Eye Sleep Paralysis? Awakening Ptosis: A Case Report

Awakening ptosis (AP) or sleep induced apraxia of eyelid opening is a rare condition in which patients report a transient, isolated upper eyelid ptosis that is usually unilateral, only upon awakening. The condition presents with very brief and self-resolving recurring episodes or typically resolves upon manual lid elevation. The literature on this condition is limited to few case reports/series. Such reports describe AP as benign and to be a possible result of an abnormal, transient and persistent sleep-related muscular atonia into wakefulness. Risk factors for AP include female gender, Caucasian ethnicity, median age of 60 and concurrent autoimmune diseases. Neuroimaging and lab testing are usually normal. The condition resolves in several months without management.