Relationships Between Sleep Duration, Timing, Consistency, and Chronotype with Myopia Among School-Aged Children

Overview

Journal J Ophthalmol

Publisher Wiley

Specialty Ophthalmology

Date 2022 Jul 29

PMID 35903175

Authors

Rong Li

Yiting Chen

Anda Zhao

Lili Huang

Zichong Long

Wenhui Kang

Yong Yin

Shilu Tong

Shenghui Li

Affiliations

Soon will be listed here.

Abstract

Background: The role of sleep in childhood myopia has been a research focus; however, the existing evidence is conflicting on sleep duration and timing, and as yet, no studies involve sleep consistency and chronotype. This study is done to make multiple-perspective analyses on the associations between sleep variables and myopia.

Methods: A population-based cross-sectional study was conducted in Shanghai, China, which included 10,142 school-aged children (7-12 years old, 53.2% boys). The Chinese version of the Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep variables. Propensity score matching was adopted to balance the difference of covariates between nonmyopic and myopic groups. Logistic regression models were implemented to examine the associations between sleep variables and myopia.

Results: Sleep duration and timing, mainly during weekdays, were correlated with myopia in a dose-dependent pattern, in which longer sleep duration was associated with decreased risk of myopia (9-10 hours/day: odds ratio (OR) = 0.87; ≥10 hours/day: OR = 0.77; by comparison with <9 hours/day); later bedtime (9 pm to 9:30 pm: OR = 1.46; 9:30 pm to 10 pm: OR = 1.51; 10 pm and after: OR = 2.08; by comparison with before 9 pm) and later wake-up time (7 am and after: OR = 1.36; by comparison with before 6:30 am) increased the risk (all < 0.05). Moreover, longer weekend catch-up sleep duration and intermediate and evening chronotype were positively correlated with myopia, while social jetlag was associated with a lower odds of myopia. All these findings were also similarly observed in the matching sample.

Conclusions: Multiple dimensions of sleep were involved in childhood myopia. In addition to sleep duration and timing, sleep consistency and chronotype were also strictly related to myopia. More studies are needed to enrich the current evidence, thus further clarifying the association between sleep and childhood myopia.

Citing Articles

Sleep Duration, Sleep Habits, and Social Jetlag From 4 to 6 years Their Impacts on Myopia Among School-Aged Children: The Ma'anshan Birth Cohort Study.

Wang M, Tong J, Zhu D, Huang K, Wu X, Gao G Nat Sci Sleep. 2025; 17:365-378.

PMID: 40051711 PMC: 11883176. DOI: 10.2147/NSS.S500191.

Effects of Insufficient Sleep on Myopia in Children: A Systematic Review and Meta-Analysis.

Zhao X, He Y, Zhang J, Lin S, Zou H, Ma Y Nat Sci Sleep. 2024; 16:1387-1406.

PMID: 39308665 PMC: 11416795. DOI: 10.2147/NSS.S472748.

Evaluation of risk factors for childhood myopia progression: A systematic review of the literature.

Chen C, Yao J Indian J Ophthalmol. 2024; 72(Suppl 5):S721-S727.

PMID: 39141497 PMC: 11670848. DOI: 10.4103/IJO.IJO_1909_23.

Diurnal gene expression patterns in retina and choroid distinguish myopia progression from myopia onset.

Stone R, Tobias J, Wei W, Carlstedt X, Zhang L, Iuvone P PLoS One. 2024; 19(7):e0307091.

PMID: 39028695 PMC: 11259283. DOI: 10.1371/journal.pone.0307091.

Causal relationships between height, screen time, physical activity, sleep and myopia: univariable and multivariable Mendelian randomization.

Liu X, Zhao F, Yuan W, Xu J Front Public Health. 2024; 12:1383449.

PMID: 38966704 PMC: 11222599. DOI: 10.3389/fpubh.2024.1383449.

References

Volkow N, Tomasi D, Wang G, Telang F, Fowler J, Logan J . Evidence that sleep deprivation downregulates dopamine D2R in ventral striatum in the human brain. J Neurosci. 2012; 32(19):6711-7. PMC: 3433285. DOI: 10.1523/JNEUROSCI.0045-12.2012. View

Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw S . A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol. 2020; 20(1):27. PMC: 6961361. DOI: 10.1186/s12886-019-1220-0. View

Morgan I, Rose K . How genetic is school myopia?. Prog Retin Eye Res. 2004; 24(1):1-38. DOI: 10.1016/j.preteyeres.2004.06.004. View

