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Sleep duration and the risk of major eye disorders: a systematic review and meta-analysis

Eye volume 37, pages 2707–2715 (2023)Cite this article

Subjects

Abstract

Background

To assess the relationship between sleep duration and the risk of major eye disorders including myopia, glaucoma, cataract, age-related macular degeneration (AMD), and diabetic retinopathy (DR).

Methods

Databases including PubMed, Embase, Web of Science, and Cochrane library were searched for eligible publications before July 2021. Studies assessing the relationship between sleep duration and any one of the major eye disorders were identified. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were estimated using random-effects models.

Results

We identified 21 relevant articles including 777348 participants, and 17 were cross-sectional, 3 were longitudinal, and 1 was case-control. Pooled results indicated that long sleep duration was significantly associated with the risk of DR (OR = 1.84, 95% CI 1.24, 2.73), and short sleep duration was significantly associated with the risk of cataract (OR = 1.20, 95% CI 1.05, 1.36). Besides, a significant relationship was observed between the risk of DR and long sleep duration per day (i.e., nighttime sleep plus daytime napping, OR = 1.74, 95% CI 1.23, 2.44) rather than per night (OR = 2.17, 95% CI 0.95, 4.99). The extreme of long sleep duration (i.e., >10 h per night) increased the risk of myopia (OR = 1.02, 95% CI 1.01, 1.04).

Conclusions

Inappropriate sleep duration might increase the risk of major eye disorders. The findings could contribute to the growing knowledge on the possible relationship between circadian rhythms and eye disorders.

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Fig. 1
Fig. 2: Forest plot showing the association between long sleep duration and major eye disorders.
Fig. 3: Forest plot showing the association between short sleep duration and major eye disorders.
Fig. 4: Subgroup analyses for specific definitions of short-and-long sleep duration.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017;5:e888–97.

    Article  PubMed  Google Scholar 

  2. Congdon N, O’Colmain B, Klaver CC, Klein R, Muñoz B, Friedman DS, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol (Chic, Ill: 1960). 2004;122:477–85.

    Article  Google Scholar 

  3. Saw SM, Foster PJ, Gazzard G, Seah S. Causes of blindness, low vision, and questionnaire-assessed poor visual function in Singaporean Chinese adults: The Tanjong Pagar Survey. Ophthalmology. 2004;111:1161–8.

    Article  PubMed  Google Scholar 

  4. Klein R, Klein BE, Linton KL, De Mets DL. The Beaver Dam Eye Study: visual acuity. Ophthalmology. 1991;98:1310–5.

    Article  CAS  PubMed  Google Scholar 

  5. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96:614–8.

    Article  PubMed  Google Scholar 

  6. Shan Z, Ma H, Xie M, Yan P, Guo Y, Bao W, et al. Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2015;38:529–37.

    Article  PubMed  Google Scholar 

  7. Yin J, Jin X, Shan Z, Li S, Huang H, Li P, et al. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc. 2017;6:e005947.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Short MA, Booth SA, Omar O, Ostlundh L, Arora T. The relationship between sleep duration and mood in adolescents: a systematic review and meta-analysis. Sleep Med Rev. 2020;52:101311.

    Article  PubMed  Google Scholar 

  9. Jee D, Morgan IG, Kim EC. Inverse relationship between sleep duration and myopia. Acta Ophthalmol. 2016;94:e204–10.

    Article  PubMed  Google Scholar 

  10. Wei SF, Li SM, Liu L, Li H, Kang MT, Sun YY, et al. Sleep duration, bedtime, and myopia progression in a 4-year follow-up of Chinese children: The Anyang childhood eye study. Investig Ophthalmol Vis Sci. 2020;61:37.

    Article  Google Scholar 

  11. Chew M, Tan NYQ, Lamoureux E, Cheng CY, Wong TY, Sabanayagam C. The associations of objectively measured sleep duration and sleep disturbances with diabetic retinopathy. Diabetes Res Clin Pract. 2020;159:107967.

    Article  CAS  PubMed  Google Scholar 

  12. Stone RA, Pardue MT, Iuvone PM, Khurana TS. Pharmacology of myopia and potential role for intrinsic retinal circadian rhythms. Exp Eye Res. 2013;114:35–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Xu X, Wang D, Xiao G, Yu K, Gong Y. Sleep less, myopia more. Theory Clin Pract Pediat. 2017;1:11–7.

  14. Qi LS, Yao L, Wang XF, Shi JM, Liu Y, Wu TY, et al. Risk factors for incident myopia among teenaged students of the experimental class of the air force in China. J Ophthalmol. 2019;2019:3096152.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–9.

