The Prevalence of Myopia and Its Association with Sleep Duration, Physical Activity, and Eye Exercises

PURPOSE: Myopia is the most common visual impairment among Chinese children and adolescents. The purpose of this study is to explore key interventions for myopia prevalence, especially for early-onset myopia. METHODS: Univariate and multivariate analyses were conducted to evaluate potential associations between risk factor exposure and myopia. Lasso regression was performed to prioritize the risk features, and the selected leading influencing factors were used to establish the assembled simulation model. Finally, the rms package of R was used to construct a nomogram forecasting model to predict the risk of myopia. RESULTS: The prevalence of myopia among children and adolescents in Ningxia has shown a rapid upward trend in the past 25 years, from 50.3% in 1995 to 61.4% in 2019, with a growth rate of 10%. Children and adolescents with high grades had a high risk of myopia, which was 3.783 times higher in college school students than that of primary school students. Getting enough sleep time during school days per day (OR = 0.722, 95% CI: 0.620-0.840), be active in physical activity (OR = 0.823, 95% CI: 0.709-0.953), and do eye exercises (OR = 0.725, 95% CI: 0.570-0.919) were the top three protective factors. The AUCs of integrated simulation model for myopia was 0.707. CONCLUSIONS: The prevalence of myopia among children and adolescents were high in Ningxia Hui Autonomous Region of Northwest China, and the findings illustrate that reaching the recommended sleep time during school days, being active in physical exercise, and doing eye exercises among different ages are the leading three protective factors for myopia. Such data are critical and valuable for public health agencies to formulate intervention strategies for preventing high myopia and subsequent myopic maculopathy, cataract, retinal detachment, and glaucoma, including promotion of eye exercise, physical activity, enough sleep duration, and health education.