Is Quality of Sleep Impacted by Dry Eye Disease?
According to research conducted by the Beijing Institute of Ophthalmology, patients with dry eye disease have worse sleep quality compared to those who are not similarly affected. Given lifestyle changes and the significant increase in the population of those contending with sleep disorders, the authors of the study conclude that identifying potentially modifiable risk factors is clinically important for the primary prevention of sleep disorders. (1)
The lead author, Yixuan Gu, PhD describe how sleep is disrupted in this patient population by noting that, “Poor sleep quality in dry eye patients may be related to incomplete eyelid closure, eye discomfort and mental stress. The dry mouth symptoms of patients with Sjogren’s syndrome, which require them to frequently get up at night to drink water or consume more fluids before sleep, may also be one of the culprits causing poor sleep quality,” (2) There are emerging studies indicating that dry eye disease was associated with the risk of sleep disorder.
The authors searched for observational studies published prior to April 2023 with the goal of identifying modifiable risk factors. Results of the search revealed 21 studies that included over 419,000 individuals. The information collected included the study author(s) country, study type, data collection period, publication year, type of dry eye, number of participants in the dry eye and control subjects, age, female proportion and sleep-related judgment criteria. The analysis showed that patients with dry eye disease had worse sleep quality compared to 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. The Pittsburgh Sleep Quality Index (PSQI) scores of the dry eye subjects were significantly higher when compared to those of the control subjects.
The patients with dry eye had higher scores than the control subjects in sleep quality, sleep latency and sleep disturbance in the PSQI. There were no differences seen between the 2 groups regarding sleep duration, sleep efficiency, daytime dysfunction and sleep medication scores. The investigators did find that patients with dry eye were at significantly higher risks of sleep disorders, insufficient sleep and excessive sleepiness.
It is important to recognize there is a need for additional large-scale prospective studies to provide more assistance in patient management and treatment since there remains insufficient evidence to establish a causal relationship and related mechanisms between dry eye and sleep disorders.
- Gu Y, Cao K,Li A, et al, BMC Opthalmol.2024
- An Y, Kim H., Sci Rep. 2022