title: The association of sleep quality with dry eye disease: the Osaka study.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Poor sleep quality is associated with dry eye disease, especially with dry eye symptoms.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Kawashima
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Ryogoku Eye Clinic, Sumida-ku, Tokyo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Uchino
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yokoi
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Ryogoku Eye Clinic, Sumida-ku, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Uchino
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Komuro
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Sonomura
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
keywords: Pittsburgh Sleep Quality Index; dry eye; questionnaire; sleep quality; symptom; tear film break-up time; visual display terminals