Abstract
BACKGROUND/OBJECTIVES: Visual impairment (VI) is associated with significant disruptions in sleep quality. This study aimed to investigate the association between VI and sleep quality across varying severities of VI and ocular conditions in adults. SUBJECTS/METHODS: A cross-sectional, observational, study was conducted among 277 adults with VI and 278 age- and sex-matched controls from two hospitals. Participants underwent comprehensive ocular examinations and completed the Arabic version of the Pittsburgh Sleep Quality Index (PSQI). Sociodemographic and clinical data were collected, and ocular conditions were recorded. Multivariate logistic regression models were used to evaluate the association between VI, its severity, ocular conditions, and poor sleep quality while adjusting for potential confounders. RESULTS: VI patients had worse sleep quality than controls (mean PSQI: 6.83 ± 3.6 vs. 5.30 ± 3.5; p < 0.001), with 57.8% experiencing poor sleep (PSQI > 5) compared to 36.7% of controls(p < 0.001). In multivariate analysis, patients with VI had significantly higher odds of poor sleep quality compared to controls (OR = 2.0 (95% CI: 1.4-2.8); p < 0.001). Moderate VI (OR = 2.1, 95% CI: 1.4-3.2, p = 0.001) and blindness (OR = 2.9, 95% CI: 1.4-5.9, p = 0.004) were significantly associated with poor sleep quality. Diabetic retinopathy (OR = 2.2, 95% CI: 1.4-3.4; p < 0.001) and combined ocular conditions (OR = 3.6, 95% CI: 1.4-9.3; p = 0.009) were significantly associated with poor sleep quality. CONCLUSIONS: VI is significantly associated with poor sleep quality, particularly in moderate VI and blindness. Diabetic retinopathy and combined ocular conditions were associated with poor sleep quality. Comprehensive management strategies addressing sleep in VI patients are essential for improving their overall well-being.