As contact wearers, we have all been there: You crawl into your bed, settle in peacefully, and drift off to a blissful night of sleep, only to wake up the next morning and immediately realize that you forgot to take out your contacts the night before. After the initial blurred vision and the discomfort of dryness wears off, you briefly begin to wonder just how bad it is to sleep with contacts in.
Can you Sleep With Contacts in?
Eye doctors generally recommend you not sleep with contacts in as it restricts the amount of oxygen your eyes are able to receive. Sleeping with contacts in also traps dirt and debris under your contact lens, increasing the likelihood of an eye infection.
If you wear your contacts daily, it is only natural that you would start to feel a bit frustrated with them after a while. Unlike the daily routines of those who have perfect or even just decent vision, the process of putting in and taking out your contacts just so that you can see what you’re doing can be quite tedious. People who do not wear contacts don’t quite understand that that extra bit of effort each day adds up to way more time than we’d all like to admit.
Despite the fiddly steps that we must take each time we put them in or take them out, most of us probably believe that we have fantastic hygiene when it comes to our contacts. Many studies, however, have shown that not to be entirely correct. Statistically, 33% of people fall asleep in contacts that are not meant for overnight wear. Additionally, a staggering number of us (between 40%-90%) have admitted to not properly caring for our contacts from time to time.
After a long day, when you just want to go to bed, naturally you would be tempted to save some time and head straight to bed with your contacts still in. Surely it’s acceptable every once in a while, right? The short answer is no. Below we’ll fully answer all of your burning questions about sleeping with your contacts in.
What Happens to Your Eyes When You Wear Contacts?
When you put your contacts in, you are enhancing the function of the corneas. You will immediately know this because you will be able to view the world around you much more clearly. The corneas are known as the “windows” of your eyes, and they affect how you see. If they are damaged, misshapen, or otherwise abnormal – your vision will reflect this, meaning you will have a blurred outlook, and difficulty seeing objects clearly that are either close to you (Hyperopia, farsightedness), or far away from you (Myopia, nearsightedness).
The cornea itself is a transparent tissue that, without the presence of blood vessels (meaning there is no blood flow), must get its oxygen from the air. When the contacts cover the corneas, this limits the amount of oxygen that they are able to get. Without oxygen, the cornea can become more damaged or less transparent – further affecting your vision.
One consequence of limiting the oxygen to your corneas, which impairs your vision, is an ailment called corneal neovascularization. With this, the tissue will begin to search for other means to get the oxygen it needs, causing tiny blood vessels to grow over your corneas. These blood vessels will then, undoubtedly, obstruct your vision. Even if they do not cause complete blindness, your doctor may decide that you are no longer a candidate for contact lenses, meaning you will have to wear glasses for the rest of your life.
Why Do Some People Leave Their Contacts In When They Sleep?
The reality is – we have all been there. Even if you haven’t actually slept with the contacts in, there have been times where you may have considered it. There are many times in life when the situation is not on your side, such as:
- Unplanned sleepovers. Staying too late into the evening at a friend or relative’s house might make you think it would just be more comfortable to spend the night, rather than having to drive home. Suggestion: Keep an extra container and travel bottle of solution in the trunk of your car for impromptu sleepovers, or even if you just need to take them out throughout the day because they are bothering you.
- No solution/container is available. If you have worn contacts for any amount of time, you know the feeling of squeezing your solution bottle, only to have it spray out more air than liquid. It is a lot easier than you’d think not to realize that you have gotten to the end of your bottle and you do not have enough solution to fill the container. It’s also not one of the first things you think of when you head to the store for supplies, so it’s easy to forget to buy a new bottle. Suggestion: Always buy two bottles at a time, and keep a travel sized bottle in the cupboard. Your travel bottle can be your backup until you can get to the store the next day.
- Laziness. This one can affect the best of us at the worst of times. While you may be tempted to skip taking them out just this once, don’t! Suggestion: Since most contact lenses are not meant for extended wear, it’s best to remove them as soon as possible anyway. Try removing them when you arrive home for the evening, or at the latest – when you’re brushing your teeth at the end of the night.
