Dry eye and sleep quality: a large community-based study in Hangzhou

Sleep. 2019 Oct 21;42(11):zsz160. doi: 10.1093/sleep/zsz160.


Study objectives: To investigate the relationship between dry eye and sleep quality in a large community-based Chinese population.

Methods: A total of 3,070 participants aged 18-80 were recruited from a community-based study in Hangzhou, China during 2016-2017. Sleep quality was evaluated using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), and dry eye was evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Multivariable linear regression and logistic regression models were used to investigate the associations, adjusting for age, smoking, drinking, season, and other potential confounders.

Results: Overall, CPSQI score and sleep dysfunction were significantly associated with mild, moderate, and severe dry eye (ORs for CPSQI score: 1.07, 1.13, 1.14, all p < 0.001; for sleep dysfunction: 1.31, 1.73, 1.66, all p < 0.05). Furthermore, worse OSDI score was presented in participants with worse CPSQI score or sleep dysfunction (CPSQI score > 7) (β: 0.13, 0.54; all p < 0.001). In addition, six of the seven components of CPSQI showed significant associations with dry eye (all p < 0.001), except for the component of sleep medication use. Moreover, we observed significant associations of dry eye in all three subscales of OSDI with CPSQI score and sleep dysfunction.

Conclusion: Our large, community-based study showed a strong association between poor sleep quality and an increased severity of dry eye, suggesting that preventing either one of the discomforts might alleviate the other.

Keywords: dry eye; sleep quality; the Ocular Disease Index; the Pittsburgh Sleep Quality Index.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Comorbidity
  • Dry Eye Syndromes / epidemiology*
  • Dry Eye Syndromes / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sleep / physiology*
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / physiopathology
  • Surveys and Questionnaires
  • Young Adult