Medical conditions, reduced tear quality, or lack of tear production can all cause dry eyes upon waking. Treatment options will vary, but may include the use of eye drops and certain lifestyle changes.
This article explores what could be causing dry eyes upon waking, treatment options, and home remedies.
A person with dry eyes upon waking may experience the following symptoms:
- redness on the whites of the eye
- burning sensations
- sensitivity to light
- blurring vision
- stringy mucus near their eye
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.
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.
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
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
- 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
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.
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
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.
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.
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.