The Association of Sleep Duration with Visual Impairment in Middle-aged and Elderly Adults: The China Health and Retirement Longitudinal Baseline

Abstract Background Sleep disorders may heighten the risk of visual impairment to further impact health outcomes. Little is known regarding the association of visual impairment with sleep disorders in China. Our objective was to examine the association of visual impairment with sleep disorders. Methods This cross-sectional study used the data from 13264 respondents to the 2011 survey of the China Health and Retirement Longitudinal Study, a nationally representative survey of adults aged 45 years or older. Visual impairment (VI) and sleep duration were examined using self-reported questionnaires. Respondents were identified as having VI if they reported blindness or partial blindness. With regards to sleep duration, participants were categorized into three groups: 1) those reporting short sleep duration (≤ 6 hours/night), 2) those reporting long sleep duration (> 8 hours/night), and 3) those reporting 6 to 8 hours of sleep per night (used as the reference group). Weighted multilevel logistic regression models, adjusting for sociodemographic characteristics, health behaviors, and medical history, were used. Results Of 13,264 respondents, 6,880 (51.9%) were women. The mean, standard deviation (SD) age was 59.39 (9.71) years. A total of 842 (6.3%) of respondents reported VI. The prevalence of short and long sleep duration was significantly higher among respondents with VI than those without VI (P < 0.001). The associations also persisted after stratifying the sample by age or sex. Multilevel logistic regression models showed that compared with 6–8 h/night of sleep, sleep duration of ≤ 6h/night was associated with a 1.19-fold (95% confidence interval (CI) = 1.02–1.40) higher VI risk, and sleep duration of > 8 h/night was associated with a 1.36-fold (95% CI = 1.05–1.75) higher VI risk. Higher risk of VI was associated with short (odds ratio [OR] = 1.34, 95% CI: 1.04–1.73) and long (OR = 1.60, 95% CI: 1.04–2.44) sleep durations in middle-aged respondents, as well as short sleep duration (OR = 1.27, 95% CI: 1.05–1.55) in elderly respondents. However, the association between VI and long sleep duration (OR = 1.34, 95% CI = 0.97–1.84) was absent in elderly respondents. Conclusion In this study, both short and long sleep durations were associated with VI. More comprehensive and integrated health care and rehabilitation systems covering vision and sleep are needed to address age-related VI.