The Association of Dry Eye Symptom Severity and Comorbid Insomnia in US Veterans

Anat Galor, Benjamin E. Seiden, Jasmine J. Park, William J Feuer, Allison L. McClellan, Elizabeth R. Felix, Roy C. Levitt, Constantine D. Sarantopoulos, Douglas M. Wallace

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

PURPOSE: To investigate the association between dry eye (DE) and insomnia symptom severity. METHODS: Cross-sectional study of 187 individuals seen in the Miami Veterans Affairs eye clinic. An evaluation was performed consisting of questionnaires regarding insomnia (insomnia severity index [ISI]) and DE symptoms, including ocular pain, followed by a comprehensive ocular surface examination. Using a two-step cluster analysis based on intensity ratings of ocular pain, the patient population was divided into two groups (high and low ocular pain groups: HOP and LOP). A control group was ascertained at the same time from the same clinic as defined by no symptoms of DE (Dry Eye Questionnaire 5 [DEQ5], <6). The main outcome measure was the frequency of moderate or greater insomnia in the DE groups. RESULTS: The mean age of the study sample was 63 years, and 93% were male. All insomnia complaints were rated higher in the HOP group compared with the LOP and control groups (P<0.0005). Most (61%) individuals in the HOP group experienced insomnia of at least moderate severity (ISI≥15) compared with the LOP (41%) and control groups (18%) (P<0.0005). Black race (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.2-6.0; P=0.02), depression severity (OR, 1.2; 95% CI, 1.1-1.3; P<0.0005), and DE symptom severity (DEQ5; OR, 1.1; 95% CI, 1.01-1.2; P=0.03) were significantly associated with clinical insomnia (ISI≥15) after controlling for potential confounders. CONCLUSIONS: After adjusting for demographics and medical comorbidities, we show that DE symptom severity is positively associated with insomnia severity.

Original languageEnglish (US)
Pages (from-to)S118-S124
JournalEye & contact lens
Volume44
DOIs
StatePublished - Sep 1 2018

Fingerprint

Sleep Initiation and Maintenance Disorders
Veterans
Eye Pain
Odds Ratio
Confidence Intervals
Control Groups
Cluster Analysis
Comorbidity
Cross-Sectional Studies
Demography
Outcome Assessment (Health Care)
Depression

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The Association of Dry Eye Symptom Severity and Comorbid Insomnia in US Veterans. / Galor, Anat; Seiden, Benjamin E.; Park, Jasmine J.; Feuer, William J; McClellan, Allison L.; Felix, Elizabeth R.; Levitt, Roy C.; Sarantopoulos, Constantine D.; Wallace, Douglas M.

In: Eye & contact lens, Vol. 44, 01.09.2018, p. S118-S124.

Research output: Contribution to journalArticle

@article{1a2b7871cd284eabb8afae9c5fc88c7f,
title = "The Association of Dry Eye Symptom Severity and Comorbid Insomnia in US Veterans",
abstract = "PURPOSE: To investigate the association between dry eye (DE) and insomnia symptom severity. METHODS: Cross-sectional study of 187 individuals seen in the Miami Veterans Affairs eye clinic. An evaluation was performed consisting of questionnaires regarding insomnia (insomnia severity index [ISI]) and DE symptoms, including ocular pain, followed by a comprehensive ocular surface examination. Using a two-step cluster analysis based on intensity ratings of ocular pain, the patient population was divided into two groups (high and low ocular pain groups: HOP and LOP). A control group was ascertained at the same time from the same clinic as defined by no symptoms of DE (Dry Eye Questionnaire 5 [DEQ5], <6). The main outcome measure was the frequency of moderate or greater insomnia in the DE groups. RESULTS: The mean age of the study sample was 63 years, and 93{\%} were male. All insomnia complaints were rated higher in the HOP group compared with the LOP and control groups (P<0.0005). Most (61{\%}) individuals in the HOP group experienced insomnia of at least moderate severity (ISI≥15) compared with the LOP (41{\%}) and control groups (18{\%}) (P<0.0005). Black race (odds ratio [OR], 2.7; 95{\%} confidence interval [CI], 1.2-6.0; P=0.02), depression severity (OR, 1.2; 95{\%} CI, 1.1-1.3; P<0.0005), and DE symptom severity (DEQ5; OR, 1.1; 95{\%} CI, 1.01-1.2; P=0.03) were significantly associated with clinical insomnia (ISI≥15) after controlling for potential confounders. CONCLUSIONS: After adjusting for demographics and medical comorbidities, we show that DE symptom severity is positively associated with insomnia severity.",
author = "Anat Galor and Seiden, {Benjamin E.} and Park, {Jasmine J.} and Feuer, {William J} and McClellan, {Allison L.} and Felix, {Elizabeth R.} and Levitt, {Roy C.} and Sarantopoulos, {Constantine D.} and Wallace, {Douglas M.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1097/ICL.0000000000000349",
language = "English (US)",
volume = "44",
pages = "S118--S124",
journal = "Eye and Contact Lense",
issn = "1542-2321",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - The Association of Dry Eye Symptom Severity and Comorbid Insomnia in US Veterans

