Yuzhu Luo,1,* Yuting Gao,1,* Zhong Guan,1,* Heting Liu,1 Shuman Tao1– 5 

1Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People’s Republic of China; 2MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, 230032, People’s Republic of China; 3Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, 230032, People’s Republic of China; 4NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, 230032, People’s Republic of China; 5Center for Big Data and Population Health, Institute of Health and Medicine, Hefei Comprehensive National Science Center, Hefei, 230032, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Shuman Tao; Heting Liu, Email taoshuman@ahmu.edu.cn; liuheting@ahmu.edu.cn

Objective: To investigate the prevalence of dry eye disease (DED) among children and adolescents aged 9 to 19 years in Fengyang County, and to explore the associations of sleep duration and social jetlag with DED, with the aim of providing scientific evidence for sleep-based interventions to prevent DED in this population.
Methods: Between November and December 2023, 14 primary and secondary schools were randomly selected in Fengyang County, Chuzhou City, Anhui Province, China. Students from Grade 4 to Grade 12 (aged 9– 19 years) were invited to participate. A trained professional conducted clinical assessments to evaluate DED, and participants completed self-administered questionnaires to report their sleep behaviors. Sleep quality was assessed by an item from Pittsburgh Sleep Quality Index. Chi-square tests and independent-samples t-tests were used to compare sociodemographic characteristics between DED and non-DED groups. Logistic regression models were applied to examine the associations of sleep duration, social jetlag, and their interaction with DED after adjusting for potential confounders.
Results: The overall prevalence of DED among children and adolescents in Fengyang County was 51%. After adjusting for confounders, binary logistic regression analysis showed that students who slept less than 9 hours per night had a significantly higher likelihood of DED (OR = 1.37, 95% CI: 1.21– 1.68), and those with social jetlag ≥ 1 hour also had an elevated risk of DED (OR = 1.28, 95% CI: 1.07– 1.54). Notably, the group with sleep duration ≥ 9 h combined with social jet lag ≥ 1 h showed a significant positive association with DED after adjusting for sleep quality (OR = 1.77, 95% CI: 1.35– 2.33).
Conclusion: Both insufficient sleep duration and significant social jetlag are associated with an increased risk of DED in children and adolescents. These findings suggest the need for targeted sleep education programs in schools that emphasize not only sufficient sleep duration but also consistent sleep–wake schedules between weekdays and weekends to promote ocular health among youth.

Keywords: adolescent, child, dry eye syndromes, sleep duration