At every age we need adequate, uninterrupted sleep for optimal, wakeful functioning. Insufficient sleep is associated with a number of chronic diseases and conditions such as diabetes, cardiovascular disease, obesity, and depression.1 Traditional medicine also considers appropriate sleep, among other factors, essential to maintain ocular health.2
Sleep and ocular health
A 2016 study from Japan concluded sleep quality is associated with dry eye disease (DED), and sleep disturbance seems to be an influencing factor on DED, especially dry eye symptoms.3
Previously from Dr. Mastrota: Cataract surgery for patients with PXF
We are familiar with ocular surface disease (OSD) in patients with sleep apnea, often associated with floppy eyelid syndrome.4 In a longitudinal examination of risk factors for severe dry eye symptoms in U.S. veterans, sleep apnea was identified as a risk factor for severe dry eye symptoms.5 Additionally, sleep posture may be a factor in OSD.
Alevi et al reports that in addition to current dry eye treatments, patients who sleep on their sides or face down may see a reduction in dry eye and meibomian gland dysfunction (MGD) if they change their sleep pattern to the supine position.6
It is interesting to note that sleep disturbance is a common nonmotor phenomenon in Parkinson's disease as well as dry eye syndrome.7, 8
Identifying sleep disturbance
In addition, sleep disturbance can be identified and quantified using the Pittsburgh Sleep Quality Index (PSQI) questionnaire tool (http://www.psychiatry.pitt.edu/sites/default/files/page-images/PSQI_Inst...). The PSQI is a self-report questionnaire that assesses sleep quality over a one-month interval.9
1. Centers for Disease Control and Prevention. Sleep and Sleep Disorders. Available at: https://www.cdc.gov/sleep/index.html. Accessed 6/6/17.
2. Haji-Ali-Nili N, Khoshzaban F, Karimi M. Lifestyle Determinants on Prevention and Improvement of Dry Eye Disease from the Perspective of Iranian Traditional Medicine. Iran J Med Sci. 2016 May;41(3):S39.
3. Kawashima M, Uchino M, Yokoi N, Uchino Y, Dogru M, Komuro A, Sonomura Y, Kato H, Kinoshita S, Tsubota K. The association of sleep quality with dry eye disease: the Osaka study. Clin Ophthalmol. 2016 Jun 1;10:1015-21.
4. Mastrota KM. Impact of floppy eyelid syndrome in ocular surface and dry eye disease. Optom Vis Sci. 2008 Sep;85(9):814-6.
5. Ong ES, Alghamdi YA, Levitt RC, McClellan AL, Lewis G, Sarantopoulos CD, Felix ER, Galor A. Longitudinal Examination of Frequency of and Risk Factors for Severe Dry Eye Symptoms in US Veterans. JAMA Ophthalmol. 2016 Dec 22. doi: 10.1001/jamaophthalmol.2016.4925. [Epub ahead of print]
6. Alevi D, Perry HD, Wedel A, Rosenberg E, Alevi L, Donnenfeld ED. Effect of Sleep Position on the Ocular Surface. Cornea. 2017 May;36(5):567-571.
7. Martinez-Ramirez D, De Jesus S, Walz R, Cervantes-Arriaga A, Peng-Chen Z, Okun MS, Alatriste-Booth V, Rodríguez-Violante M. A Polysomnographic Study of Parkinson’s Disease Sleep Architecture. Parkinsons Dis. 2015;2015:570375.
8. Nowacka B, Lubinski W, Honczarenko K, Potemkowski A, Safranow K. Ophthalmological features of Parkinson disease. Med Sci Monit. 2014 Nov 11;20:2243-9.
9. Buysse DJ, Reynolds C, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193–213.
10. Centers for Disease Control and Prevention. MMWR. 2011 March 4;60(8):234-266. Available at: http://www.cdc.gov/mmwr/PDF/wk/mm6008.pdf. Accessed 6/6/17.
11. Centers for Disease Control and Prevention. Insufficient Sleep is a Public Health Problem. Available at: http://www.cdc.gov/features/dssleep/. Accessed 6/6/2017.
12. National Sleep Foundation. Healthy Sleep Tips. Available at: https://sleepfoundation.org/excessivesleepiness/sleep-tools-tips/healthy.... Accessed 6/6/2017.