Effects of insomnia on symptomatic dry eye during COVID-19 in China: An online survey

Abstract

Sleep is an essential determinant of health and quality of life. This study aimed to evaluate sleep disorders and symptomatic dry eye (DE) occurrence. This study was a cross-sectional survey of 1393 participants in China. The insomnia severity index (ISI) Questionnaire was used to evaluate sleep quality, and the ocular surface disease index (OSDI) questionnaire was used to assess DE symptoms. Subjects were divided into 2 groups based on subjects with and without symptomatic DE. The patients who had DE (10.48 ± 7.27) had substantially lower ISI scores compared to those without DE (3.57 ± 5.10) (P = .003). Furthermore, each ISI item and total ISI score was significantly correlated with OSDI dry eye severity and total OSDI dry eye score. Higher prevalence of insomnia was found in participants with symptomatic DE, and insomnia correlated significantly with DE symptoms. The present results suggest that clinicians and healthcare workers need to remember that DE and insomnia are highly co-existing health issues.

Associations between dry eye disease and sleep quality: a cross-sectional analysis

“…8 In another recent study involving 1393 participants in China, those with DE symptoms, defined as a score of >12 out of 100 on the OSDI, also had higher ISI scores (mean=10.48±7.27, p=0.003) compared with those without DE symptoms (mean=3.57±5.10, p=0.003). 29 It is interesting to note that similar to prior reports, 30 DE signs were similarly distributed across our three DE symptom groups (none, mild-moderate and severe), highlighting the disconnect between symptoms and signs of disease. We hypothesise that this observation is driven by the reality that DE symptoms, specifically ocular pain, can arise from multiple sources, including nociceptive and neuropathic/nociplastic mechanisms.…”

“… 8 In another recent study involving 1393 participants in China, those with DE symptoms, defined as a score of >12 out of 100 on the OSDI, also had higher ISI scores (mean=10.48±7.27, p=0.003) compared with those without DE symptoms (mean=3.57±5.10, p=0.003). 29 …”

“…In the China Hangzhou study (n=3070), the OSDI was used to assess DE symptoms, and a Chinese version of the PSQI was used to assess sleep quality. Patients were classified based on DE severity using OSDI scores: normal (score 0-12), mild (score [13][14][15][16][17][18][19][20][21][22], moderate (score [23][24][25][26][27][28][29][30][31][32] and severe (score 33-100). Similar to our results, mean PSQI global scores were higher in groups with worse DE symptoms (normal=4.7±2.8, mild=5.4±3.1, moderate=6.1±3.1 and severe=6.5±3.4, p<0.001).…”