Abstract: Objective This study aimed to evaluate the sleep quality and emotional state in patients with dry eye, and to analyze the correlation between clinical characteristics of dry eye and sleep quality as well as emotional state. Methods A total of 70 patients with dry eye visiting the Department of Ophthalmology of West China Hospital of Sichuan University were enrolled, and 40 age- and gender-matched healthy subjects were included as the control group. Sleep quality was assessed by the Chinese version of the Pittsburgh sleep quality index(CPSQI), Epworth sleepiness score, and insomnia severity index(ISI). The Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were administered to evaluate the degree of anxiety and depression. The ocular surface disease index(OSDI)questionnaire was used for assessing symptoms of dry eye, while the optical quality analysis system II was used to evaluate dynamic changes of tear film and quality of vision. Moreover, LipiView^® II Ocular Surface Interferometer was used for partial blink rate(PBR), lipid layer thickness(LLT), and meibomian gland dropout degree tests. Meanwhile, fluorescein breakup time(FBUT), corneal fluorescein staining(CFS), and the schirmer Ⅰ test(SⅠt)were measured. Results Compared with participants without dry eye, the total CPSQI score and its components scores, and ISI scores were significantly higher in patients with dry eye(P<0.001). The scores of the anxiety(P<0.001)and depression(P=0.001)were also significantly higher in patients with dry eye than that in controls. Compared to patients with good sleep in the dry eye group, the OSDI score(P=0.046), and the SⅠt results(P<0.032)were worse in patients with poor sleep. The ISI scores(P<0.001), the anxiety scores(P=0.001), and the depression scores(P<0.001)were higher in patients with poor sleep. The correlation analysis revealed that the OSDI score was positively associated with the total CPSQI score, subjective sleep quality, and sleep latency. Also, SⅠt results were negatively correlated with the total CPSQI score and the score of subjective sleep quality, sleep latency, and habitual sleep efficiency. Furthermore, FBUT was negatively related to sleep efficiency score. CFS was negatively associated with sleep duration and positively correlated with sleep disorder. In addition, there were significant positive correlations between OSDI score and the degree of the anxiety and ISI score. Conclusion Poor sleep may be common and serious in patients with dry eye, which might be accompanied by anxiety and depression. Besides, sleep disorders may affect the occurrence and development of dry eye by reducing tear secretion and tear film stability and aggravating corneal injury or resulting in psychological burden.

Key words: Dry eye, Sleep quality, Emotional state, Anxiety, Depression, Correlation