- Forgetfulness. It may sound unlikely, but if your contacts are newer and still in the stage of really comfortable flexibility, you might actually forget that you have them in sometimes. Suggestion: Similar to the suggestion above, set a specific time in the evening when you know you should take your contacts out. Setting an alarm to remind yourself can help. Then, before you get into bed, do a blink test to see if you can feel the contacts shift. Squeeze your eyes closed tightly and look up; when you open your eyelids, you should be able to feel your contacts move back into the proper position.
Why Should You Not Sleep with Contacts In?
Your eye isn’t getting enough oxygen. We have seen the importance of oxygen in our eyes, as mentioned above. Additionally, without oxygen, your eye can become swollen or inflamed, making it easier for bacteria to get into your cornea.
You aren’t blinking. Blinking allows your tears to wash away the toxins in the bacteria, and it also permits the contacts to shift. The ability of the contacts to move slightly is essential for our lenses because the small movement helps the oxygen to get underneath. The lack of moisture from not blinking is what causes the dryness you feel in the morning and forces the contact lens to adhere more tightly to your eye.
You are trapping the debris in your eye. Throughout the day, all kinds of microscopic objects get into our eyes, such as dust and germs. Without taking the contacts out, you can be creating a breeding ground of grime that is resting against your eye for many hours.
What Happens When You Do Sleep with Contacts In
It is important to remember that every person and their eyes are entirely different. Just because you know someone who has slept with their contacts in for several days (or weeks!) at a time, does not mean that your eyes will be able to handle the same treatment. Similarly, if you have done it once or twice with no problems, it could be that third time that proves to be too much for your eyes.
The repercussions listed below are not a guarantee of an outcome, but instead, they are potential health risks that we face when we choose to sleep with contact lenses in.
One of the most common results of sleeping with contacts in is an eye infection. There are various types of infections that can occur in your eye. If you believe that you may have an eye infection, you should see your doctor immediately who can help determine the appropriate course of action. Some of the infections that are possible to occur include:
- Fungal keratitis. An infection in the cornea that comes from a build-up of fungi. Helpful hint: Any ailment that ends with -itis indicates that there is inflammation. As a general rule of thumb, inflammation is usually one of the first signs that you need to consult your doctor. If it is not appropriately treated, this inflammation can lead to further medical conditions.
- Acanthamoeba keratitis. This infection can result from parasites that are found in water and soil, which infect the cornea and can cause blindness. This is an important reason why contact wearers should always wash their hands prior to touching their eyes, and should not wear their contacts while swimming or even showering.
At times, sensitive eyes can present similar symptoms to those of an eye infection. Even if you haven’t fallen asleep with your contacts in, we contact wearers are still at a higher risk of eye infections, and it would be beneficial to be aware of what the symptoms are. Keep note if you begin to see the following eye infection symptoms:
- Pain in the eye
- Swelling and inflammation
- Weeping eyes
- Pus or discharge
If you have these symptoms and they continue to persist, leave your contacts out and see your doctor as soon as possible.
Need for Medication
If moderate, the usual treatment for the above infections is often antibiotic eye drops, pain medication, and anti-inflammatories. Without the appropriate use of a prescription drug, the symptoms and consequences can worsen.
Corneal ulcers occur when small open sores appear on the cornea resulting from inflammation, or keratitis. They can cause a hole in the cornea and are quite painful. When the ulcers pop, there may be a gushing of liquid that flows from the eye. Severe cases of corneal ulcers can lead to loss of the eye.
As mentioned above, infections can cause sores or holes in the cornea. In order for our eyes to continue to be healthy and to be able to see correctly, the cornea must be smooth. If there are ulcers or holes, a corneal transplant could be required to replace the damaged cornea with a healthy cornea that is received from a donor.
