Nocturnal Evaporative Stress

Are you a Dry Eye sufferer that also suffers from poor quality sleep and daytime tiredness? It’s no coincidence. Poor quality of sleep is related to a disruption in the circadian rhythm, which has been reported to influence tear secretion and tear stability. 1


According to several studies, about 25 million adults in the U.S. have obstructive sleep apnea. Since it is estimated that only 10% of the population has been adequately screened for an appropriate diagnosis, the actual number of sleep apnea sufferers is likely much higher.

Compared to a normal population, sleep apnea patients have higher ocular irritation symptoms, abnormal tear break-up time and increased upper and lower lid laxity. There is also a correlation between normal-tension glaucoma and sleep apnea, due to the lack of oxygenation of the optic nerve head during sleep.

While the use of a CPAP device is widely considered the best sleep apnea treatment, one frequent complaint by CPAP users is that the mask releases air over the eyes, causing eye dryness, discomfort, and disruptions in sleep. Eye Eco products reduce or eliminate this unwanted side-effect to sleep apnea treatment providing a comfortable, uninterrupted sleep.


Nocturnal lagophthalmos is another condition associated with poor sleep and dry eyes. Impartial lid closure prevents the natural tears from spreading properly.2 In addition, lagophthalmos patients are more vulnerable to recurrent corneal erosions.3 Some doctors believe the prevalence of lagophthalmos to have increased in the last few decades up to 10-20% of the population.4


Floppy eye syndrome patients have extensive lid laxity which has been linked to signs of Dry Eye due to tear film abnormality.5 Compared to the normal population, floppy eye syndrome patients may show decreased Schirmer’s score, Meibomian gland drop out and symptoms of ocular pain similar to those of Dry Eye patients.6

1Kawashima, Motoko, et al. "The association of sleep quality with dry eye disease: the Osaka study." Clinical Ophthalmology (Auckland, NZ) 10 (2016): 1015.

2Mastrota, Katherine. "Why So Dry?." Optometric Management 45.11 (2010): 33-34.

3Maharaj, Richard “Getting Closure: Exposing the Eyelid Overbite” Eye on Eyes (2012)

4Mastrota, Katherine M. "Diagnosing and treating lagophthalmos." (2015).

5Liu, Daniel Tzong-Shyue, et al. "Tear film dynamics in floppy eyelid syndrome." Investigative ophthalmology & visual science 46.4 (2005): 1188-1194.

6Chhadva, Priyanka, et al. "The Impact of Eyelid Laxity on Symptoms and Signs of Dry Eye Disease." Cornea 35.4 (2016): 531.