Individuals with dry eye more likely to experience worse sleep quality, study shows distinct patterns

Dry eye disease (DED) is a common ocular condition affecting millions worldwide, characterized by discomfort, visual disturbances, and potential damage to the ocular surface. Recent research has begun to uncover a potential link between DED and sleep quality, suggesting that the health of our eyes may be intertwined with the quality of our sleep.

Against the above background, Lei Tian, Capital Medical University, Beijing, China, and colleagues aimed to review the association between dry eye and sleep quality systematically.

For this purpose, they searched the online databases for observational studies published before April 2023. Meta-analysis was performed using STAT15 software. The meta-analysis included a total of 21 studies with 419,218 participants.

Based on the review, the researchers reported the following findings:

• Dry eye subjects had a worse sleep quality than the healthy population, with poorer subjective sleep quality, a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep, and longer sleep latency.
• The Pittsburgh Sleep Quality Index (PSQI) scores of subjects with dry eye were significantly higher than those of the control subjects (WMD = 1.78).
• The dry eye subjects scored higher than the control subjects in sleep quality, sleep latency, and sleep disturbance in PSQI; there was no difference between the dry eye individuals and control subjects in sleep duration, sleep efficiency, daytime dysfunction, and sleep medication scores.
• The risk of sleep disorders in the dry eye subjects was significantly higher than that in the non-dry eye subjects (RR = 2.20); the risk of insufficient sleep in the dry eye subjects was higher than that in the control subjects (RR = 3.76), and the prevalence of excessive sleepiness in dry eye subjects was higher than that in the control subjects (RR = 5.53).
• The ESS scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 3.02).

The findings indicate that dry eye patients have a lower sleep quality than the healthy population, with longer sleep latency, poorer subjective sleep quality, and a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep.

"However, so far, there is insufficient evidence to establish a causal relationship and related mechanisms between dry eye and sleep disorder," the researchers wrote. "In the future, there will be a need for more large-scale prospective studies to provide more assistance in patient management and treatment."

Reference:

Gu, Y., Cao, K., Li, A. et al. Association between sleep quality and dry eye disease: a literature review and meta-analysis. BMC Ophthalmol 24, 152 (2024). https://doi.org/10.1186/s12886-024-03416-7