Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study

ObjectiveTo examine the association between visual acuity (VA), sleep quality, and sleep duration among Chinese adults.Subjects/MethodsData were derived from the Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), a cross-sectional, community-based study conducted in Fushun, China, from July 2012...

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Main Authors: Yu Wang, Shisong Rong, Zixi Zhou, Yuanbo Liang, Zhong Lin, Fenghua Wang, Qitong Wang, Kemi Feng, Xiaoxia Ding, Dongxiao Zang, Dong Li, Bo Zang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1521347/full
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author Yu Wang
Shisong Rong
Zixi Zhou
Yuanbo Liang
Zhong Lin
Fenghua Wang
Qitong Wang
Kemi Feng
Xiaoxia Ding
Dongxiao Zang
Dong Li
Bo Zang
author_facet Yu Wang
Shisong Rong
Zixi Zhou
Yuanbo Liang
Zhong Lin
Fenghua Wang
Qitong Wang
Kemi Feng
Xiaoxia Ding
Dongxiao Zang
Dong Li
Bo Zang
author_sort Yu Wang
collection DOAJ
description ObjectiveTo examine the association between visual acuity (VA), sleep quality, and sleep duration among Chinese adults.Subjects/MethodsData 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).ResultsRestricted cubic splines revealed a significant J-shaped association between VA and sleep quality (P 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.ConclusionsOur 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.
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spelling doaj-art-2347f74f74cb4e3f88b527920b0c55c22025-08-20T03:28:00ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.15213471521347Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy StudyYu Wang0Shisong Rong1Zixi Zhou2Yuanbo Liang3Zhong Lin4Fenghua Wang5Qitong Wang6Kemi Feng7Xiaoxia Ding8Dongxiao Zang9Dong Li10Bo Zang11Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, ChinaMass Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA, United StatesDepartment of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, ChinaEye Hospital, Wenzhou Medical University, Wenzhou, ChinaEye Hospital, Wenzhou Medical University, Wenzhou, ChinaDepartment of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Ophthalmology, China Medical University, Shenyang, Liaoning, ChinaEye Hospital, Wenzhou Medical University, Wenzhou, ChinaDepartment of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, ChinaDepartment of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, ChinaDepartment of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, ChinaDepartment of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, ChinaObjectiveTo examine the association between visual acuity (VA), sleep quality, and sleep duration among Chinese adults.Subjects/MethodsData 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).ResultsRestricted cubic splines revealed a significant J-shaped association between VA and sleep quality (P 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.ConclusionsOur 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.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1521347/fullvisual acuitysleep qualitysleep durationPittsburgh Sleep Quality Index (PSQI)cross-sectional study
spellingShingle Yu Wang
Shisong Rong
Zixi Zhou
Yuanbo Liang
Zhong Lin
Fenghua Wang
Qitong Wang
Kemi Feng
Xiaoxia Ding
Dongxiao Zang
Dong Li
Bo Zang
Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study
Frontiers in Psychiatry
visual acuity
sleep quality
sleep duration
Pittsburgh Sleep Quality Index (PSQI)
cross-sectional study
title Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study
title_full Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study
title_fullStr Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study
title_full_unstemmed Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study
title_short Association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes: evidence from a cross-sectional analysis of the Fushun Diabetic Retinopathy Study
title_sort association of visual acuity with sleep quality and sleep duration in patients with type 2 diabetes evidence from a cross sectional analysis of the fushun diabetic retinopathy study
topic visual acuity
sleep quality
sleep duration
Pittsburgh Sleep Quality Index (PSQI)
cross-sectional study
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1521347/full
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