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Impaired sleep quality in children with allergic conjunctivitis and their parents

Eye volume 37, pages 1558–1565 (2023)Cite this article

Subjects

Abstract

Objectives

To investigate the sleep quality in children with allergic conjunctivitis (AC) and their parents.

Methods

Prospective, case-controlled study. Zhongshan Ophthalmic Center, a tertiary referral centre. Participants comprised 73 children aged 4–12 years with AC and their parents, and 81 healthy, age-matched children who served as controls and their parents. General information was recorded and ocular manifestations of children with AC were scored. Sleep quality of the children and parents were assessed using Children’s Sleep Habits Questionnaire (CSHQ) and Pittsburgh Sleep Quality Index (PSQI).

Results

Children with AC and their parents had reduced sleep quality (Children’s CSHQ: 48.3 ± 6.55 vs. 38.8 ± 4.63; Parental PSQI: 5.62 ± 2.12 vs. 3.40 ± 1.90, both p < 0.001) and significantly higher prevalence of poor sleep quality (CSHQ ≥ 41 in Children: 89.0% vs. 23.5%; PSQI > 7 in Parents: 18.5% vs. 1.23%, both p < 0.001). Children with AC scored worse on subcomponents of CSHQ including sleep onset delay, sleep duration, parasomnia, sleep-disordered breathing, and daytime sleepiness. Parents scored worse on subscores of PSQI including sleep duration, sleep disturbances, use of sleeping medication, and daytime sleepiness. Poor sleep quality in children with AC was associated with follicle formation (OR:3.95; 95% CI: 1.88–8.31, p < 0.001) and keratitis (OR:6.03; 95% CI: 1.29–28.3, p = 0.028). Parental poor sleep quality was associated with follicle formation (OR:7.14; 95% CI: 2.06–24.8, p = 0.002) and keratitis (OR:4.49; 95% CI: 1.27–15.9, p = 0.020) in children.

Conclusions

AC has a negative association with sleep quality in children and their parents, especially in those children with severe follicle formation and keratitis.

State the details of Clinical Trials

Chictr.org.cn, https://www.chictr.org.cn/showproj.aspx?proj=43511, ChiCTR1900027486.

Statement of significance

Allergic conjunctivitis is a frequently encountered problem diagnosed and managed by ophthalmologists, paediatricians, allergists, and primary care physicians and has become a major public health issue. Sleep is crucial for learning and effective development in children. Our study discovered a strong association between these two conditions. This is the first study to evaluate the association of allergic conjunctivitis and sleep quality in children and their parents. This case-controlled study found that allergic conjunctivitis had a negative impact on sleep quality not only for children but also for their parents. The findings of this study suggest a multifaceted impact of AC with sleep quality; detailed assessment of sleep quality for improved care of paediatric patients with allergic conjunctivitis would be useful.

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Data availability

Data are available upon reasonable request from the authors.

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Funding

This study is supported by grants (82070922) from the National Natural Science Foundation of China, a grant (2019A1515012012) from the Science Foundation of Guangdong Province and a grant (303020101) from the High-level Hospital Construction Project.

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Author notes

  1. These authors contributed equally: Jing Li, Shi-yao Zhang.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China

    Jing Li, Shi-yao Zhang, Zixin Fan, Ren Liu, Ling Jin & Lingyi Liang

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Contributions

LL conceived the study; JL, and SZ initially designed the study, analysed data, and prepared the manuscript; ZF, and RL collected clinical samples; LJ contributed to data visualisation. All authors read and approved the final version of the manuscript.

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Correspondence to Lingyi Liang.

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Li, J., Zhang, Sy., Fan, Z. et al. Impaired sleep quality in children with allergic conjunctivitis and their parents. Eye 37, 1558–1565 (2023). https://doi.org/10.1038/s41433-022-02182-4

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