In severe cases, the infections mentioned above, if not treated properly, can lead to partial or complete vision loss. Without medication or surgery, the infection will cause the cornea to become foggy or glazed, causing loss of vision.
Burst Blood Vessels
Wearing your contacts overnight (or wearing them for too long) can cause the blood vessels in your eye to break, causing blood to leak out into the white (conjunctiva) of your eye. This is known as a subconjunctival hemorrhage, and while it doesn’t require treatment, it is still unsightly, may last for up to two weeks, and can be easily avoided.
Secondary Giant Papillary Conjunctivitis
GPC is an allergic reaction in the eye that increases when contacts are left in overnight. One of the four stages of sleep is REM – Rapid Eye Movement. During this stage, your eyes will continue to move around quickly, causing your contacts to rub against your closed eyelids. When GPC occurs, small bumps develop on the underside of the eyelid, which can be painful and itchy.
CLARE (Contact Lens Induced Acute Red Eye)
CLARE, or tight lens syndrome, can cause redness, light sensitivity, and pain in the eyes. It is a fairly regular occurrence in people who sleep with their contacts in because of a constant build-up of bacteria on the lens. Without removing and cleaning the lenses, the eye’s immune response is to attempt to fight off the presence of the bacteria.
What Should You Do If You Accidentally Fall Asleep with Contacts In?
As you can see, it’s very highly discouraged to sleep with your lenses in intentionally; but to say it hasn’t accidentally happened to every one of us at least once wouldn’t be entirely accurate. Here’s what to do if you find yourself in this situation:
- Remove them right away. The best thing to do is to remove your contacts as soon as possible. If you find that your eyes are too dry, try using eye drops to get some of the moisture back, then remove the lenses. Avoid removing the contacts when they are too dry to prevent additional abrasions on your eyes or ripping the contacts.
- Give your eyes a break. It may be frustrating to wear your glasses for the day if you’re used to wearing the contacts more often. However, it’s essential to leave your contacts out for a few hours because your eyes need a chance to get more oxygen and flush out the bacteria. This time will also give you the opportunity to keep an eye on your eyes (no pun intended) and note if any pain, redness, or inflammation continues throughout the day. Chances are, if you’re like most of us, after a night of sleeping with your contacts in, it feels better to take them out for a few hours anyway.
- See your doctor. If you find that you do have continued pain, the initial redness doesn’t go down, or more severe symptoms have presented themselves, it’s imperative that you see a doctor. The sooner your symptoms can be treated, the more likely you will be able to heal your eyes without further complications.
Is It Ever Acceptable to Sleep with Contacts In?
Due to the risks that are multiplied when you fall asleep with your contacts in, it is never recommended to sleep with lenses in that are not designed for extended wear.
The FDA has approved the use of continuous wear contact lenses which are made of silicone hydrogel. This material allows more oxygen to pass through the lens, giving your eyes a better opportunity to breathe. More oxygen means that you can wear your contact lenses for extended periods of time (some last up to 30 days) without taking them out each night.
If you are considering these types of lenses, it would be a worthwhile conversation to have with your eye doctor at your yearly appointment to find out if you are a good candidate.
What Are Some Alternatives?
Some people (present company included) genuinely do not enjoy the bothersome task of constant insertion and removal of contacts each day. So what are our alternatives?
Daily wear contacts which should be thrown away at the end of each use. The benefit to this is that it doesn’t take any extra thought to take them out and toss them – no cleaning required. They can often be more expensive; however, you do save on the need for cleaning.
LASIK has grown in popularity since it was approved by the FDA in the late ’90s. While the upfront costs are higher, and the procedure is more daunting, there is something to be said about the freedom of being able to go to sleep or wake up without the thought of contact lenses.
So you may be thinking that these risks don’t apply to you because you only do it once in a while when you forget or run out of cleaning solution. The reality is that this “once in a while” mentality often leads from one night into several nights, further resulting in leaving them in for a month or longer. It may be a pain to include this in your daily routine, but it is crucial to maintain good habits when it comes to your eye health and your contact lenses.
