Meng Wang,1,* Juan Tong,2,* Dongqing Zhu,1 Kun Huang,2 Xiaoyan Wu,2 Guopeng Gao,3 Liu Jiang,3 Shuangqin Yan,3 Fangbiao Tao,2 Shuman Tao4,5 

1Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China; 2Department of Maternal, Child and Adolescent Health, School of Public Health/ MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China; 3Ma’anshan Maternal and Child Health Care Center, Ma’anshan, Anhui, People’s Republic of China; 4Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230031, People’s Republic of China; 5MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course / Center for Big Data and Population Health of IHM, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Shuman Tao, Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People’s Republic of China, Email taoshuman@ahmu.edu.cn

Purpose: To examine the associations of sleep parameters and their trajectories at preschool age with myopia among school-aged children by using a birth cohort study design.
Patients and methods: All participants were recruited from the Ma’anshan Birth Cohort Study. Sleep duration, sleep habits, and social jetlag were collected in 4 years, 5.5 years, and 6 years. Cycloplegic refraction and ocular biometry were performed at 7 years. Key statistical analyses were performed using the latent class growth models, binary logistic regression, generalized linear models, and linear mixed models, respectively.
Results: A total of 1561 children were included in the study (mean age of 7.93 years, 52.6% boys). Social jetlag of at least 1 hour at age 4 was positively linked to an increased risk of myopia in school-age children and axial length (AL) but negatively correlated with spherical equivalent refraction (SER) (P< 0.05). Inadequate sleep duration at 5.5 years was associated with an increase in AL among school-age children (β=0.16; 95% CI: 0.07– 0.24). A pattern of increasing-declining social jetlag was positively correlated with AL/CR ratio (RR=1.55; 95%CI: 1.01– 2.37). Poor sleep habits, higher social jetlag at age 4, and the declining-increasing trajectory of social jetlag were negatively associated with SER in school-aged children (P< 0.05). Furthermore, the declining-increasing and increasing-declining trajectories of social jetlag were positively correlated with the elongation of AL.
Conclusion: The correlations between sleep parameters at preschool age and myopia in school-aged children reveal that maintaining regular sleep habits in preschool may contribute to the early prevention of myopia.

Keywords: myopia, sleep, cycloplegic spherical equivalent refraction, axial length, children