Lv Y, Cai L, Zeng X, Gui Z, Lai L, Tan W . Association between weekend catch-up sleep and executive functions in Chinese school-aged children. J Clin Sleep Med. 2020; 16(8):1285-1293. PMC: 7446075. DOI: 10.5664/jcsm.8494. View

Matricciani L, Paquet C, Galland B, Short M, Olds T . Children's sleep and health: A meta-review. Sleep Med Rev. 2019; 46:136-150. DOI: 10.1016/j.smrv.2019.04.011. View

Morgan I, Ohno-Matsui K, Saw S . Myopia. Lancet. 2012; 379(9827):1739-48. DOI: 10.1016/S0140-6736(12)60272-4. View

Reiter A, Sargent C, Roach G . Concordance of Chronotype Categorisations Based on Dim Light Melatonin Onset, the Morningness-Eveningness Questionnaire, and the Munich Chronotype Questionnaire. Clocks Sleep. 2021; 3(2):342-350. PMC: 8293076. DOI: 10.3390/clockssleep3020021. View

Roman-Vinas B, Chaput J, Katzmarzyk P, Fogelholm M, Lambert E, Maher C . Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study. Int J Behav Nutr Phys Act. 2016; 13(1):123. PMC: 5123420. DOI: 10.1186/s12966-016-0449-8. View

Schlarb A, Sopp R, Ambiel D, Grunwald J . Chronotype-related differences in childhood and adolescent aggression and antisocial behavior--a review of the literature. Chronobiol Int. 2013; 31(1):1-16. DOI: 10.3109/07420528.2013.829846. View

10.

Chakraborty R, Read S, Collins M . Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics. Invest Ophthalmol Vis Sci. 2011; 52(8):5121-9. DOI: 10.1167/iovs.11-7364. View

11.

Schaeffel F, Bartmann M, Hagel G, Zrenner E . Studies on the role of the retinal dopamine/melatonin system in experimental refractive errors in chickens. Vision Res. 1995; 35(9):1247-64. DOI: 10.1016/0042-6989(94)00221-7. View

12.

Hirshkowitz M, Whiton K, Albert S, Alessi C, Bruni O, DonCarlos L . National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health. 2017; 1(1):40-43. DOI: 10.1016/j.sleh.2014.12.010. View

13.

Wei S, Li S, Liu L, Li H, Kang M, Sun Y . Sleep Duration, Bedtime, and Myopia Progression in a 4-Year Follow-up of Chinese Children: The Anyang Childhood Eye Study. Invest Ophthalmol Vis Sci. 2020; 61(3):37. PMC: 7401424. DOI: 10.1167/iovs.61.3.37. View

14.

Wang F, Zhou J, Lu Y, Chu R . Effects of 530 nm green light on refractive status, melatonin, MT1 receptor, and melanopsin in the guinea pig. Curr Eye Res. 2010; 36(2):103-11. DOI: 10.3109/02713683.2010.526750. View

15.

Sun W, Ling J, Zhu X, Lee T, Li S . Associations of weekday-to-weekend sleep differences with academic performance and health-related outcomes in school-age children and youths. Sleep Med Rev. 2019; 46:27-53. DOI: 10.1016/j.smrv.2019.04.003. View

16.

Wittmann M, Dinich J, Merrow M, Roenneberg T . Social jetlag: misalignment of biological and social time. Chronobiol Int. 2006; 23(1-2):497-509. DOI: 10.1080/07420520500545979. View

17.

Wiechmann A, Summers J . Circadian rhythms in the eye: the physiological significance of melatonin receptors in ocular tissues. Prog Retin Eye Res. 2008; 27(2):137-60. DOI: 10.1016/j.preteyeres.2007.10.001. View

18.

Haynie D, Lewin D, Luk J, Lipsky L, OBrien F, Iannotti R . Beyond Sleep Duration: Bidirectional Associations Among Chronotype, Social Jetlag, and Drinking Behaviors in a Longitudinal Sample of US High School Students. Sleep. 2017; 41(2). PMC: 6018914. DOI: 10.1093/sleep/zsx202. View

19.

Yu H, Wang Q, Wu W, Zeng W, Feng Y . Therapeutic Effects of Melatonin on Ocular Diseases: Knowledge Map and Perspective. Front Pharmacol. 2021; 12:721869. PMC: 8593251. DOI: 10.3389/fphar.2021.721869. View

20.

Zhou Z, Morgan I, Chen Q, Jin L, He M, Congdon N . Disordered sleep and myopia risk among Chinese children. PLoS One. 2015; 10(3):e0121796. PMC: 4374782. DOI: 10.1371/journal.pone.0121796. View