March 3, 2025
By Nicole Liu, MOptom, PhD
Photo Credit: Getty Images
In recent years, the relationship between sleep and myopia has emerged as an important area of research. The biological plausibility of sleep’s influence on eye development through circadian rhythms,1,2 melanopsin, and dopamine signalling,3,4 combined with the growing evidence of sleep-myopia associations,5,6 suggests that understanding and implementing sleep interventions could provide a cost-effective, noninvasive complement to existing myopia prevention strategies.
A recent meta-analysis and Mendelian randomization study by Dong et al. (2024)7 added important insights into this relationship. With a large study sample size (209,979 participants from 29 studies) and dual methodological approach, combining observational evidence with genetic causal inference, this study revealed significant associations between sleep duration and myopia risk (short sleep: OR=1.23, 95% CI=1.08-1.42; long sleep: OR=0.75, 95% CI=0.66-0.86). Subgroup analyses revealed that sleep-myopia associations were particularly strong in Asian populations but not in European countries. Meanwhile, the authors analyzed 122 single nucleotide polymorphisms (SNPs) for chronotype, 65 for sleep duration, 24 for short sleep duration, and six for long sleep duration to assess causal relationships between sleep traits and myopia. However, none of the genetically determined sleep traits showed causal associations with myopia.
Although the potential geographical bias with meta-analysis data primarily from Asian populations and genetic data from European sources might limit the generalizability of the study findings, this detailed analysis reveals the complexity of the sleep-myopia relationship and suggests that observed associations might be mediated through other environmental or lifestyle factors rather than direct genetic pathways.
In conclusion, current evidence supports integrating healthy sleep habits alongside established interventions like increased outdoor activity and reduced prolonged near work. While Dong et al.’s study shows no direct genetic causation, the consistent associations between sleep patterns and myopia across multiple studies, combined with our understanding of circadian biology and eye growth patterns, provide a strong rationale for including sleep hygiene education as part of comprehensive myopia prevention programs.
Abstract
Association of Sleep Traits with Myopia in Children and Adolescents: A Meta-Analysis and Mendelian Randomization Study
Xing-Xuan Dong, Jia-Yu Xie , Dan-Lin Li , Yi Dong , Xiao-Feng Zhang , Carla Lanca , Andrzej Grzybowski , Chen-Wei Pan
Purpose: The association between sleep and myopia in children and adolescents has been reported, yet it remains controversial and inconclusive. This study aimed to investigate the influence of different sleep traits on the risk of myopia using meta-analytical and Mendelian randomization (MR) techniques.
Methods: The literature search was performed on August 31, 2023, based on PubMed, Embase, Web of Science, and the Cochrane library. The meta-analysis of observational studies reporting the relationship between sleep and myopia was conducted. MR analyses were carried out to assess the causal impact of genetic pre-disposition for sleep traits on myopia.
Results: The results of the meta-analysis indicated a significant association between the risk of myopia and both short sleep duration [odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.08–1.42, P = 0.003] and long sleep duration (OR = 0.75, 95% CI = 0.66–0.86, P < 0.001). MR analyses revealed no significant causal associations of genetically determined sleep traits with myopia, including chronotype, sleep duration, short, and long sleep duration (all P > 0.05).
Conclusions: No evidence was found to support a causal relationship between sleep traits and myopia. While sleep may not independently predict the risk of myopia, the potential impact of sleep on the occurrence and development of myopia cannot be disregarded.
Dong, X. X., Xie, J. Y., Li, D. L., Dong, Y., Zhang, X. F., Lanca, C., … & Pan, C. W. (2024). Association of sleep traits with myopia in children and adolescents: A meta-analysis and Mendelian randomization study. Preventive Medicine, 107893.
DOI: https://doi.org/10.1016/j.ypmed.2024.107893
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Dr. Nicole Liu is the Clinical Research Manager at ZEISS Vision Care, where she oversees clinical trials related to myopia. She completed her PhD in Optometry and Vision Science at the University of New South Wales and the Brien Holden Vision Institute, investigating the influence of circadian rhythm on the development of myopia under the supervision of Professor Padmaja Sankaridurg and Associate Professor Thomas John Naduvilath. |
References
- Chakraborty R, Ostrin LA, Nickla DL, Iuvone PM, Pardue MT, Stone RA. Circadian rhythms, refractive development, and myopia. Ophthalmic and Physiological Optics. 2018;38(3):217-245. doi:doi:10.1111/opo.12453
- Stone RA, Tobias JW, Wei W, et al. Diurnal retinal and choroidal gene expression patterns support a role for circadian biology in myopia pathogenesis. Sci Rep. Jan 4 2024;14(1):533. doi:10.1038/s41598-023-50684-2
- Chakraborty R, Landis EG, Mazade R, et al. Melanopsin modulates refractive development and myopia. Exp Eye Res. Jan 2022;214:108866. doi:10.1016/j.exer.2021.108866
- Zhou X, Pardue MT, Iuvone PM, Qu J. Dopamine signaling and myopia development: What are the key challenges. Progress in Retinal and Eye Research. 2017/11/01/ 2017;61:60-71. doi:https://doi.org/10.1016/j.preteyeres.2017.06.003
- Jin E, Lee CE, Li H, Tham Y-C, Chen DZ. Association between sleep and myopia in children and adolescents: a systematic review and meta-analysis. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2024/07/01 2024;262(7):2027-2038. doi:10.1007/s00417-023-06338-0
- Liu XN, Naduvilath TJ, Sankaridurg PR. Myopia and sleep in children—a systematic review. Sleep. 2023;doi:10.1093/sleep/zsad162
- Dong XX, Xie JY, Li DL, et al. Association of sleep traits with myopia in children and adolescents: A meta-analysis and Mendelian randomization study. Prev Med. Mar 2024;180:107893. doi:10.1016/j.ypmed.2024.107893
