According to the Vision Center of Excellence, sleeping with one's eyes open, or nocturnal lagophthalmos, can be caused by a number of factors, including a cone-shaped cornea and prior eye injuries. Neurological conditions, such as Bell's palsy, and eye protrusion, such as that caused by Grave's disease, also cause nocturnal lagophthalmos. The use of alcohol or sedatives prior to sleep increases the risk of nocturnal lagophthalmos.
The Vision Center of Excellence warns that failing to close one's eyes while asleep can cause permanent damage over time. Sensations upon waking tend to include a feeling of having dry eyes, which can be mild or severe. This chronic dryness sometimes leads to a spontaneous breakdown of the cornea, the outer surface of the eye. This manifests as a feeling of a foreign object in the eye. Redness, swelling and an unusual discharge are common effects of this condition.
According to the Vision Center of Excellence, treatments for nocturnal lagophthalmos involve either easing the movement of the eyelids or increasing the forces that pull them closed. Eyedrops are used for milder cases, but more severe cases require application of extra pressure to the eyes or eyelids. This can be an eye mask, but implanted gold weights or even springs in the eyelids are sometimes used.