![]() ![]() Hypothesis of the effects of nocturnal lagophthalmos on dry eye disease and sleep quality. Number of symptoms of eyes upon awakening A p-value of <0.05 was considered statistically significant. Given that the data were not normally distributed, we applied Student’s t-test, the Wilcoxon signed rank test, the chi-squared test, the Mann–Whitney U test, and age-and-gender-adjusted multivariate logistic regression analysis for statistical analysis in Stata, software version 16. Where appropriate, data are given as mean ± standard deviation (SD). Logistic regression analysis was performed using the presence of NL as a dependent valuable. Each variable was compared between the groups. We defined DED as having a previous diagnosis of DED (D5) and/or having both dryness (answer 1 or 2 on D3) and foreign body sensation (answer 1 or 2 on D4) in the eyes. We also compared groups with and without DED based on the answers to the validated short questionnaire (dryness and irritation of the eyes, and former diagnosis of DED ). We did not include subjects who answered 3 (not sure) in the analysis. Subjects who answered 1 for question S11 were categorized as the NL (+) group, and those who answered 2 were categorized as the NL (−) group. The subjects were divided into two groups according to the presence of NL. “How long do you spend outside during daytime?”ġ: less than one h, 2: 1 h, 3: 2 h, 4: 3 h, 5: 4 h, 6: 5 h, 7: 6 h, 8: 7 h, 9: 8 h, 10: 9 h, 11: more than 10 h “Do you take eye drops after waking or for sleeping?” “How do your eyes feel when you wake up?”ġ: good, 2: not good, 3: have difficulty opening, 4: feel foreign body sensation, 5: feel pain, 6: eye discharge, 7: lacrimation, 8: dry, 9: sensitive to light, 10: others, multiple answers allowed “Do you wake up to eye pain during sleep?”ġ: never, 2: once a week, 3: twice to four times a week, 4: every night “How long does it take you to fall asleep after you go to bed?” “At what time do you go to bed during weekdays?” “At what time do you get up during weekdays?” ![]() “How would you rate the quality of your sleep?”ġ: great, 2: good, 3: average, 4: not good, 5: poorly “Have you been diagnosed as having DED?”ġ: constantly, 2: sometimes 3: rarely, 4: never “How often do you have a sensation of a foreign body in your eye?”ĭ5. “How often do you feel dryness in your eye?”ġ: constantly, 2: sometimes, 3: rarely, 4: neverĭ4. Preventative eye care for lagophthalmos before and during sleep may be helpful for DED and sleep quality.ĭ3. The current study suggested that NL was associated with worsened DED symptoms and poor sleep quality. Logistic regression analysis showed that NL correlated with younger age, symptomatic DED, and eye symptoms upon waking. NL was more prevalent in the DED group ( p = 0.007). Furthermore, people belonging to the DED group were more frequently working night shifts ( p < 0.001). Sleep duration was significantly shorter ( p = 0.008), sleep latency was longer ( p < 0.001), and sleep efficacy was worse compared with the non-DED group ( p < 0.001). The DED group was comprised of 890 subjects (44 ± 13.8 years, 359 males) and women were predominant ( p < 0.001). Participants were divided into two groups according to the presence of DED, and responses were compared between the groups. The participants were asked to answer a questionnaire about DED, sleep quality, and happiness. We launched a survey website to recruit 2000 Japanese. This study aimed to evaluate the prevalence of NL and sleep quality in DED patients. ![]() Nocturnal lagophthalmos (NL) refers to the inability to close the eyelids during sleep, which is known to affect dry eye disease (DED) symptoms and sleep quality. ![]()
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