The Association Between Sleep Disorders and Incidence of Dry Eye Disease in Ningbo: Data From an Integrated Health Care Network

Abstract

PurposeTo investigate the association between sleep disorders and dry eye disease (DED) in Ningbo, China.MethodsOur data came from the Yinzhou Health Information System (HIS), including 257932 patients and was based on a 1:1 matching method (sleep disorder patients vs. patients without sleep disorders) during 2013–2020. Sleep disorders and DED were identified using ICD-10 codes. Cox proportional hazards regression was used to identify the association between sleep disorders and DED.ResultsThe eight-year incidence of DED was significantly higher in participants with diagnosis of sleep disorders (sleep disorders: 50.66%, no sleep disorders: 16.48%, P < 0.01). Sleep disorders were positively associated with the diagnosis of DED (HR: 3.06, 95% CI: 2.99–3.13, P < 0.01), when sex, age, hypertension, diabetes and other systemic diseases were adjusted. In the sleep disorders patients, advancing age, female sex, and presence of coexisting disease (hypertension, diabetes, hyperlipidemia, thyroid disease, depression, heart disease, and arthritis) were significantly associated with the development of DED by the multivariate cox regression analysis (all P < 0.05).In addition, there was a significantly positive association between estazolam and the incidence of DED in both sleep disorder and non-sleep disorder groups (all P < 0.05).ConclusionsSleep disrder was associated with a three-time increased risk of DED. This association can be helpful in effective management of both sleep disorders and DED.

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“…As an important environmental and lifestyle factor, how sleep pattern plays a role in disease as well as in health has been increasingly under investigation. It has been observed that sleeping is not only associated with many systemic diseases, such as hypertension ( Levenson et al, 2017 ) and coronary heart disease ( Cheng et al, 2014 ; Lao et al, 2018 ), but also with eye diseases, such as diabetic retinopathy ( Tan et al, 2018 ), vision impairment ( Sun et al, 2021 ), dry eye ( Au et al, 2019 ; Zheng et al, 2022 ), myopia and cataract ( Zhou et al, 2023 ). Interestingly, researchers provided evidence that night sleeping hours were associated with the decreased expression of TIMP-3, IER3, and SLC16A8 in AMD patients ( Sharma et al, 2021 ).…”

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“…31 A significant positive correlation between poor sleep quality and DED has also been reported, 32,33 as well as an association between sleep disturbances and a threefold increased risk of DED. 34 This evidence suggests that a reciprocal relationship exists between sleep quality and DED.…”