Priscilla Jovita F1, B. Optom Student,
Narmadha R 2, Assistant Professor
1,2Dhanalakshmi Srinivasan University, Trichy, India
Myopia, commonly referred to as near-sightedness, is a refractive error in which nearby objects are seen clearly while distant ones appear blurry. This occurs when light rays from infinity are focused in front of the retina when accommodation is at rest. The only systemic associations documented for myopia include higher risks of sleep disorders and depression. Shorter sleep duration and poorer sleep quality have been associated with greater myopic refractive error. (1) Additionally, light–dark and wake–sleep cycles have been shown to influence ocular growth patterns. (1,2)
Association Between Sleep Quality and Myopia
Sleep quality has a significant connection with myopia in children and is considered a risk factor for its development. Myopia may also contribute to sleep disorders because affected individuals often experience poor unaided vision and may have extensive retinal damage and neuronal dysfunction. (3)
In children, factors such as timing, duration, and quality of sleep play important roles. Children who experience sleep disturbances are 1.59 times more likely to develop myopia. (1,3)
Sleep may help slow the progression of high myopia through improved duration and quality, as well as by maintaining a healthy circadian rhythm. Adequate sleep contributes to regulating eye growth and improving visual processing.
Recommended daily sleep duration:
- Children & Adolescents: 9–11 hours
- Adults: 7–9 hours
Research indicates that the risk of developing myopia decreases by 10% for each additional hour of sleep. (1,4)
Sleep Quality and Myopia
| Grades of Myopia | Sleep Quality | Sleep Duration (per night) |
|---|---|---|
| No Myopia | Normal | 7–9 hours |
| Mild Myopia | Normal | 7–9 hours |
| Moderate Myopia | Slight disturbances | 6–8 hours |
| High Myopia | Poor (insomnia, daytime fatigue possible) | 5–7 hours |
Table 1: Relationship Between Myopia Severity and Sleep Quality
Sleep Disorders in High Myopia
Sleep disorders in children with high myopia may be linked to retinal complications and inadequate unaided vision. These children often experience significant blurriness and rely heavily on glasses or contact lenses for clear vision.
The retina in myopic individuals may show dysfunction, potentially involving the intrinsically photosensitive retinal ganglion cells (ipRGCs), though more human evidence is needed. These retinal and visual challenges can cause conscious and unconscious distress, contributing to sleep difficulties both during the day and night. (2)
The Role of Sleep and Circadian Rhythms in Myopia
Figure 1: Comparison of Healthy Sleep and Stable Circadian Rhythm vs. Disrupted Sleep and Unstable Circadian Rhythm
Discussion
Research shows a strong connection between sleep deprivation and an increased risk of developing myopia. Evidence on the role of sleep and circadian rhythms in myopia is growing. Regular light–dark cycles are essential for normal eye growth, and disruptions can lead to refractive changes. While the exact mechanisms are not fully understood, it is evident that adequate sleep is vital for maintaining healthy vision and preventing myopia. (8)
Conclusion
The relationship between myopia and sleep has been widely explored, yet a definitive conclusion remains elusive. Despite conflicting findings, numerous studies imply that poor sleep quality may contribute to myopia. Lack of sufficient sleep and irregular sleep–wake patterns may increase self-reported myopia in children and adolescents.
Children with myopia often show more variable sleep duration and shorter sleep latency compared to non-myopic children. Healthy, uninterrupted sleep is essential for maintaining good eye health, so remember: sleep well to see well. (9,10)
References
- Liu, X. N., Naduvilath, T. J., & Sankaridurg, P. R. (2023). Myopia and sleep in children – A systematic review. Sleep, 46(11), zsad162.
- Ayaki, M., Torii, H., Tsubota, K., & Negishi, K. (2016). Decreased sleep quality in high myopia children. Scientific Reports, 6(1), 33902.
- He, J., Lin, Y. Y., Chen, J., et al. (2022). Association of sleep quality with myopia based on different genetic risk levels. International Journal of Ophthalmology, 15(10), 1657.
- Chawla, O., Singh, A., Kumawat, D., et al. (2024). Systematic review of sleep duration and development of myopia. Cureus, 16(3).
- Chakraborty, R., Ostrin, L. A., Nickla, D. L., et al. (2018). Circadian rhythms and refractive development. Ophthalmic and Physiological Optics, 38(3), 217–245.
- Stone, R. A., Lin, T., Laties, A. M., & Iuvone, P. M. (1989). Retinal dopamine and form-deprivation myopia. PNAS, 86(2), 704–706.
- Ostrin, L. A. (2019). Ocular and systemic melatonin and the influence of light exposure. Clinical and Experimental Optometry, 102(2), 99–108.
- Loman, J., Quinn, G. E., Kamoun, L., et al. (2002). Darkness & near work: Myopia progression in law students. Ophthalmology, 109(5), 1032–1038.
- Xu, S., Zong, Z., Zhu, Y., et al. (2023). Sleep–wake schedules and myopia in Chinese school children. BMC Ophthalmology, 23(1), 135.
- Ostrin, L. A., Read, S. A., Vincent, S. J., & Collins, M. J. (2020). Sleep in myopic and non-myopic children. TVST, 9(9), 22.