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    How sleep affects the ocular surface

    Insufficient or poor sleep may play role in ocular health

    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

    Related: Why you’re missing the dry eye right in front of you

    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

    Katherine M. Mastrota, MS, OD, FAAO
    Clinical director of Omni Center for Dry Eye Specialty Care in New York City

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