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

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

doi:10.1097/icl.0000000000000349

Cited by 32 publications

(30 citation statements)

References 67 publications

(69 reference statements)

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“…A value of 6 or greater on the DEQ5 indicates mild or greater dry eye symptoms and a value of 12 or greater indicates severe symptoms (40). OSDI scores over 30 indicate severe dry eye symptoms (41).…”

Section: Methodsmentioning

confidence: 99%

“…In addition to the numeric dry eye pain assessment throughout treatment, dry eye assessment prior to treatment included standardized questionnaires regarding ocular dryness, the Dry Eye Questionnaire 5 (DEQ5) (score 0-22) and Ocular Surface Disease Index (OSDI) (score 0-100), higher scores indicate more severe symptoms (39,40). A value of 6 or greater on the DEQ5 indicates mild or greater dry eye symptoms and a value of 12 or greater indicates severe symptoms (41).…”

Section: Dry Eye Ocular Examinationmentioning

confidence: 99%

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Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia

Sivanesan

Levitt

Sarantopoulos

et al. 2018

Neuromodulation: Technology at the Neural Interface

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Our data indicate that TENS may similarly provide analgesia in patients with dry eye symptoms as it does for many other chronic pain conditions. Furthermore, the noted effect on symptoms of photophobia and dryness suggest that all may be linked by similar trigeminal-thalamic-cortical pathways. Prospective studies with electrical stimulation of dry eye are needed to further elucidate its benefit and mechanism of action.

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Section: Methodsmentioning

confidence: 99%

Section: Dry Eye Ocular Examinationmentioning

confidence: 99%

Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia

Sivanesan

Levitt

Sarantopoulos

et al. 2018

Neuromodulation: Technology at the Neural Interface

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View full text Add to dashboard Cite

show abstract

“…Galor et al 51 investigated the association between DED and insomnia symptom severity in 187 patients (mean age, 63 years) and the DED group with high pain experienced more severe insomnia compared to the DED low pain group. They evaluated the pain of DED using numeric rating scales for pain, spontaneous burning pain, and sensitivity to wind and light.…”

Section: Sleep Disorders Are Prevalent and Severe In Dedmentioning

confidence: 99%

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Ayaki

Ohta

Kawashima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Sleep is an essential life habit and closely associated with lifespan, diabetes, hypertension, and mental health. Sleep disorders are a prominent, but overlooked problem in patients with dry eye disease (DED), characterized by a poor sleep index, short sleep duration, long sleep latency, and poor subjective sleep. DED and sleep disorders are more prevalent in women than men. Moreover, sleep quality in DED is worse than in other eye diseases, including glaucoma, retinal diseases, cataract, and allergic and chronic conjunctivitis. METHODS. We reviewed the literature for studies investigating sleep and health, eyes and sleep, and DED and sleep, in terms of systemic and eye health, especially in women. RESULTS. Two studies reported that approximately half of patients with DED suffer from poor sleep. The severity of mood disorders, including anxiety and depression, is correlated strongly with sleep disorders in DED, and the symptoms and signs of DED, especially pain, also are correlated with sleep quality. Sleep disorders are documented in primary Sjögren's syndrome and an association with sleep apnea and depression is suggested. Primary Sjögren's syndrome includes arthritis and other rheumatic disease causing pain and fatigue; however, how sicca contributes to sleep disorders is not known. CONCLUSIONS. Possible explanations for sleep disorders in DED may be depression, pain, and eye exposure at night. Reciprocal effects may be expected and consultation-liaison psychiatry is recommended for the management of sleep disorders in DED. Topical medication and lid heating also may be advantageous for sleep quality in DED.

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“… 47 , 48 Finally, DE and other COPC are strongly associated with affective disorders such as PTSD, anxiety, depression, 46 , 49 , 50 and insomnia attendant with psychological stress and pain amplification. 51 – 56 …”

Section: De and Chronic Pain Syndromes Tend To Co-exist And Share Feamentioning

confidence: 99%

Evidence that dry eye represents a chronic overlapping pain condition

et al. 2017

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Recent data suggest that corneal somatosensory dysfunction may be the underlying cause of severe dry eye symptoms in the absence of ocular surface pathology seen in a subset of patients diagnosed with “dry eye syndrome.” This subset of patients tends to demonstrate a unique constellation of symptoms that are persistent, more severe, and generally respond poorly to current dry eye therapies targeting inadequate or dysfunctional tears. A growing body of literature suggests that symptoms in these patients may be better characterized as neuropathic ocular pain rather than dry eye. In these patients, dry eye symptoms are often associated with numerous comorbid pain conditions and evidence of central pain processing abnormalities, where eye pain is just one of multiple overlapping peripheral manifestations. In this review, we discuss the concept and potential mechanisms of chronic overlapping pain conditions as well as evidence for considering neuropathic ocular pain as one of these overlapping pain conditions.

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

Abstract: After adjusting for demographics and medical comorbidities, we show that DE symptom severity is positively associated with insomnia severity.

Cited by 32 publications

References 67 publications

Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia

Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia

Sleep Disorders are a Prevalent and Serious Comorbidity in Dry Eye

Evidence that dry eye represents a chronic overlapping pain condition

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