Patients with dry eye have poorer sleep quality, higher risk for unhealthy sleep duration
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Key takeaways:
- Subjective sleep quality, sleep latency and sleep disturbance scores were higher among patients with dry eye vs. healthy controls.
- Patients with dry eye were at higher risk for insufficient or excessive sleep.
Patients with dry eye disease have worse sleep quality and may be at greater risk for unhealthy sleep duration, although a causal relationship between dry eye and sleep disorder has not been established, according to a meta-analysis.
“Sleep is an essential physiological process for life, accounting for approximately one-third of human daily activities,” Yixuan Gu and colleagues at the Beijing Institute of Ophthalmology wrote in BMC Ophthalmology. “In recent years, bad sleep quality, including sleep disorder, insomnia, circadian rhythm disorders and excessive sleep, have become a persistent global social issue.”
Researchers searched PubMed, EMBASE, Cochrane, Web of Science and grey literature databases for studies published before April 2023 to assess the association between dry eye and sleep quality. They identified 21 studies with 419,218 participants, of whom 152,567 had dry eye, and 266,651 were healthy controls. In total, there were 12 cross-sectional studies, six cohort studies and three case-control studies involving patients from the U.S., Australia, China, India, Italy, Japan, South Korea, the Netherlands, Singapore, Sweden, Turkey and the U.K.
According to results, sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) in seven of the studies, which showed that total PSQI score was significantly higher — signifying worse sleep quality — among patients with dry eye vs. controls (P < 0.001).
Four articles outlined subjective sleep quality scores, which showed that patients with dry eye had significantly higher scores than controls (P = 0.001), as did patients in two articles that mentioned sleep latency scores and three that mentioned sleep disturbance scores (P < 0.001).
In two articles that mentioned sleep duration scores, there was no significant difference between the two groups, nor was there significant difference in studies that mentioned sleep efficiency, daytime dysfunction and sleep medication scores.
Further, incidence of insufficient sleep, defined as less than 5 hours of sleep, was significantly higher among patients with dry eye vs. controls (RR = 3.76; P < 0.001), as was excessive sleep, defined as at least 9 hours of sleep (RR = 5.53; P < 0.001).
“Our meta-analysis indicates that dry eye patients have a lower sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency and a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep,” researchers wrote. “However, so far, there is not enough evidence to establish a causal relationship and related mechanisms between dry eye and sleep disorder.”
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