    Article  PubMed  Google Scholar 

  16. Zizi F, Pandey A, Murrray-Bachmann R, Vincent M, McFarlane S, Ogedegbe G, et al. Race/ethnicity, sleep duration, and diabetes mellitus: analysis of the National Health Interview Survey. Am J Med. 2012;125:162–7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Adenekan B, Pandey A, McKenzie S, Zizi F, Casimir GJ, Jean-Louis G. Sleep in America: role of racial/ethnic differences. Sleep Med Rev. 2013;17:255–62.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lauderdale DS, Knutson KL, Yan LL, Rathouz PJ, Hulley SB, Sidney S, et al. Objectively measured sleep characteristics among early-middle-aged adults: the CARDIA study. Am J Epidemiol. 2006;164:5–16.

    Article  PubMed  Google Scholar 

  19. Silva GE, Goodwin JL, Sherrill DL, Arnold JL, Bootzin RR, Smith T, et al. Relationship between reported and measured sleep times: the sleep heart health study (SHHS). J Clin Sleep Med. 2007;3:622–30.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med. 2015;8:2–10.

    Article  PubMed  Google Scholar 

  21. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.

    Article  PubMed  Google Scholar 

  22. Lee SH, Kim HB, Lee KW. Association between sleep duration and attention-deficit hyperactivity disorder: a systematic review and meta-analysis of observational studies(✰). J Affect Disord. 2019;256:62–9.

    Article  PubMed  Google Scholar 

  23. Bucher HC, Guyatt GH, Griffith LE, Walter SD. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol. 1997;50:683–91.

    Article  CAS  PubMed  Google Scholar 

  24. Qu Y, Yu J, Xia W, Cai H. Correlation of myopia with physical exercise and sleep habits among suburban adolescents. J Ophthalmol. 2020;2020:2670153.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Bmj. 1997;315:629–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Chew M, Tan NYQ, Lamoureux E, Cheng CY, Wong TY, Sabanayagam C. The associations of objectively measured sleep duration and sleep disturbances with diabetic retinopathy. Graefe’s Arch Clin Exp Ophthalmol = Albrecht von Graefes Arch fur klinische und experimentelle Ophthalmologie. 2020;159:107967.

    CAS  Google Scholar 

  28. Rim TH, Kim DW, Kim SE, Kim SS. Factors associated with Cataract in Korea: a Community Health Survey 2008–2012. Yonsei Med J. 2015;56:1663–70.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Loman J, Quinn GE, Kamoun L, Ying GS, Maguire MG, Hudesman D, et al. Darkness and near work: myopia and its progression in third-year law students. Ophthalmology. 2002;109:1032–8.

    Article  PubMed  Google Scholar 

  30. Gong Y, Zhang X, Tian D, Wang D, Xiao G. Parental myopia, near work, hours of sleep and myopia in Chinese children. Health. 2014;06:64–70.

    Article  Google Scholar 

  31. Zhou Z, Morgan IG, Chen Q, Jin L, He M, Congdon N. Disordered sleep and myopia risk among chinese children. PLoS ONE. 2015;10:e0121796.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Huang L, Kawasaki H, Liu Y, Wang Z. The prevalence of myopia and the factors associated with it among university students in Nanjing: a cross-sectional study. Medicine. 2019;98:e14777.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Liu XN, Naduvilath TJ, Wang J, Xiong S, He X, Xu X, et al. Sleeping late is a risk factor for myopia development amongst school-aged children in China. Sci Rep. 2020;10:17194.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Raman R, Gupta A, Venkatesh K, Kulothungan V, Sharma T. Abnormal sleep patterns in subjects with type II diabetes mellitus and its effect on diabetic microangiopathies: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 20). Acta Diabetol. 2012;49:255–61.

    Article  CAS  PubMed  Google Scholar 

  35. Meng LL, Liu Y, Geng RN, Tang YZ, Li DQ. Association of diabetic vascular complications with poor sleep complaints. Diabetol Metab Syndr. 2016;8:80.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Jee D, Keum N, Kang S, Arroyo JG. Sleep and diabetic retinopathy. Acta Ophthalmol. 2017;95:41–7.

    Article  CAS  PubMed  Google Scholar 

  37. Dharmastuti DP, Agni AN, Widyaputri F, Pawiroranu S, Sofro ZM, Wardhana FS, et al. Associations of physical activity and sedentary behaviour with vision-threatening diabetic retinopathy in indonesian population with type 2 diabetes mellitus: Jogjakarta Eye Diabetic Study in the Community (JOGED.COM). Ophthalmic Epidemiol. 2018;25:113–9.

    Article  CAS  PubMed  Google Scholar 

  38. Tan NYQ, Chew M, Tham YC, Nguyen QD, Yasuda M, Cheng CY, et al. Associations between sleep duration, sleep quality and diabetic retinopathy. PLoS ONE. 2018;13:e0196399.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lee JA, Han K, Min JA, Choi JA. Associations of sleep duration with open angle glaucoma in the Korea national health and nutrition examination survey. Med (US). 2016;95:e5704.

