Wang Yu, Rong Shisong, Zhou Zixi, Liang Yuanbo, Lin Zhong, Wang Fenghua, Wang Qitong, Feng Kemi, Ding Xiaoxia, Zang Dongxiao, Li Dong, Zang Bo
Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China.
Mass Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA, United States.
Front Psychiatry. 2025 Jul 17;16:1521347. doi: 10.3389/fpsyt.2025.1521347. eCollection 2025.
To examine the association between visual acuity (VA), sleep quality, and sleep duration among Chinese adults.
SUBJECTS/METHODS: Data were derived from the Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), a cross-sectional, community-based study conducted in Fushun, China, from July 2012 to May 2013. The study included 1284 participants (58.7% female, mean age 61.3 years) with type 2 diabetes. VA was assessed using the LogMAR chart and stratified into six groups based on LogMAR scores: <0 (optimal), 0-0.1, 0.1-0.2, 0.2-0.3, 0.3-0.5, and ≥0.5 for multivariable-adjusted analyses. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).
Restricted cubic splines revealed a significant J-shaped association between VA and sleep quality ( for non-linearity = 0.004). This relationship was characterized by a positive correlation for VA values below 0.5 LogMAR, with the association plateauing at higher VA levels. Compared to the optimal VA group, the odds ratios (ORs) for poor sleep quality were: 1.18 (95% CI: 1.05-1.33) for 0-0.1, 1.73 (1.52-1.97) for 0.1-0.2, 1.99 (1.74-2.28) for 0.2-0.3, 1.55 (1.33-1.80) for 0.3-0.5, and 1.80 (1.54-2.10) for ≥0.5. No significant association was found between VA and sleep duration, whether short or long, in fully adjusted models.
Our findings reveal a J-shaped association between visual acuity and sleep quality, while no significant association was observed with sleep duration. Even mild vision changes, not typically classified as impairment, may significantly affect sleep. This underscores the importance of early sleep health consideration in eye care.
研究中国成年人的视力（VA）、睡眠质量和睡眠时间之间的关联。
受试者/方法：数据来源于抚顺糖尿病视网膜病变队列研究（FS-DIRECT），这是一项于2012年7月至2013年5月在中国抚顺进行的基于社区的横断面研究。该研究纳入了1284名2型糖尿病患者（女性占58.7%，平均年龄61.3岁）。使用LogMAR视力表评估视力，并根据LogMAR评分分为六组进行多变量调整分析：<0（最佳）、0 - 0.1、0.1 - 0.2、0.2 - 0.3、0.3 - 0.5和≥0.5。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。
受限立方样条显示视力与睡眠质量之间存在显著的J形关联（非线性检验P = 0.004）。这种关系的特点是LogMAR值低于0.5时呈正相关，在较高视力水平时关联趋于平稳。与最佳视力组相比，睡眠质量差的比值比（OR）分别为：0 - 0.1组为1.18（95%置信区间：1.05 - 1.33），0.1 - 0.2组为1.73（1.52 - 1.97），0.2 - 0.3组为1.99（1.74 - 2.28），0.3 - 0.5组为1.55（1.33 - 1.80），≥0.5组为1.80（1.54 - 2.10）。在完全调整模型中，未发现视力与睡眠时间之间存在显著关联，无论是短睡眠时间还是长睡眠时间。
我们的研究结果揭示了视力与睡眠质量之间的J形关联，而未观察到与睡眠时间存在显著关联。即使是通常不被归类为损伤的轻度视力变化，也可能显著影响睡眠。这凸显了在眼科护理中早期考虑睡眠健康的重要性。
