Prevalence of dry eye disease and its association with sleep quality and depression: a hospital-based survey in Thai population
Objectives To estimate the prevalence of dry eye disease (DED) and explore its association with depression and poor sleep quality.Design A cross-sectional study.Setting The study was conducted at the ophthalmology outpatient clinic of a tertiary university hospital in Thailand, from September 2022 t...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e094046.full |
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| Summary: | Objectives To estimate the prevalence of dry eye disease (DED) and explore its association with depression and poor sleep quality.Design A cross-sectional study.Setting The study was conducted at the ophthalmology outpatient clinic of a tertiary university hospital in Thailand, from September 2022 to April 2023.Participants A total of 1321 patients aged 18 years or older, without any history of orbital disease, active superficial or intraocular infection/inflammation, eyelid pathology, or prior intraocular or eyelid surgery within the past 6 months, were enrolled in the study.Interventions All patients underwent dry eye examination, including the Ocular Surface Disease Index questionnaire, tear break-up time and ocular surface staining. Physical activity was measured using the Global Physical Activity Questionnaire, which was expressed as total Metabolic Equivalent of Task-minutes per week. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), Composite Scale of Morningness (CSM) and STOP-Bang. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9).Primary and secondary outcome measures Prevalence of DED and association pathways involving depression, sleep quality and DED.Results The mean age of the participants was 58.3±14.0 years, with a female predominance of 73.7%. Of the 1321 patients, 668 were diagnosed with DED, resulting in a hospital-based prevalence of 50.6% (95% CI: 47.8%, 53.3%). After adjusting for age, sex and underlying disease, PSQI, PHQ-9, STOP-Bang and CSM scores remained significantly associated with DED with adjusted ORs of 2.48 (95% CI: 1.96, 3.14; p<0.001), 1.65 (95% CI: 1.05, 2.61; p=0.031), 1.81 (95% CI: 1.05, 3.14; p=0.033) and 1.32 (95% CI: 1.04, 1.68; p=0.023), respectively. The effects of depression on DED were mediated indirectly via poor sleep quality (OR=1.32; 95% CI: 1.18, 1.49; p<0.001) and directly via other mechanisms (OR=1.66; 95% CI: 1.06, 2.58; p=0.021).Conclusions DED is notably common among Thai patients. Depression and poor sleep quality are significantly associated with DED. Poor sleep quality may mediate the relationship between depression and DED. |
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| ISSN: | 2044-6055 |