    Google Scholar 

  40. Qiu M, Ramulu PY, Boland MV. Association between sleep parameters and glaucoma in the United States population: National Health and Nutrition Examination Survey. J Glaucoma. 2019;28:97–104.

    Article  PubMed  Google Scholar 

  41. Khurana RN, Porco TC, Claman DM, Boldrey EE, Palmer JD, Wieland MR. Increasing sleep duration is associated with geographic atrophy and age-related macular degeneration. Retina. 2016;36:255–8.

    Article  PubMed  Google Scholar 

  42. Pérez-Canales JL, Rico-Sergado L, Pérez-Santonja JJ. Self-reported sleep duration in patients with neovascular age-related macular degeneration. Ophthalmic Epidemiol. 2016;23:20–6.

    Article  PubMed  Google Scholar 

  43. Peltzer K, Pengpid S. Self-reported sleep duration and its correlates with sociodemographics, health behaviours, poor mental health, and chronic conditions in rural persons 40 years and older in South Africa. Int J Environ Res Public Health. 2018;15:1357.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of healthy sleep duration among adults—United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65:137–41.

    Article  PubMed  Google Scholar 

  45. McEwen BS. Sleep deprivation as a neurobiologic and physiologic stressor: allostasis and allostatic load. Metab: Clin Exp. 2006;55:S20–23.

    Article  CAS  PubMed  Google Scholar 

  46. Ba-Ali S, Brøndsted AE, Andersen HU, Sander B, Jennum PJ, Lund-Andersen H. Assessment of diurnal melatonin, cortisol, activity, and sleep−wake cycle in patients with and without diabetic retinopathy. Sleep Med. 2019;54:35–42.

    Article  PubMed  Google Scholar 

  47. Knutson KL, Leproult R. Apples to oranges: comparing long sleep to short sleep. J Sleep Res. 2010;19:118.

    Article  PubMed  Google Scholar 

  48. Grandner MA, Drummond SP. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Med Rev. 2007;11:341–60.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration, and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry. 2016;80:40–52.

    Article  PubMed  Google Scholar 

  50. Linsenmeier RA. Effects of light and darkness on oxygen distribution and consumption in the cat retina. J Gen Physiol. 1986;88:521–42.

    Article  CAS  PubMed  Google Scholar 

  51. Zizi F, Jean-Louis G, Brown CD, Ogedegbe G, Boutin-Foster C, McFarlane SI. Sleep duration and the risk of diabetes mellitus: epidemiologic evidence and pathophysiologic insights. Curr Diab Rep. 2010;10:43–7.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health. 2015;1:233–43.

    Article  PubMed  Google Scholar 

  53. Xie J, Li Y, Zhang Y, Vgontzas AN, Basta M, Chen B, et al. Sleep duration and metabolic syndrome: an updated systematic review and meta-analysis. Sleep Med Rev. 2021;59:101451.

    Article  CAS  PubMed  Google Scholar 

  54. Wu JQ, Appleman ER, Salazar RD, Ong JC. Cognitive behavioral therapy for insomnia comorbid with psychiatric and medical conditions: a meta-analysis. JAMA Intern Med. 2015;175:1461–72.

    Article  PubMed  Google Scholar 

  55. Zachariae R, Lyby MS, Ritterband LM, O’Toole MS. Efficacy of internet-delivered cognitive-behavioral therapy for insomnia - a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2016;30:1–10.

    Article  PubMed  Google Scholar 

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Funding

This study was supported by the National Natural Science Foundation of China (82122059).

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Author notes

  1. These authors contributed equally: Miao Zhou, Dan-Lin Li.

Authors and Affiliations

  1. School of Public Health, Medical College of Soochow University, Suzhou, China

    Miao Zhou, Dan-Lin Li, Jia-Yan Kai & Chen-Wei Pan

  2. Department of Ophthalmology, Peking University People’s Hospital, Beijing, China

    Miao Zhou

  3. Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China

    Miao Zhou

  4. Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China

    Xiao-Feng Zhang

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Contributions

CWP and MZ contributed to the conception and design of the study. MZ, DLL and JYK performed the literature search and data collection. MZ drafted the manuscript and carried out the statistical analysis. CWP and XFZ critically revised the work. All authors read and approved the final manuscript.

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Correspondence to Xiao-Feng Zhang or Chen-Wei Pan.

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Zhou, M., Li, DL., Kai, JY. et al. Sleep duration and the risk of major eye disorders: a systematic review and meta-analysis. Eye 37, 2707–2715 (2023). https://doi.org/10.1038/s41433-023-02403-4

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