with the discomforting symptoms and the demands of managing them.
This bidirectional relationship between poor sleep and dry eyes can be difficult to contend with, but there are management solutions that can offer relief and improve sleep quality.
Warm Compresses for Dry Eye Relief
If your eyes are dry and itchy at night, a warm compress can be applied to help alleviate discomfort. According to the TFOS DEWS II report, warm compresses help stimulate Meibomian glands in the eyelids so that they’re able to produce more oil[5], which is a vital part of the protective tear film. They help to prevent tears from evaporating too quickly, increase blood circulation, and relax the eyes, resulting in improved comfort.
The I-RELIEF™ Hot & Cold Therapy Eye Mask is one solution: this reusable eye mask for dry eyes with a washable fabric slipcover uses naturally hydrating ThermaBeads™ for deep penetrating, moist heat therapy. I-RELIEF™ can also be used cold to provide relief from headaches, tension, sinus pressure, swelling or puffiness, and red, tired, or painful eyes.
Ocular Hygiene: A Key Step in Dry Eye Management
Ocular hygiene is an essential part of a comprehensive eye care routine, especially when you suffer from dry eyes. The eyelids and lashes protect the eyes from debris, toxins, and other particles that can lead to redness, inflammation, pain, or itching. Keeping them clean helps to break the dry eye cycle by improving dry eye symptoms, reestablishing tear film stability, and improving the function of the Meibomian glands[6].
I-MED Pharma offers a range of ocular hygiene cleansers, including I-LID ’N LASH® wipes or pump, which gently remove debris and reduce bioburden. These can be used twice daily to clean your lids and lashes and soothe the delicate skin around the eyes.
For these in need of a deeper clean, I-LID ’N LASH® PLUS wipes help to maintain lid and lash hygiene with the added benefits of tea tree oil (TTO), an essential oil with superior cleansing properties that has been shown to be effective in relieving symptoms of blepharitis and improving tear film stability[7].
I-LID ’N LASH® ocular hygiene cleansers can be used in the morning or at night, after using a warm compress but before applying preservative-free artificial tears or overnight ointment. For maximum efficiency, gently cleanse in a circular motion starting at the roots of the eyelashes and working outwards.
Overnight Ointment for Nighttime Dry Eyes
If you suffer from severe dry eye or nocturnal lagophthalmos and notice your dry eyes are worse in the morning, one potential solution is using an overnight ointment. Overnight ointments have a prolonged contact time with the ocular surface to protect the eyes while you sleep.
I-DEFENCE® is a hydrating and lubricating night time eye ointment for dry eyes, applied directly to the surface of the eye, that contains 0.40% sodium hyaluronate and provides maximum relief for severe chronic dry eye. Using an ointment to protect the eye during sleep can help to improve sleep quality as well as comfort levels during the day.
Additional Recommendations for Improving Sleep and Eye Health
Sleep Environment:
Establishing a sleep-friendly environment can also have a positive effect on sleep quality and dry eye symptoms. It can be beneficial to use a humidifier to prevent the surrounding air from getting too dry[8]. In the case of lagophthalmos, limiting direct airflow towards the eyes as much as possible can also be helpful[9]. Screen time should also be limited before bed to avoid sleep disruption.
Diet:
One common dietary factor in dry eye is omega-3 deficiency. In this case, supplements can provide systemic relief from dry eye symptoms. I-VU® OMEGA-3 PLUS omega-3 capsules for dry eyes and I-VU® OMEGA-3 liquid provide the three most important omega-3 fatty acids (EPA, DHA, and DPA) in the high-quality, re-esterified triglyceride form (rTG) for easier absorption into the bloodstream.
Visiting Your Eye Care Professional:
When you suffer from dry eye, it is important to pay regular visits to your eye care professional, especially if you have specific complaints. Your eye care professional will be able to provide recommendations and management solutions tailored to your particular situation, and regular follow-ups ensure the progress of your dry eye management practices is monitored and adjusted as needed.
Conclusion
As we have seen, sleep and dry eye have a complex relationship. If you find that your eyes are especially dry or uncomfortable at night or in the morning, it’s worth consulting with your eye care professional to discuss the steps you can take to manage your symptoms. A multi-step approach is key to effective dry eye management, and a comprehensive eye care routine can help ensure that you’re able to get the rest you need!
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[1] Ramar, Kannan, et al. “Sleep is Essential to Health: An American Academy of Sleep Medicine Position statement.” Journal of Clinical Sleep Medicine, vol. 17, no. 10, Oct. 2021, pp. 2115–2119, https://doi.org/10.5664/jcsm.9476.
[2] Magno, Morten Schjerven, et al. “The Relationship Between Dry Eye and Sleep Q” The Ocular Surface, vol. 20, Apr. 2021, pp. 13–19, https://doi.org/10.1016/j.jtos.2020.12.009.
[3] Ayaki, Masahiko, et al. “Sleep Disorders Are a Prevalent and Serious Comorbidity in Dry Eye.” Investigative Ophthalmology & Visual Science, vol. 59, no. 14, 27 Nov. 2018, https://doi.org/10.1167/iovs.17-23467.
[4] Matossian, Cynthia, et al. “The Prevalence and Incidence of Dry Eye Disease Among Patients Using Continuous Positive Airway Pressure or Other Nasal Mask Therapy Devices to Treat Sleep Apnea.” Clinical Ophthalmology (Auckland, N.Z.), U.S. National Library of Medicine, 15 Oct. 2020, https://pmc.ncbi.nlm.nih.gov/articles/PMC7573305/.
[5] “TFOS DEWS II Report.” TFOS, tfosdewsreport.org/report-management_and_therapy/147_36/en/. Accessed 29 Nov. 2024.
[6] Chuckpaiwong, Varintorn, et al. “Compliance with Lid Hygiene in Patients with Meibomian Gland D” Clinical Ophthalmology, Volume 16, Apr. 2022, pp. 1173–1182, https://doi.org/10.2147/opth.s360377.
[7] Maher, Thuraya Noaman. “The Use of Tea Tree Oil in Treating Blepharitis and Meibomian Gland D” Oman Journal of Ophthalmology, vol. 11, no. 1, 2018, p. 11, https://doi.org/10.4103/ojo.ojo_205_2016.
[8] “Dry Eye.” National Eye Institute, U.S. Department of Health and Human Services, nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye#section-id-5930. Accessed 29 Nov. 2024.
[9] Kabat, Alan G. and Joseph W. Sowka. “’Like Sandpaper in the Morning’: Here’s How You Can Help Break the Vicious Cycle of Nocturnal L” Review of Optometry, vol. 149, no. 4, 2012, https://go.gale.com/ps/i.do?p=AONE&u=lond95336&id=GALE%7CA289217524&v=2.1&it=r&sid=AONE&asid=3dde1430.