If you are an experienced sleeper (and most of us are), you would know that a decent night’s sleep is pretty important. However, you probably also know that there are myriad things that can interrupt our sleep – it’s too cold, too hot, too noisy, too quiet, you have a small infant, you have a big infant, or you share your bed with a chronic snorer. If that list wasn’t enough, recent studies have given us yet another sleep-disrupting factor to add to it – dry eye disease.

What is Dry Eye?

If you’re a parent of a newborn you may be more inclined to ask “what is sleep?”, a question that is evidently also pertinent to dry eye sufferers. But firstly, what exactly is dry eye?

Dry eye disease is a chronic eye condition with a complex range of underlying factors. Globally, it is thought that dry eye disease has a prevalence of up to 50%. Although it doesn’t sound like much, dry eye disease can be debilitating and can significantly affect a person’s quality of life, even being associated with mental illness. In the US alone, the economic burden of managing dry eye disease, including dry eye treatments and an indirect loss of work productivity, is estimated to be over $55 billion. Doesn’t sound like such a trivial condition now, does it?

Much of dry eye disease is thought to go undiagnosed, often because people with dry eye don’t always think to see an eyecare professional for diagnosis or treatment. Here are some of the symptoms of dry eye disease:

• A sensation of dryness, grittiness, or stinging in the eyes
• Feeling like there’s a foreign particle stuck in the eye
• A red tinge to the rims of your eyelids or the whites (conjunctiva) of the eyeball
• Feeling unusually fatigued after a visually intensive task, such as computer work or reading
• Vision that fluctuates between each blink

Studies Indicate a Two-Way Relationship Between Dry Eye and Poor Sleep

Can we also add “poor sleep” to the list of dry eye disease symptoms? According to several studies emerging over the past few years, it appears that it may be relevant. The prevalence of poor sleep quality amongst people with dry eyes varies from study to study, but all research points to an increased likelihood of a bad night’s rest if you concurrently suffer from dry eye.

Not surprisingly, there is a two-way relationship between sleep quality and dry eye. Not only does having dry eye mean you’re more likely to have a poor night’s sleep, but having a bad night is also linked to subsequently experiencing dry eye disease. One study reported that low sleep quality more than doubled the risk of symptomatic dry eye. Conversely, having dry eye disease was found to make you one and a half times more likely to catch a poor night’s sleep. It was also noted that there is a positive relationship between the frequency of dry eye symptoms and prevalence of poor sleep quality. In other words, people who often experience dry eye symptoms are more likely to have sleep disturbances compared to someone who only occasionally experiences dry eye.

It’s not fully understood exactly how poor sleep contributes to dry eye disease or how dry eye disease causes a poor night’s sleep. The relationship between the two is known to be very complex with a multitude of confounding factors. Sleep deprivation has been shown to result in reduced tear production after just one night, as well as changes to the evaporation rate of tears from the eye’s surface. It’s also been suggested that people with dry eyes may be more prone to inflammation of the eye during sleep compared to those without dry eye disease.

However, it can be tricky to isolate the direct effects of dry eye on sleep and vice versa. Consider this:

• Sleep apnea is associated with dry eye disease as well as sleep disruptions
• People with an autoimmune disease known as Sjogren’s syndrome are more likely to experience a bad night’s sleep; one of the symptoms of Sjogren’s is dry eye
• Depression is linked to poor sleep quality and is also increased in likelihood in those with dry eye disease
• Using computers or other digital devices during the day can disrupt sleep at night; additionally – you guessed it – digital devices are also associated with an increased risk of dry eye disease

Treatments for Dry Eye Disease

As you can see, sleep and dry eye have a complicated relationship, with the waters further muddied by various other factors. Although assessing dry eye disease is not (yet) mainstream when it comes to trying to improve one’s sleep quality, future treatment strategies for sleep disorders may well come to one day include managing dry eyes. Chronic poor quality sleep is linked with a shortened lifespan, diabetes, high blood pressure, obesity, and cardiovascular disease, as well as an increased risk of motor vehicle accidents and other injuries.

A tailored dry eye management plan can be obtained by visiting your optometrist or eye specialist. This is the most effective approach as there are different types of dry eyes and a variety of underlying causes. Your eyecare professional may recommend one or more management strategies. These include lubricating eye drops, medicated eye drops, warm compresses, eyelid hygiene, or even more novel treatments such as intense pulsed light therapy or eye drops formulated from your own blood serum.

If you need a little more sleep in your life, investigating whether dry eye therapies can help may be worthwhile. From improving your mood during the day to possibly extending your life by a few extra years, grabbing a good night’s sleep is always important!