Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;3(3):e0048.
doi: 10.1097/coa.0000000000000048. Epub 2024 Sep 19.

Sleep Disturbances and Dry Eye Symptoms and Signs, Systemic Conditions, and Inflammatory Markers in the Dry Eye Assessment and Management Study

Alan Huang  1 , Patrick Augello  2 , Penny Asbell  3 , Gui-Shuang Ying  4 ; DREAM Research Group
Affiliations

Sleep Disturbances and Dry Eye Symptoms and Signs, Systemic Conditions, and Inflammatory Markers in the Dry Eye Assessment and Management Study

Alan Huang et al. Cornea Open. 2024 Sep.

Abstract

Purpose: To investigate the association between sleep disturbances, dry eye disease (DED) severity, and DED risk factors.

Methods: We conducted a secondary analysis of the Dry Eye Assessment and Management (DREAM) study, a randomized trial of 535 patients with moderate-to-severe DED. Participants self-reported sleep disturbances at baseline. DED symptoms were assessed using the Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI). DED signs were assessed using tear film break-up time, Schirmer test, corneal and conjunctival staining, tear osmolarity, and meibomian gland dysfunction assessment. Immune cells were assessed using conjunctival impression cytology. Outcomes were compared between participants with ongoing and no history of sleep disturbances, adjusting for confounders.

Results: Mean age was 58 years, with 81% female participants. Ongoing sleep disturbances (n=113) were significantly associated with older age (mean 60.5 vs. 57.4; p=0.03), smoking (39.8% vs. 28.7%; p=0.02), and DED treatment usage. Systemic conditions associated with sleep disturbances included thyroid dysfunction (26.5% vs.15.7% p=0.007), irritable bowel (18.6% vs. 5.4%; p<.0001), osteoarthritis (38.9% vs. 21.6%; p=0.0007), and depression (30.1% vs. 11.5%; p<.0001). Sleep disturbances were associated with lower conjunctival staining scores (2.46 vs. 2.77; p=0.03) and higher concentrations of dendritic cells in ocular surface white blood cells (12.0% vs. 8.1%; p=0.01).

Conclusions: Sleep disturbances were associated with older age, smoking history, systemic diseases, and higher dendritic cell concentration among patients with moderate-to-severe DED. These findings support further investigation of sleep disturbances as a comorbidity of patients with DED. Additional research is needed to understand the mechanisms behind this relationship.

Keywords: dry eye disease; dry eye risk factors; inflammatory markers; sleep disturbances.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: None to disclose.

Similar articles

See all similar articles

References

    1. Papas EB. The global prevalence of dry eye disease: A Bayesian view. Ophthalmic Physiol Opt. 2021;41(6):1254–1266. doi:10.1111/opo.12888 - DOI - PubMed
    1. Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II Epidemiology Report. Ocul Surf. 2017;15(3):334–365. doi:10.1016/j.jtos.2017.05.003 - DOI - PubMed
    1. Bartlett JD, Keith MS, Sudharshan L, Snedecor SJ. Associations between signs and symptoms of dry eye disease: a systematic review. Clin Ophthalmol. 2015;9:1719–1730. doi:10.2147/OPTH.S89700 - DOI - PMC - PubMed
    1. Ayoubi M, Cabrera K, Mangwani S, Locatelli EVT, Galor A. Associations between dry eye disease and sleep quality: a cross-sectional analysis. BMJ Open Ophthalmol. 2024;9(1):e001584. doi:10.1136/bmjophth-2023-001584 - DOI - PMC - PubMed
    1. Yu J, Asche CV, Fairchild CJ. The Economic Burden of Dry Eye Disease in the United States: A Decision Tree Analysis. Cornea. 2011;30(4):379. doi:10.1097/ICO.0b013e3181f7f363 - DOI - PubMed

LinkOut - more resources