Other Necessary Contact Lens Advice:
- Remove them when your eyes may come into contact with water, such as swimming or showering. As we learned above, one of the most common eye infections comes from a bacteria that is found in water – this can be the ocean or even your sink faucet. This is also the reason why contact wearers are instructed not to use water to clean or store their lenses.
- Do not wear them outside of your lens’ guidelines, meaning do not wear your contacts for your 16-hour day if they are not designed for extended wear. The recommended length of time is generally from 12-14 hours.
- Continue proper cleaning of your lenses, remembering to clean after each wear, and never store your lenses in an old solution that is topped off with a new solution. After some time, the solution can lose potency and effectiveness. By simply adding additional solution to the old solution, there is not as much cleaning power as there would be with a full bowl of fresh solution.
- Even if you use a no-rub solution, it is still a good idea to rub your contacts with clean solution periodically. This will help to promote the removal of some of the bacteria that may cling to the lenses after they soak in the solution.
- Avoid rubbing your eyes while wearing contacts, which can cause micro-scratches on your eye, increasing the possibility of infection. You also don’t want to risk the likelihood of tearing your contacts while they’re still in your eye.
- Replace the case where you store your lenses every three months. Contact lens solution does its best to clear away all remaining bacteria and residue from your lenses; however, after some time, the bacteria will still build up and stay inside the case. After a while, even brand-new contacts can become tainted with old bacteria, so it’s best to replace the case often. The good news is that most new solution bottles come with a new storage container, so you should at least be changing it with each new bottle of solution.
- Observe the discard date. Not everyone knows that our contacts have an expiration date, and even fewer people pay attention to it. Because people often wear their contacts for longer than they should or don’t wear them every single day, a box consisting of a one-year supply of contacts can end up lasting for well over a year. While this sounds like an economical way to save a few bucks, you should still be aware of the expiration date. Even though contacts are individually sealed, it is possible for the seal to become damaged over time, leading to potential contamination of the lenses. Fortunately, the shelf life can be close to four years, so with proper wear and disposal, you should be able to get through them in time.
- See your eye doctor once a year. Just like with any healthcare check-up, seeing your eye doctor once a year is crucial for your eye health. It is an excellent way to ensure that your eyes aren’t developing any further problems, as well as seeing if your vision has improved or gotten worse. Wearing contact lenses with the wrong prescription is also not advised.
- Be sure to throw away your disposable lenses. Over time, substances that are found in your tears, such as proteins, can build up on the lenses. This is why we must use the cleaning solution after each wear. Disposable contacts are different in that they are made from materials that are meant to be disposed of, not kept.
- When you are taking an overnight flight, be sure to pack your travel-sized cleaning solution along with your storage container and glasses into your carry on. For some people, it is easier to get through the airport with contacts in, rather than glasses, but when the lights go down in the cabin, it’s best to make the switch. You can always put them in again before landing.
- Avoid using your saliva to clean your lenses. Aside from the fact that it is incredibly unpleasant and unhygienic, it also poses a pretty significant health risk. Our mouths are full of bacteria and food remnants. Licking a contact and putting it directly back onto your eye is a recipe for disaster. Many pharmacies carry pocket-sized, one time use mini contact solution vials. They can also be found in some First Aid kits. Be sure to try all options before considering the saliva method.
After you spend some time reading various horror stories, studies, and research on the possible ramifications that sleeping with contacts in can have on your eyes, it is crucial and necessary to take eye care seriously. The convenience of contacts (versus seeing glasses) is actually an important responsibility. Keep in mind that your eyes are very fragile, and you only get two of them.
When it comes to wearing contacts, many people try to skimp or cut corners in an effort to reduce costs or save time. Everyone would agree that poor vision can be constraining and costly, but we would all also agree that unnecessary eye problems (such as a complete loss of vision) are even more frustrating, expensive, and exceedingly scarier.