November 05, 2025

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Dry Eye And Ocular Pain Intensity Closely Associated With Increased Sleep Disturbances

In a recent study published in the BMJ Open Ophthalmology explored the intricate relationship between dry eye (DE) disease and sleep quality. Mohammad Ayoubi and team at the Miami Veterans Affairs eye clinic uncovered this significant connections on how specific aspects of sleep closely intertwine with DE symptoms.
The study comprised 141 veterans with a mean age of 56 and utilized a comprehensive approach. The participants filled out questionnaires gauging the severity of DE symptoms, including the 5-Item Dry Eye Questionnaire (DEQ-5) and the Ocular Surface Disease Index (OSDI). Ocular pain was measured using the Numerical Rating Scale (NRS) and the Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-E). An ocular surface examination was conducted to assess the DE signs. The Pittsburgh Sleep Quality Index (PSQI) was also employed to evaluate different aspects of sleep quality.
76% of participants reported mild or more severe DE symptoms. This study found that ocular symptoms were more closely associated to sleep metrics than signs. The measure of DE symptoms (OSDI) exhibited the strongest association with sleep disturbances, with an association coefficient of 0.49 (p<0.0005). For DE signs, ocular surface inflammation and meibum quality correlated to subjective sleep quality (PSQI subscore 1, r=0.29, p=0.03, for both).
Linear regression analyses indicated that ocular symptom questionnaires remained linked to sleep disturbances and ocular surface inflammation and meibum quality stayed associated with subjective sleep quality.
The findings of this study underscores the profound connection between DE symptoms and ocular pain intensity with sleep disturbances. The study suggests that the link between DE signs and subjective sleep quality is somewhat weaker by emphasizing the complexity of the interplay between DE disease and sleep patterns despite these robust relationships. This research offers critical insights that could help future interventions for individuals suffering with the challenges of both DE and sleep issues.
Reference:
Ayoubi, M., Cabrera, K., Mangwani, S., Locatelli, E. V. T., & Galor, A. (2024). Associations between dry eye disease and sleep quality: a cross-sectional analysis. BMJ Open Ophthalmology, 9(1), e001584. https://doi.org/10.1136/bmjophth-2023-001584

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