The association of sleep quality with dry eye disease: The Osaka study

Motoko Kawashima, Miki Uchino, Norihiko Yokoi, Yuichi Uchino, Murat Dogru, Aoi Komuro, Yukiko Sonomura, Hiroaki Kato, Shigeru Kinoshita, Kazuo Tsubota

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)


Purpose: To investigate the association of dry eye disease with sleep quality. Methods: In 2011, a cross-sectional survey was conducted among all the employees, mainly young and middle-aged Japanese office workers, who used visual display technology, at a company in Osaka, Japan (N=672; age range =26-64 years). The participants were classified according to the Japanese dry eye diagnosis criteria by dry eye examination results including the Schirmer test, fluorescein and lissamine green staining, tear film break-up time, and symptom questionnaire into three groups as follows: definite dry eye disease, probable dry eye disease, and no dry eye disease. To determine sleep quality, Japanese version of the Pittsburgh Sleep Quality Index (global score) was implemented. The global score (range =0-21) was calculated by summing seven sleep variable scores (scale, 0-3); scores ≥5.5 indicated poor sleep. Results: The total mean global score was 5.1±2.3 (completed N=383); 45% of the dry eye disease participants reported having poor sleep quality, while 34% of the no dry eye disease participants did so, with a significant difference found in the global score (P=0.002). Furthermore, a statistically significant association was observed between the global score and dry eye disease (P=0.005). Conclusion: Poor sleep quality is associated with dry eye disease, especially with dry eye symptoms.

Original languageEnglish
Pages (from-to)1015-1021
Number of pages7
JournalClinical Ophthalmology
Publication statusPublished - 2016 Jun 1


  • Dry eye
  • Pittsburgh sleep quality index
  • Questionnaire
  • Sleep quality
  • Symptom
  • Tear film break-up time
  • Visual display terminals

ASJC Scopus subject areas

  • Ophthalmology


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