| Objectives The purpose of this study was to find out the prevalence of refractive error in children at 6 years,and to examine the relationship between sleep time,social jetlag and refractive error of 6-year-old children.Methods Based on the Ma’anshan Birth Chort（MABC）,the Questionnaire of Preschool Children Health were used to collect the general demographic sociological characteristics,sleep time and social jetlag information at the age of 48 months,66 months and 72 months of children.Social jetlag refers to the time difference between an individual’s body clock at the weekend and the daily life of the school day.At the age of 72 months,the distanse vision was tested with the national standard logarithmic visual acuity chart（GB 11533-2011）.The refraction information of the children with distanse vision less than 5.0 was obtained by mydriatic refractometry.A total of 2 284 children aged 72 months were followed up.After excluding 188 children without visual examination and 114 children with incomplete sleep information,a total of 1 982 children were included in the analysis.Chi Square tests were used to compare the differences of sleep time and social jetlag distribution among children with different demographic characteristics in each period.Latent growth curve model（LCGM）was used to classify the trajectory of social jetlag among different ages.The relationship between sleep time,socialjet lag of children aged 48 months,66 months,72 months,persistent sleep time,continuous social jetlag and refractive error were performed using Logistic regression model.Single factor analysis of variance was used to compare the difference of the right eye equivalent spherical diameter（SE）among preschool children of dilated pupils with normal,myopic,hyperopia and astigmatic,and were analyzed separately for the three kinds of lowest distance vision of two eyes（= 4.9,= 4.8,≤ 4.7）.Associations between sleep time,socialjet lag of children with dilated pupils aged 48 months,66 months,72 months,persistent sleep time,continuous social jetlag and the right eye SE were analyzed by generalized linear model,and were analyzed separately for the three kinds of lowest distance vision of two eyes（= 4.9,= 4.8,≤ 4.7）.Results The detection rates of myopia（SE ≤-0.50 D）,hyperopia（SE ≥ 2.00 D）and astigmatism（|cylinder power| ≥ 1.50 D）in preschool children were 4.5%,7.6% and7.5% respectively.The proportion of sleep deprivation（< 10 h/d）in children aged 48 months,66 months and 72 months were 19.6%,25.7% and 49.1% respectively,and the percentages of long level of social jetlag（≥ 1 h）was 16.6%,14.4% and 20.8%respectively.Multivariate Logistic regression results showed that sleep deprivation of children aged48 months was positively correlated with myopia（RR = 1.74,95%CI: 1.06,2.86）;long social jetlag of children aged 48 months was positive correlated with myopia（RR= 2.04,95%CI: 1.19,3.49）.No statistical association was found between the sleep duration,social jetlag at 66 months and 72 months and refractive error.Persistent long social jetlag at 48-72 months of age in preschool children increased the risk of myopia（RR = 2.36,95%CI: 1.34,4.16）,and deceased the risk of hyperopia（RR = 0.31,95%CI: 0.13,0.78）.Continuous sleep deprivation（L-L）at 48-66 months of age in children increased the risk of myopia（RR = 2.09,95%CI: 1.01,4.33）.There was no statistical correlation between persistent sleep deprivation（L-L-L）and myopia,hyperopia and astigmatism in children aged 48-72 months.The preschool children with dilated pupils were divided into three groups according to the lowest distance vision of both eyes,the lowest distance vision of both eyes was4.9,the lowest distance vision of both eyes was 4.8,and the lowest distance vision of both eyes was or less than 4.7.The rates of myopia were 1.9%,8.9% and 40%respectively by different distance visions,the proportion of hyperopia were 21.3%,23.3% and 26.4% respectively by different distance visions,the percentages of astigmatism were 14.0%,32.9% and 39.1% respectively by different distance visions.With the decrease of distance vision,the general trend of SE decreased in the normal group and the myopic group,while the trend of SE increased in the hyperopia group,the differences were statistically significant.After adjustment for confounding factors,social jetlag of children aged 48 months was negatively correlated with right eye SE（β =-0.62,95%CI:-0.91,-0.33）.There were both negative correlation between social jetlag at 48 months and right eye SE in the lowest distance vision of both eyes was 4.8（β =-0.83,95%CI:-1.25,-0.40）,and the lowest distance vision of both eyes was or less than 4.7（β =-0.87,95%CI:-0.64,-0.09）.No statistical association was found among sleep duration at 48 months of age,sleep duration and social jetlag at at66 months and 72 months with right eye SE.There was a negative correlation between children’s persistent long social jetlag and right eye SE（β =-0.91,95%CI:-1.31,-0.51）.There were both negative correlation between persistent long social jetlag and right eye SE in the lowest distance vision of both eyes was 4.8（β =-1.13,95%CI:-1.82,-0.46）,and the lowest distance vision of both eyes was or less than 4.7（β =-1.75,95%CI:-2.73,-0.77）.There was no statistical association between persistent sleep deprivation and right eye SE in preschool children with dilated pupils.Conclusions These findings suggested that astigmatism and hyperopia were the most common refractive error among preschool children,not myopia.Sleep deprivation at 48 months and persistent sleep deprivation were risk factors for myopia of 72 months of children.Long social jetlag level at 48 months and persistent long level of social jetlag increased the risk of myopia in children aged 72 months.Meanwhile,persistent long level of social jet lag could reduce the risk of hyperopia in preschool children,mild to moderate hyperopia could be used as a hyperopia reserve to prevent myopia in the process of emmetropization.There was a greater probability of myopia when the distance vision was less than 4.7.These findings suggested that the importance of develop good sleep habits,maintain adequate sleep time and examinate distant vision regularly to prevent the occurrence and development of myopia in the early years. |
PDF Full Text Request