Sleep Deprivation Reduces Tear Secretion and Impairs the Tear Film
Condition: We Investigated the Effect of Sleep Deprivation on the Tear Film and Ocular Surface.
MeSH terms: Sleep Deprivation
Study type: Interventional

Summary: 
      Tear film consists of three layers including outer lipid layer, aqueous layer and inner mucin
      layer.1,2 Lipid layer protects the aqueous layer of tear film from evaporation and mucin
      layer adhere the tear film to ocular surface. Aqueous layer, which is produced in lacrimal
      glands, is the most important in the health of ocular surface. Reduction of aqueous tear
      secretion results in the disruption of homeostasis at ocular surface and leads to dry eye
      syndrome.2 Dry eye syndrome is a common ocular surface disease associated with symptoms of
      eye discomfort, grittness and visual disturbance.1,2 Dry eye syndrome disrupts normal
      homeostasis at the ocular surface resulting in epithelial damage, epithelial cell apoptosis,
      loss of goblet cells, and squamous metaplasia.1-3 The changes and inflammation of ocular
      surface subsequently lead to tear instability, which causes an increased tear osmolarity and
      aggravates the inflammatory cascades. This leads to a vicious cycle.2 The regulation of tear
      film secretion is under neural and hormonal control.4 Dry eye syndrome has been associated
      with diverse and multiple causes, including depressive disorder, drugs, hormonal status, and
      systemic diseases.2 Sleep deprivation (SD) is known to cause profound impair¬ments in
      executive function and vigilant attention.5,6 It is also reportedly associated with autonomic
      and endocrine functioning7-9 and has been shown to increase blood pressure and stress hormone
      levels and decrease parasympathetic tone.10,11 Tear secretion is regulated by neurological
      factors and hormones,12 and so SD may have an effect on the tear film and ocular surface.
      However, only a few studies have evaluated the effect of sleep on the tear film and ocular
      surface.

      In this study, we investigated the effect of SD on the tear film and ocular surface.
    

Detailed description: 
      References

        1. The definition and classification of dry eye disease: report of the Definition and
           Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf.
           2007;5:75-92.

        2. Johnson ME, Murphy PJ. Changes in the tear film and ocular surface from dry eye
           syndrome. Prog Retin Eye Res. 2004;23:449-474.

        3. Giacomo Savini, Pinita Prabhawasat, Takashi Kojima, Martin Grueterich, Edgar Espana,
           Eiki Goto. The challenge of dry eye diagnosis. Clin Ophthalmol. 2008; 2: 31-55.

        4. Kamperis K, Hagstroem S, Radvanska E, Rittig S, Djurhuus JC. Excess diuresis and
           natriuresis during acute sleep deprivation in healthy adults. Am J Physiol Renal
           Physiol. 2010;299:F404-F411.

        5. Mahler B, Kamperis K, Schroeder M, Frøkiær J, Djurhuus JC, Rittig S. Sleep deprivation
           induces excess diuresis and natriuresis in healthy children. Am J Physiol Renal Physiol.
           2012;302:F236-F243.

        6. McEwen BS. Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and
           allostatic load. Metabolism. 2006;55(10 Suppl 2):S20-S23.

        7. Nascimento DC, Andersen ML, Hipólide DC, Nobrega JN, Tufik S. Pain hypersensitivity
           induced by paradoxical sleep deprivation is not due to altered binding to brain
           mu-opioid receptors. Behav Brain Res. 2007;178:216-220.

        8. Everson CA. Functional consequences of sustained sleep deprivation in the rat.
           Behavioural Brain Research. 1995;69:43-54.

        9. Kim JH, Kim JH, Nam WH, Yi K, Choi DG, Hyon JY, Wee WR, Shin YJ. Oral alcohol
           administration disturbs tear film and ocular surface. Ophthalmology. 2012;119:965-71.

       10. Leproult R, Copinschi G, Buxton O, Van Cauter E. Sleep loss results in an elevation of
           cortisol levels the next evening. Sleep 1997;20:865-870.

       11. Dartt DA. Neural regulation of lacrimal gland secretory processes: relevance in dry eye
           diseases. Prog Retin Eye Res. 2009;28:155-177.

       12. The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the
           International Dry Eye WorkShop (2007). Ocul Surf. 2007;5:93-107.
    

Intervention name(s): sleep deprivation
Intervention type(s): Behavioral
Intervention description(s): sleep deprivation for one night
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Health Services Research