Association of Dry Eye Disease with Physical Activity and Sleep Quality: Osaka study

Abstract

Purpose: To investigate the association between physical activity and sleep quality, and dry eye disease.

Methods: Data from the cross-sectional study conducted in a certain company in 2011(the Osaka study) were analyzed. The participants were classified into definite dry eye disease(DED), probable-DED, and non-DED by dry eye examination results including Schirmer test, fluorescein and lissamine green staining, tear film break-up time, and symptom questionnaire, according to the Japanese Dry Eye diagnosis criteria. The short form of the International Physical Activity Questionnaire (IPAQ-J) and the Pittsburg Sleep Quality Index (PSQI-J) were implemented to determine physical activity and sleep quality, respectively. The participants’ physical activity level in metabolic equivalent units per week (MET, min/week) was calculated and classified into high, moderate, and low level on the basis of the IPAQ. The global PSQI score ranging from 0 to 21 was calculated by summing the scores of seven sleep variables on a scale of 0 to 3; the score ≥5.5 indicates poor sleep.

Results: According to the IPAQ, the breakdown of the participants by physical activity levels was 10.1% for high, 48.7% for moderate, and 41.2% for low, respectively. (completed N=425) . More participants tended to score high in the physical activity in non-DED group (14.4%) than in DED, with a significant difference between mean MET scores for DED and non-DED (P=0.03). Total mean PSQI global score was 5.1±2.3 (completed N=383). A total of 45% of the DED and probable-DED groups reported poor sleep quality while 34% of non-DED group did, with a significant difference in the global score between probable-DED and non-DED (p=0.006). Furthermore, statistically significant correlation was observed between the PSQI score and the dry eye symptoms score (r=0.27,p<0.001).

Conclusions: These results suggest that both physical activity and sleep quality were associated with DED. The high level of physical activity seems to lower the risk of DED. And sleep disturbances seem to be an influencing factor of DED, especially dry eye symptoms. Further study with larger longitudinal or intervention trials will allow us to draw more definitive conclusions.

Keywords: 486 cornea: tears/tear film/dry eye