AU - Galor, Anat

AU - Seiden, Benjamin E.

AU - Park, Jasmine J.

AU - Feuer, William J

AU - McClellan, Allison L.

AU - Felix, Elizabeth R.

AU - Levitt, Roy C.

AU - Sarantopoulos, Constantine D.

AU - Wallace, Douglas M.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - PURPOSE: To investigate the association between dry eye (DE) and insomnia symptom severity. METHODS: Cross-sectional study of 187 individuals seen in the Miami Veterans Affairs eye clinic. An evaluation was performed consisting of questionnaires regarding insomnia (insomnia severity index [ISI]) and DE symptoms, including ocular pain, followed by a comprehensive ocular surface examination. Using a two-step cluster analysis based on intensity ratings of ocular pain, the patient population was divided into two groups (high and low ocular pain groups: HOP and LOP). A control group was ascertained at the same time from the same clinic as defined by no symptoms of DE (Dry Eye Questionnaire 5 [DEQ5], <6). The main outcome measure was the frequency of moderate or greater insomnia in the DE groups. RESULTS: The mean age of the study sample was 63 years, and 93% were male. All insomnia complaints were rated higher in the HOP group compared with the LOP and control groups (P<0.0005). Most (61%) individuals in the HOP group experienced insomnia of at least moderate severity (ISI≥15) compared with the LOP (41%) and control groups (18%) (P<0.0005). Black race (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.2-6.0; P=0.02), depression severity (OR, 1.2; 95% CI, 1.1-1.3; P<0.0005), and DE symptom severity (DEQ5; OR, 1.1; 95% CI, 1.01-1.2; P=0.03) were significantly associated with clinical insomnia (ISI≥15) after controlling for potential confounders. CONCLUSIONS: After adjusting for demographics and medical comorbidities, we show that DE symptom severity is positively associated with insomnia severity.

AB - PURPOSE: To investigate the association between dry eye (DE) and insomnia symptom severity. METHODS: Cross-sectional study of 187 individuals seen in the Miami Veterans Affairs eye clinic. An evaluation was performed consisting of questionnaires regarding insomnia (insomnia severity index [ISI]) and DE symptoms, including ocular pain, followed by a comprehensive ocular surface examination. Using a two-step cluster analysis based on intensity ratings of ocular pain, the patient population was divided into two groups (high and low ocular pain groups: HOP and LOP). A control group was ascertained at the same time from the same clinic as defined by no symptoms of DE (Dry Eye Questionnaire 5 [DEQ5], <6). The main outcome measure was the frequency of moderate or greater insomnia in the DE groups. RESULTS: The mean age of the study sample was 63 years, and 93% were male. All insomnia complaints were rated higher in the HOP group compared with the LOP and control groups (P<0.0005). Most (61%) individuals in the HOP group experienced insomnia of at least moderate severity (ISI≥15) compared with the LOP (41%) and control groups (18%) (P<0.0005). Black race (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.2-6.0; P=0.02), depression severity (OR, 1.2; 95% CI, 1.1-1.3; P<0.0005), and DE symptom severity (DEQ5; OR, 1.1; 95% CI, 1.01-1.2; P=0.03) were significantly associated with clinical insomnia (ISI≥15) after controlling for potential confounders. CONCLUSIONS: After adjusting for demographics and medical comorbidities, we show that DE symptom severity is positively associated with insomnia severity.

UR - http://www.scopus.com/inward/record.url?scp=85056256730&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056256730&partnerID=8YFLogxK

U2 - 10.1097/ICL.0000000000000349

DO - 10.1097/ICL.0000000000000349

M3 - Article

C2 - 28181961

AN - SCOPUS:85056256730

VL - 44

SP - S118-S124

JO - Eye and Contact Lense

JF - Eye and Contact Lense

SN - 1542-2321

ER -