Can You Sleep With Your Eyes Open? Why It Occurs and the Dangers

Causes Include Sleep Disorders and Bell's Palsy

What causes a boy to sleep with his eyes open?
What causes a boy to sleep with his eyes open?. Jena Cumba/Photodisc/Getty Images

It may be a useful skill to have when you want to get some rest when you are supposed to appear attentive, but is it really possible to sleep with your eyes open? Learn why it occurs, the most common causes including Bell's palsy, and some of the possible dangers associated with incompletely closing the eyes during sleep.

Causes of Incomplete Eye Closure During Sleep

First, it is important to agree about what sleep is.

For these purposes, let’s include a lack of conscious awareness of one’s surroundings. In general, sleep involves lying in a recumbent position with the body at rest. We typically are unable to see or respond to external stimuli and we keep our eyes closed. Even with our eyes open, we would not respond to the environment while asleep.

However, this classic description of sleep may not always fit in some circumstances. For example, in the case of parasomnias, sleep (including unresponsiveness) may occur with the eyes remaining open. In these abnormal sleep behaviors, the person remains asleep, or unconscious, but is able to sleepwalk or perform other actions. Part of the brain remains awake while another part is asleep. These behaviors can be quite elaborate, including eating, cooking, driving, and sex. The person experiencing a parasomnia may even have their eyes open, but they will typically have a glazed over look and would be unresponsive to questioning or direction.

Beyond the parasomnias, some people may simply incompletely close their eyes during sleep, allowing the white part of the eye (called the sclera) to remain uncovered. As the eyes closed, the pupils and irises naturally roll upward for protection. Incomplete closure of the eyelids may occur occasionally in healthy people.

Others may be unable to close their eyes due to other medical problems. This is called lagophthalmos. It may occur most commonly as part of a condition called Bell’s palsy, which results in facial weakness and may be due to an infection of the seventh cranial (or facial) nerve. It may also occur with a stroke affecting the brainstem.

It may also be possible to disengage your mind from the processing of visual input while keeping your eyes open, such as may occur in hypnosis or deep meditation.

Interestingly, there are animals like migrating birds or mammals that are able to keep one eye open as they only sleep with one side of their brain at a time (a phenomenon called unihemispheric sleep).

What Are the Dangers Associated with Sleeping with Your Eyes Open?

In general, sleeping with your eyes open (even if only a small degree) may be possible. It is typically harmless, but it may lead to dry or red eyes in the morning if it is prolonged. This irritation may have long-term consequences if it becomes chronic.

In this case, it may be necessary to apply a lubricant to the eye and patch it overnight. Eye drops may also relieve the irritation during the day.

If you are concerned about keeping your eyes open during sleep, especially if you are noticing problems with your eyes, speak with your doctor and consider evaluation by an ophthalmologist to ensure that damage is not occurring to the surface of your eye.

Sources:

Kryger MH et al. "Principles and Practice of Sleep Medicine." Elsevier, 6th edition, 2016.

Mahoach DS, Stickgold R. "Sleep: Keeping One Eye Open." Curr Biol. 2016 May 9;26(9):R360-1.

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