To familiarize himself with Bauby's sheltered existence, director Julian Schnabel made the movie in the same hospital where Bauby was treated, meeting many of the orderlies who had treated him. He also shot scenes on the same balcony where Bauby relaxed, and on the same nearby beach to which his family had taken him.
The script was originally in English and Johnny Depp was cast to play Jean-Dominique Bauby. He dropped out because it conflicted with filming of "Pirates of the Caribbean: At World's End." Gary Oldman was also in consideration. But eventually, director Julian Schnabel convinced the studio (Pathé, a French studio founded in Paris) to change the language to French to stay true to Bauby's life and story.
Almost the entire opening 40 minutes of the film are taken from Bauby's point of view.
In real life, John-Dominique had two children, not three. The filmmakers could not decide between the three final children vying for the roles, and it was decided to grant all three children parts.