Of 3846 eligible subjects aged 12–19 years, self-reported sleep duration and refractive error examination data were available for 3625 subjects (94.2%), and these subjects were included in the analysis for the current study. Spherical equivalents in the right and left eyes were highly correlated (Pearson’s correlation = 0.92, p < 0.001). Thus, data for right eyes were used for analysis. The demographic characteristics of the 3625 subjects enrolled in the study are summarized by myopia severity status in Table 1. Subjects with myopia were more likely to be older (p < 0.001) and taller (p < 0.001) and to have high education levels (p < 0.001), high economic family income (p < 0.001) and lower sleep duration (p < 0.001), compared to those without myopia. The proportion of wearing correction glasses was 7.4 (standard error [SE], 1.3) in non-myopia, 24.8 (SE, 1.4) in mild myopia, 85.1 (SE, 1.4) in moderate myopia and 94.1 (SE, 1.6) in high myopia (p < 0.001).
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The distribution of refractive error in this study is shown in Fig. 1. The skewness was ?0.76 (SE, 0.04), and the kurtosis was 0.57 (SE, 0.08). As shown in Table 2, the sleep duration significantly decreased as age increased (p < 0.001). The prevalence of myopia significantly increased from 79.8% at 12 years of age to 84.5% at 19 years of age (Table 2). In addition, the prevalence of high myopia significantly increased from 5.7% at 12 years of age to 17.1% at 19 years of age. The refractive error distribution according to sleep duration (hr/day) is shown in Fig. 2. 115, p < 0.001). The prevalence of myopia according to sleep duration is shown in Table 3. The prevalence of myopia significantly decreased from 88.4% in those with 5 hr of sleep to 75.4% in those with 10 hr of sleep. However, the prevalence of high myopia was not appreciably different according to sleep duration. 15 hr/day) than male adolescents (7.51 hr/day).
The refractive error increased by 0.14 D per 1 hr increase in sleep before adjustment and by 0.10 D per 1 hr increase in sleep after adjusting for potential confounders including sex, age, height, education level, economic status and physical activity (Table 5). Multiple logistic regression analysis showed that the crude and the adjusted OR for myopia was 0.87 (95% confidence interval [CI], 0.81–0.92) and 0.90 (95% CI, 0.83–0.97) per 1 hr increase in sleep, whereas the crude and the adjusted OR for high myopia was 0.88 (95% CI, 0.80–0.98) and 0.94 (95% CI, 0.85–1.04) per 1 hr increase in sleep (Table 6). The association between sleep duration category and myopia or high myopia is shown in Table 7. The prevalence of myopia significantly decreased from 87.7% flingster-bureaublad in those with <5 hr of sleep to 78.1% in those with >9 hr of sleep (p < 0.001). The adjusted OR for myopia was 0.59 (95% CI, 0.38–0.93, p for trend = 0.006) in those with >9 hr of sleep compared with in those with <5 hr of sleep. For high myopia, the prevalence by sleep duration category decreased from 13.4% in those with <5 hr of sleep to 8.0% in those with >9 hr of sleep (p = 0.010). However, no significant association between sleep duration and high myopia was found after adjusting for potential confounders (OR in those with >9 hr, 0.71; 95% CI, 0.41–1.25, p for trend = 0.306). The change in the OR of sleep duration for myopia when adjusting for confounders is shown in Table 8. The OR changed by 0.03, from a crude OR of 0.87 to an adjusted OR of 0.90 (adjusted for age, sex, education, economic status, height, severe physical activity, moderate physical activity and walking).