Red eyes and swollen eyelids upon awakening in the morning are common eye problems that many people suffer from with vague diagnoses usually of dry eyes or eye allergies. Sometimes just having the eyes dilate in the darkness can precipitate attacks of angle closure glaucoma in patients who have risk factors for this type of glaucoma. Frequently eye allergies are the cause, aggravated by a low level of tears in dry eyes. The lower level of tears means allergens your eyes are exposed to at night are not as diluted as a normal eye and they have a greater effect. Open windows in allergy season allow more pollen inside, and pets sleeping on pillows during the day can also add to the problems. Sleep apnea along with floppy eyelid syndrome can cause your eyes to be open and dehydrate while you sleep. A low-grade infection of the eyelid margins with staphylococcus bacteria is another common cause of swollen eyelids in the morning. Many other conditions can cause red, swollen eyes in the morning. However, there are normal aging factors that predispose you to this condition that is found more frequently in women than men.
As you sleep at night the normal tear film is not being pumped out through the tear ducts and spread across the eyes by the wiper like motion that occurs with normal blinking. In the REM states of sleep you do have some blinking occurring, but overall the eye is a static environment while you sleep trapping bacteria on the surface of the eye. The eye has it’s own immune system that is ramped up at night to compensate for this increase in bacteria. The result is a state of mild inflammation is almost everybody. As the body ages and the eyes become dryer the relative concentration of bacteria and bacterial toxins increases making a more noticeable immune response. With menopause, there is a drop in hormone levels in both men and women. The androgen hormone that is more commonly associated with men seems to be the largest factor in dry eyes in women. The incidence of dry eyes in women is at least 3-4 times more commonly reported than in men and also increases with age.
The eyelid anatomy contributes to eyelid swelling. There is a barrier to fatty tissue in the upper eyelid that degrades with age and fatty tissue enters into the lid causing it to droop all of the time. The eyelid tissue looses its elasticity with age and thins resulting in more susceptibility and visibility of swelling. Sleeping at night without blinking with the buildup of inflammation described above causes swelling in the adjacent eyelid tissue. Since you are lying down with a slight elevation to your head there is reduced drainage of fluid within the lymph system and fluid accumulates on the lower eyelid. This will reduce throughout the day if the cause is chronic low-grade inflammation overnight.
The first step in treatment is a visit to your eye doctor to rule out any other more serious causes such as heart conditions, kidney problems, obstructive sleep apnea,glaucoma, or medication side effects. Your optometrist may find other causes as outlined above that need to be treated. After that, there are a few alternative therapies you can try to help.
1. Reduce alcohol and salt consumption as they contribute to water retention
2. Try some form of cool compresses in the morning for 5-10 minutes.
3. Exercise early in the morning to stimulate the circulation.
4. Be glad your vision is good and your eyes are essentially healthy!