Association of Dry Eye, Sleep Quality, Anxiety and Depression among Young Pakistani Adults: A Cross- Sectional Study

Tear film instability is a hallmark of dry eye disease, a multifactorial disorder which is affected by several variables such as sleep quality, depression and anxiety. Objectives: To examine the connections between anxiety, depression, dry eye and sleep quality. Methods: A cross-sectional study was carried out at Madinah Teaching Hospital, Faisalabad. Prerequisites for inclusion were being between the ages of 20-35 years and not having any clinically significant eye disorders or reported sleep disorders. Patients who were taking medication or who had undergone surgery in the six months prior were not included. Descriptive statistics, Pearson correlation and multiple linear regression were used to assess the results of the HADS, OSDI and PSQI, which were used to measure symptoms of anxiety and depression, dry eye and sleep quality, respectively. Results: Multiple linear regression revealed a significant (p<0.001) relationship between the OSDI and PSQI subscales (sleep latency, sleep disturbances and use of sleep medications). Other indicators that did not show statistically significant relationships with the regression model included subjective sleep quality, sleep duration, habitual sleep efficiency, and dysfunction during the day (p>0.001). Multiple linear regression analysis revealed that the OSDI and the other variables HADS-A, HADS-D and PSQI total score were related to the following values: p=0.29, p=0.001and p<0.001, respectively. Conclusions: Dry eye was closely associated with depression and disturbed sleep, although it did not significantly correlate with anxiety. The OSDI scores and the PSQI subscale showed significant associations, suggesting a link between dry eye and sleep quality.