Dry Eyes at Night: When Symptoms Depend on the Time of Day
Medically reviewed by Andrew Greenberg, MDMedically reviewed by Andrew Greenberg, MDDry eyes at night could result from contact lens use, taking certain medications, having health conditions, screen use, sleep habits, the environment, and hormonal changes, among others. Dry eyes can feel like burning or itching or like something is stuck in your eye. No matter the cause, there are ways to manage dry eye symptoms.
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Nighttime Dry Eye CausesMedication UseCertain medications, including allergy medications, antidepressants, and blood pressure medications, contribute to dry eye. You may experience dry eye as a side effect during the day, at night, or at both times.Dust, Wind, or SmokeExposure to dust, smoke, or wind during the day can irritate your eyes and lead to dry eye symptoms at night. Your nighttime environment can also contribute to the symptoms. For example, a fan above or beside your bed or an air-conditioner could cause dry eyes.Hormonal ChangesHormonal changes due to pregnancy, menopause, certain health conditions like polycystic ovary syndrome (PCOS) or thyroid disease, or medications that affect your hormones can cause dry eyes. The mechanisms behind each differ.Sleeping With Your Eyes OpenSome people sleep with their eyes open—a phenomenon called nocturnal lagophthalmos (NL). Even slightly opening your eyes while sleeping can lead to symptoms, causing you to wake up with dry eyes. NL can affect tear production and contribute to dry eyes at night.Certain Medical ConditionsDiabetes, rheumatoid arthritis (RA), Parkinson's disease, Sjögren's syndrome, and thyroid disease are all associated with a greater incidence of dry eye. If you have one of these conditions, it's possible for dry eye symptoms to occur more often at night.Previous Eye SurgeryDry eye is one of the more common side effects of refractive surgeries such as LASIK (laser-assisted in situ keratomileusis). It can affect some people for up to a year or more after the procedure. Previous eye surgery, such as LASIK, can cause dry eye symptoms and contribute to nighttime dry eyes.Screen TimeLooking at digital screens for hours a day can lead to dry, strained eyes. Researchers conducted a literature review on the relationship between screen use and dry eyes and concluded that the primary cause of dry eyes may relate to your "blink rate"—how infrequently or incompletely people blink while looking at a screen.Wearing Contact LensesApproximately 40% of people who wear soft contact lenses experience dry eye symptoms, especially later in the day when they've been wearing them for an extended period. Contact lenses can make your eyes feel more dry, but you may not notice it until you remove them at the end of the day.
What About Dry Eyes in the Morning?It's possible to experience dry eyes upon waking. Many of the causes of dry eyes in the morning are similar to the causes of dry eyes at night. However, some sleep disorders may cause you to wake up with dry eyes. For example, people who wear a mask for sleep apnea—even a well-fitted one—can allow air to leak toward their eyelids, causing dry eyes.
Medications Linked to Dry EyesCertain medications may cause daytime or nighttime dry eye symptoms. Drugs linked to dry eyes include:AntidepressantsAntihistaminesAspirinCertain types of blood pressure medications, including beta blockers and diureticsHormone replacement therapyNasal decongestantsOral birth controlSeizure medicationsHow Dry Eyes Feel at NightHaving dry eyes at night could cause multiple sensations and symptoms. Or, you may have one or two of the symptoms below:Blurry visionBurningDiscomfort wearing contact lenses and even after removing themDrynessFeeling as if something is in your eye(s)Light sensitivityRednessTearingHow to Manage Symptoms at NightThere are several treatments you can try to manage dry eyes, such as:Use over-the-counter artificial tears: If you can, use preservative-free artificial tears. They cost a little more, but they are less likely to irritate your eyes than tears with preservatives. (Try a gel drop or ointment if tears do not help.)Reevaluate your environment: If a fan or air-conditioner blows wind toward your face while you sleep, it may be causing dry eyes. Also, remove dust on surfaces near your bed.Use a humidifier: A humidifier may counteract the effects of an air-conditioner or fan and provide more moisture to the air.Take regular breaks from screen use: The American Optometric Association's 20-20-20 rule can help. This means that every 20 minutes, take a 20-second break and look at something 20 feet away.Wear sunglasses outdoors: Sunglasses can help protect your eyes from dust, wind, and sun.Stay hydrated throughout the day: Insufficient hydration can cause various symptoms, including dry eyes.Remove your contact lenses at night: Remove your contacts to give your corneas (the dome-shaped front part of your eye) a chance to breathe.Apply a warm compress to the eyes: A warm (not hot), damp folded washcloth can help soothe dry eyes.When Symptoms Warrant a Provider VisitYou may reach a point where you need to contact a healthcare provider, like an eye doctor, to help with your dry eye symptoms at night. Contact a provider if:Home-based treatments for dry eye don't relieve your symptoms.Home-based treatments provide only partial relief.Your symptoms worsen despite home-based treatments.A healthcare provider can order prescription dry eye medications or, for severe cases, recommend procedures that will help you retain your own tears. This includes punctal plug insertion, in which an eye doctor uses a special tool to place a plug in the tear duct's opening. An eye doctor also can evaluate your eyes for ocular surface inflammation, which may contribute to your dry eyes.SummaryCertain medications, aging, screen use, medical conditions, and your environment (such as exposure to dust or wind) can cause dry eyes at night, leading to symptoms like blurry vision, burning, dryness, excessive tearing, and sensitivity to light.You can manage dry eyes by instilling artificial tears (preferably preservative-free), looking for and alleviating environmental triggers, using a humidifier, and taking regular screen breaks. If symptoms don't improve, contact a healthcare provider. Read the original article on Verywell Health.
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