Luo Yuzhu, Gao Yuting, Guan Zhong, Liu Heting, Tao Shuman
Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People's Republic of China.
MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, 230032, People's Republic of China.
Nat Sci Sleep. 2025 Sep 2;17:2041-2049. doi: 10.2147/NSS.S551300. eCollection 2025.
To investigate the prevalence of dry eye disease (DED) among children and adolescents aged 9 to 19 years in Fengyang County, and to explore the associations of sleep duration and social jetlag with DED, with the aim of providing scientific evidence for sleep-based interventions to prevent DED in this population.
Between November and December 2023, 14 primary and secondary schools were randomly selected in Fengyang County, Chuzhou City, Anhui Province, China. Students from Grade 4 to Grade 12 (aged 9-19 years) were invited to participate. A trained professional conducted clinical assessments to evaluate DED, and participants completed self-administered questionnaires to report their sleep behaviors. Sleep quality was assessed by an item from Pittsburgh Sleep Quality Index. Chi-square tests and independent-samples t-tests were used to compare sociodemographic characteristics between DED and non-DED groups. Logistic regression models were applied to examine the associations of sleep duration, social jetlag, and their interaction with DED after adjusting for potential confounders.
The overall prevalence of DED among children and adolescents in Fengyang County was 51%. After adjusting for confounders, binary logistic regression analysis showed that students who slept less than 9 hours per night had a significantly higher likelihood of DED ( = 1.37, 95% CI: 1.21-1.68), and those with social jetlag ≥1 hour also had an elevated risk of DED ( = 1.28, 95% CI: 1.07-1.54). Notably, the group with sleep duration ≥ 9 h combined with social jet lag ≥ 1 h showed a significant positive association with DED after adjusting for sleep quality ( = 1.77, 95% CI: 1.35-2.33).
Both insufficient sleep duration and significant social jetlag are associated with an increased risk of DED in children and adolescents. These findings suggest the need for targeted sleep education programs in schools that emphasize not only sufficient sleep duration but also consistent sleep-wake schedules between weekdays and weekends to promote ocular health among youth.
调查凤阳县9至19岁儿童及青少年干眼疾病（DED）的患病率，并探讨睡眠时间和社会时差与DED之间的关联，旨在为基于睡眠的干预措施提供科学依据，以预防该人群的DED。
2023年11月至12月期间，在中国安徽省滁州市凤阳县随机选取14所中小学。邀请四年级至十二年级（9至19岁）的学生参与。由一名经过培训的专业人员进行临床评估以评估DED，参与者完成自填问卷以报告其睡眠行为。睡眠质量通过匹兹堡睡眠质量指数中的一项进行评估。采用卡方检验和独立样本t检验比较DED组和非DED组之间的社会人口学特征。在调整潜在混杂因素后，应用逻辑回归模型检验睡眠时间、社会时差及其与DED的相互作用之间的关联。
凤阳县儿童及青少年中DED的总体患病率为51%。在调整混杂因素后，二元逻辑回归分析显示，每晚睡眠时间少于9小时的学生患DED的可能性显著更高（比值比 = 1.37，95%置信区间：1.21 - 1.68），社会时差≥1小时的学生患DED的风险也有所升高（比值比 = 1.28，95%置信区间：1.07 - 1.54）。值得注意的是，在调整睡眠质量后，睡眠时间≥9小时且社会时差≥1小时的组与DED呈显著正相关（比值比 = 1.77，95%置信区间：1.35 - 2.33）。
睡眠时间不足和显著的社会时差均与儿童及青少年患DED的风险增加相关。这些发现表明，学校需要开展有针对性的睡眠教育项目，不仅要强调充足的睡眠时间，还要强调工作日和周末一致的作息时间表，以促进青少年的眼部健康。
