Dry eyes can put a damper on your day and night. The itch, irritation, and gritty sensations that accompany dry eyes are more than just distracting; they can become downright painful, especially as the day winds down. If you’ve suffered from regular or seasonal eye dryness, you may have noticed that irritation often peaks in the evening, just when you’re hoping to relax, enjoy an evening out, or rest peacefully through the night.
Fortunately, dry eyes at night don’t have to be something you simply endure. By understanding the underlying causes and available treatments, you can take meaningful steps toward comfort and better eye health.
What Causes Dry Eyes?
The causes of dry eye disease vary widely. A common thread, however, is the role of tears. Healthy tears are made up of a complex mix of water, oils, and mucus that work together to keep the surface of your eyes smooth, clear, and well-lubricated. Problems arise when:
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Your eyes don’t make enough tears
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The tears you produce are of poor quality
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Your tears evaporate too quickly
Each time you blink, moisture spreads across the cornea. Without sufficient tears, the cornea can dry out and become irritated, leading to the classic symptoms of dryness: stinging, burning, grittiness, and blurry vision.
Dry Eye, Inflammation, and Health Conditions
Emerging research shows a connection between dry eye syndrome, inflammation, and metabolic disorders. A study published by the U.S. National Library of Medicine suggests that adult females with metabolic conditions may have a higher risk of dry eye disease.
Additionally, certain health issues can directly contribute to dry eye. These include:
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Sjögren’s syndrome
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Sarcoidosis
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Diabetes
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Thyroid disorders
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Sleep apnea (especially with CPAP use)
- Hormonal changes, particularly in menopausal women
- The American Optometric Association (OAO) notes that aging, and taking certain medications including antihistamines, decongestants, and blood pressure drugs, can cause dry eyes.
Why Are Dry Eyes Worse at Night?
While dry eyes can strike at any time, many people find that symptoms intensify as the day wears on and reach their peak at night. Why does this happen?
1. Tear depletion from daily use
After a full day of blinking, focusing on screens, and exposure to dry environments, the eyes’ natural tear reserves may already be low by bedtime.
2. Slowed metabolism and tear production
As you prepare for sleep, your body’s metabolism naturally slows down. Core temperature drops, blood circulation decreases, and tear production is reduced. This means fewer nutrients and moisture reach your eyes during the night.
3. Incomplete eyelid closure (Nocturnal Lagophthalmos)
Some people sleep with their eyes slightly open without realizing it — a condition called nocturnal lagophthalmos. This leaves the surface of the eye exposed to air, allowing tears to evaporate and the cornea to dry out overnight. Causes include:
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Facial palsy
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Eyelid deformity
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Incomplete healing after eyelid surgery
4. Environmental factors
Dry indoor air, air conditioning, fans blowing toward your face, or low humidity levels can accelerate tear evaporation while you sleep.
5. Medications
Certain medications, including antihistamines, decongestants, beta-blockers, antidepressants, and some blood pressure drugs, reduce tear production and may make nighttime dryness worse.
6. Other contributors
Long-term contact lens use, LASIK surgery, and aging (particularly over age 50) can also predispose you to nighttime dryness.
Symptoms of Nighttime Dry Eye
If you experience dry eyes at night, you might notice:
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Burning, stinging, or gritty sensation upon waking
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Red or irritated eyes in the morning
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Blurred vision that improves after blinking
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Sensitivity to light
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Excessive tearing as the eye tries to compensate for dryness
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Discomfort that interferes with falling or staying asleep
Natural Remedies for Dry Eyes at Night
You don’t have to accept dry eyes as a fact of life. There are effective natural and over-the-counter strategies to help relieve nighttime discomfort.
1. Lubricating eye drops, gels, and ointments
During the day, artificial tears can replenish moisture. At night, thicker gels or ointments are preferable because they provide longer-lasting lubrication. Since these can blur vision temporarily, apply them right before bedtime.
2. Moisture chambers or sleep masks
If you suffer from nocturnal lagophthalmos, using a sleep mask or moisture-sealing goggle can protect your eyes from exposure and help retain natural tears.
3. Optimize your environment
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Use a humidifier in your bedroom to maintain humidity between 40% and 60%.
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Avoid directing fans, vents, or CPAP airflow toward your face.
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Consider repositioning your bed if it’s near a draft.
4. Limit screen time before bed
Extended screen use can reduce blink rate and exacerbate dryness. Try to give your eyes a break at least 30–60 minutes before bedtime.
5. Maintain eyelid hygiene
Warm compresses and lid scrubs help reduce inflammation of the eyelid margins and improve tear film quality.
Medical Treatments for Nighttime Dry Eye
If lifestyle changes and over-the-counter remedies aren’t enough, it’s time to consult an eye care professional. A thorough eye exam can uncover the specific causes of your dryness and guide targeted treatment.
Prescription options your doctor may recommend include:
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Anti-inflammatory eye drops (e.g., cyclosporine or lifitegrast) to address underlying inflammation
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Punctal plugs to block tear drainage and help retain moisture
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Serum tears (made from your own blood components) for severe cases
In certain situations, your ophthalmologist may recommend minor surgical procedures to correct eyelid closure issues or protect the cornea.
How to Build a Nighttime Dry Eye Relief Plan
Here’s how you can create an action plan to address your nighttime dryness:
1. Evaluate your symptoms
Note when your dryness is at its worst. Is it upon waking? After staring at a screen? When using your CPAP?
2. Review your medications
If you suspect your medications might contribute to dryness, speak with your doctor about alternatives.
3. Set up your environment
Use humidifiers, reposition fans or air vents, and consider moisture goggles if eyelid closure is incomplete.
4. Establish a nighttime eye care routine
Apply ointments or gels at bedtime, and use warm compresses to improve tear film quality.
5. Book an eye exam
An eye care professional can identify the root cause and recommend personalized solutions.
When to See an Eye Doctor
Occasional dryness can often be managed at home, but you should seek professional help if:
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Your symptoms persist or worsen
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You experience significant redness, pain, or vision changes
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Your eyes feel stuck shut with mucus in the morning
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You have known risk factors (e.g., autoimmune disease, eyelid surgery history)
A comprehensive evaluation will help ensure you get the right treatment — and protect your vision.
Don’t Let Dry Eyes Disrupt Your Sleep or Quality of Life
Dry eyes at night are more than just an annoyance. They can affect your sleep quality, mood, and productivity the next day. The good news is that with the right strategies and medical guidance, you don’t have to suffer in silence.
If dry eyes are interfering with your life, schedule an appointment with the eye doctors at Barnet Dulaney Perkins. Together, we can build a plan that relieves discomfort, protects your vision, and improves your overall well-being.