How can lacrimal (tear) production be increased during sleep?

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From the FDA Drug Label

RESTASIS® ophthalmic emulsion is indicated to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca. RESTASIS demonstrated statistically significant increases in Schirmer wetting of 10 mm versus vehicle at six months in patients whose tear production was presumed to be suppressed due to ocular inflammation.

The use of cyclosporine ophthalmic emulsion (such as RESTASIS) may help increase tear production in patients with keratoconjunctivitis sicca, as it has been shown to have a statistically significant effect on Schirmer wetting. However, this effect is not seen in patients currently taking topical anti-inflammatory drugs or using punctal plugs 1, 1.

  • Key points:
    • Increase tear production in patients with keratoconjunctivitis sicca
    • Effect not seen with concurrent use of topical anti-inflammatory drugs or punctal plugs There is no information on how to increase lacrimal production during sleep.

From the Research

To increase lacrimal tear production during sleep, the most effective approach is to use a combination of preservative-free artificial tears, lubricating eye ointment, and a humidifier, as these methods have been shown to directly supplement tear volume, increase ambient moisture, and address underlying causes of dry eye. According to the study by 2, neurostimulation for tear production is a promising new treatment option for dry eye disease, and the intranasal tear neurostimulator (ITN) has been shown to increase aqueous tear production and improve dry eye-related symptoms. However, for a more practical and widely available approach, using preservative-free artificial tears or lubricating eye ointment just before bedtime can help increase tear production during sleep. Applying 1-2 drops of artificial tears or a small amount of ointment to each eye can provide direct supplementation of tear volume.

For more severe cases, consider using a humidifier in the bedroom set to 30-50% humidity, as this can help increase ambient moisture and reduce tear evaporation. Additionally, ensuring proper eyelid hygiene by gently cleaning the eyelids with warm water and mild soap before bed can help maintain healthy oil glands that contribute to tear film stability. Prescription options like Restasis or Xiidra eye drops, used twice daily as directed by an eye doctor, can also help reduce inflammation and increase natural tear production over time.

It is essential to note that sleep deprivation can disrupt the lacrimal system and induce dry eye disease, as shown in the study by 3. Therefore, addressing sleep deprivation and promoting healthy sleep habits can also help increase lacrimal tear production during sleep. The study by 4 also highlights the importance of sleep in maintaining healthy tear production, as sleep deprivation was found to reduce tear secretion and impair the tear film.

Overall, a comprehensive approach that includes a combination of artificial tears, lubricating eye ointment, humidifier use, proper eyelid hygiene, and addressing underlying causes of dry eye, such as sleep deprivation, can help increase lacrimal tear production during sleep and improve overall eye health.

References

Research

Neurostimulation for tear production.

Current opinion in ophthalmology, 2019

Research

Sleep deprivation reduces tear secretion and impairs the tear film.

Investigative ophthalmology & visual science, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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