ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Sleep Disorders

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1521347

This article is part of the Research TopicBeyond Rest: Exploring the Bidirectional Relationship and Intersecting Pathways of Sleep and Physical HealthView all 14 articles

Association of Visual Acuity with Sleep Quality and Sleep Duration in Patients with Type 2 Diabetes: Evidence from a Cross-sectional Analysis of the Fushun Diabetic Retinopathy Study (FS-DIRECT)

Provisionally accepted
Yu WangYu Wang1Shi Song RONGShi Song RONG2Zixi ZhouZixi Zhou1Yuanbo LiangYuanbo Liang3Zhong LinZhong Lin3Fenghua WangFenghua Wang4Qitong WangQitong Wang5Kemi FengKemi Feng3Xiaoxia DingXiaoxia Ding1Dongxiao ZangDongxiao Zang1Dong LiDong Li1Bo ZangBo Zang1*
  • 1Fushun Eye Hospital, Fushun City, China
  • 2Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
  • 3Wenzhou Medical University, Wenzhou, Zhejiang Province, China
  • 4Beijing Tongren Hospital, Capital Medical University, Beijing, Beijing Municipality, China
  • 5China Medical University, Shenyang, Liaoning Province, China

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Objective: To examine the association between visual acuity (VA), sleep quality, and sleep duration among Chinese adults. Subjects/Methods: Data were derived from the Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), a cross-sectional, community-based study conducted in Fushun, China, from July 2012 to May 2013. The study included 1284 participants (58.7% female, mean age 61.3 years) with type 2 diabetes. VA was assessed using the LogMAR chart and stratified into six groups based on LogMAR scores: <0 (optimal), 0-0.1, 0.1-0.2, 0.2-0.3, 0.3-0.5, and ≥0.5 for multivariable-adjusted analyses.Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Results: Restricted cubic splines revealed a significant J-shaped association between VA and sleep quality (P for non-linearity = 0.004). This relationship was characterized by a positive correlation for VA values below 0.5 LogMAR, with the association plateauing at higher VA levels. Compared to the optimal VA group, the odds ratios (ORs) for poor sleep quality were: 1.18 (95%

Keywords: Visual Acuity, sleep quality, sleep duration, Pittsburgh Sleep Quality Index (PSQI), Cross-sectional study

Received: 01 Nov 2024; Accepted: 30 Jun 2025.

Copyright: © 2025 Wang, RONG, Zhou, Liang, Lin, Wang, Wang, Feng, Ding, Zang, Li and Zang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Bo Zang, Fushun Eye Hospital, Fushun City, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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