Whether it is due to a CPAP machine or Floppy Eyelid Syndrome, nighttime dryness due to sleep apnea can be addressed through methods such as eye drops or ointments. If the eyelids are unknowingly flipped overnight, the front of the eye can be exposed and corneal damage can occur. As the name suggests, Floppy Eyelid Syndrome results in eyelids that are loose and may have the tendency to flip over, especially during sleep when they are in close contact with a pillow. Beyond the risks of nighttime dryness associated with a CPAP machine, sleep apnea is associated with a condition known as Floppy Eyelid Syndrome, which also worsen symptoms of dry eye disease. A CPAP mask rests over the nose and mouth and administers a constant flow of air to prevent breathing problems during sleep however, if the mask is loose or does not fit properly, it can result in a constant airstream bombarding the ocular surface, and can dramatically worsen symptoms such as burning and irritation. Those with sleep apnea are frequently prescribed a Continuous Positive Airway Pressure (CPAP) machine. In addition to breathing problems, sleep apnea is associated with an increased risk for dry eye symptoms for several different reasons. Sleep apnea is a condition that causes difficulty breathing during sleep. These treatment approaches, in addition to other options such as an eye mask, can be used to reduce damage to the cornea due to exposure, and minimize symptoms of dryness in the morning. If your doctor suspects you are suffering from this cause of nighttime dryness, they may suggest a series of treatment options, including overnight eye drops or ointments that work to protect the front surface of the eye overnight. Your eye doctor can diagnose nocturnal lagophthalmos during a routine eye exam based on symptoms and a distinct pattern of corneal damage. Based on the severity of the eyelid problem, nocturnal lagophthalmos can result in a varying amount of exposure of the cornea, from a millimeter to a majority of the ocular surface. In these cases, the outermost layer of the cornea usually becomes damaged and disrupted, which results in symptoms of dryness such as burning, irritation, and light sensitivity. This results in a portion of the cornea being exposed for extended periods of time, without the eyelid or the tear film properly protecting it. This condition occurs during sleep when the eyelids do not fully close or open slightly throughout the night. Nocturnal lagophthalmos is the most common cause of overnight dryness. Read on to learn more about causes of nighttime dryness and how to address them. Understanding the potential causes of nighttime dryness can reduce the risk of discomfort and irritation, and may help protect the ocular surface. Some underlying conditions can cause extreme dryness overnight that may worsen dry eye disease, leaving the eyes feeling gritty, burning, and uncomfortable in the morning. Even though our eyes are closed, the front surface of our eye is not necessarily protected. Preventative eye care for lagophthalmos before and during sleep may be helpful for DED and sleep quality.Surprisingly, nighttime can be a potentially damaging time for those suffering from dry eye disease. The current study suggested that NL was associated with worsened DED symptoms and poor sleep quality. ![]() Logistic regression analysis showed that NL correlated with younger age, symptomatic DED, and eye symptoms upon waking. NL was more prevalent in the DED group (p = 0.007). Furthermore, people belonging to the DED group were more frequently working night shifts (p < 0.001). ![]() Sleep duration was significantly shorter (p = 0.008), sleep latency was longer (p < 0.001), and sleep efficacy was worse compared with the non-DED group (p < 0.001). The DED group was comprised of 890 subjects (44 ± 13.8 years, 359 males) and women were predominant (p < 0.001). ![]() Participants were divided into two groups according to the presence of DED, and responses were compared between the groups. The participants were asked to answer a questionnaire about DED, sleep quality, and happiness. We launched a survey website to recruit 2000 Japanese. This study aimed to evaluate the prevalence of NL and sleep quality in DED patients. Nocturnal lagophthalmos (NL) refers to the inability to close the eyelids during sleep, which is known to affect dry eye disease (DED) symptoms and sleep quality.
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