# Unraveling the relationship between childhood dry eye symptoms and sleep patterns

## TL;DR

This study shows that poor sleep is strongly linked to dry eye symptoms in children, even after adjusting for other factors.

## Contribution

The study identifies a significant association between sleep quality and dry eye symptoms in children using a large-scale dataset.

## Key findings

- 13.12% of children had dry eye symptoms, and 66.25% had poor sleep quality.
- Poor sleepers had twice the risk of developing dry eye symptoms compared to good sleepers.
- Children sleeping less than 10 hours were more likely to have dry eye symptoms.

## Abstract

Given the increasing incidence of dry eye in children and the established role of sleep as a key health determinant, this study aimed to examine the prevalence of dry eye in children and its association with sleep, adjusting for confounders.

This study included 169,080 children aged 6–12 years. Dry eye syndromes (DEs) were assessed using the 5-Item Dry Eye Questionnaire, whereas sleep quality was evaluated using the Children's Sleep Habits Questionnaire. Logistic and linear regression analyses were performed.

Overall, 13.12% of the children exhibited DEs, and 66.25% experienced poor sleep. Children with poor sleep quality had a significantly higher prevalence of DEs (15.97%, 17,889/112,018) than those with normal sleep quality (7.53%, 4296/57,062) (P < 0.001). The prevalence of poor sleep was 80.64% (17,889/22,185) in children with DEs, compared to 64.08% (94,129/146,895) in those without DEs (P < 0.001). After adjusting for age, sex, body mass index, and other risk factors, poor sleepers had a higher risk of developing DEs than good sleepers (odds ratio [OR] = 2.005; 95% confidence interval [CI]: 1.933–2.080). Children who slept for < 10 h were more likely to have DEs (OR = 1.236l; 95% CI: 1.167–1.310). In logistic regression analyses stratified by age and sex, poor sleepers showed a high risk of DEs. Moreover, the three dry eye symptoms and sleep were related (P < 0.001).

This large-scale study revealed that all domains of sleep were significantly poorer in participants with DEs in children, and these associations remained significant after adjusting for comorbidities.