The Association Between Sleep Health and a History of Cataract Surgery in the United States Based on the National Health and Nutrition Examination Survey (NHANES) 2005–2008
Abstract
:1. Introduction
2. Methods
2.1. Data and Study Sample
2.2. Cataract Surgery Assessment
2.3. Assessment of Sleep-Related Variables
2.4. Assessment of Covariates
2.5. Data Analysis
3. Results
3.1. Characteristics of Participants
3.2. Univariable Poisson Regression Analysis of Cataract-Related Variables
3.3. Association Between Sleep and History of Cataract Surgery
3.4. Subgroup Analyses
3.5. Sensitivity Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All | Non-Cataract Surgery | Cataract Surgery | p-Value | |
---|---|---|---|---|
Number | 8591 | 7817 (93.4) | 774 (6.6) | |
Gender (N, %) | <0.001 | |||
Male | 4183 (48.2) | 3819 (48.9) | 364 (39.1) | |
Female | 4408 (51.8) | 3998 (51.1) | 410 (60.9) | |
Age [years, mean (SD)] | 46.26 (16.55) | 44.43 (15.28) | 72.22 (11.48) | <0.001 |
Ethnicity (N, %) | <0.001 | |||
Mexican American | 1556 (7.9) | 1497(8.2) | 59 (2.7) | |
Other Hispanic | 602 (3.9) | 562(4.0) | 40 (2.3) | |
Non-Hispanic white | 4277 (72.1) | 3730(71.2) | 547 (84.8) | |
Non-Hispanic black | 1830 (10.9) | 1721(11.2) | 109 (6.2) | |
Other | 326 (5.3) | 307(5.4) | 19 (3.9) | |
Education (N, %) | <0.001 | |||
Less than 9th grade | 997 (5.9) | 835 (5.4) | 162 (13.2) | |
9th–11th grade | 1417 (12.2) | 1290 (12.1) | 127 (14.6) | |
High school graduate or equivalent | 2078 (24.8) | 1874 (24.4) | 204 (30.3) | |
Some college or AA degree | 2366 (30.6) | 2200 (31.0) | 166 (24.4) | |
College graduate or above | 1733 (26.5) | 1618 (27.2) | 115 (17.4) | |
BMI (N, %) | 0.085 | |||
<25 kg/m2 | 2554 (32.5) | 2318 (32.4) | 236 (32.8) | |
25–30 kg/m2 | 2981 (33.9) | 2689 (33.6) | 292 (37.6) | |
>30 kg/m2 | 3056 (33.7) | 2810 (34.0) | 246 (29.6) | |
Economic level (N, %) | <0.001 | |||
<1 | 1596 (12.0) | 1481 (12.3) | 115 (9.0) | |
1–3 | 3640 (35.8) | 3189 (34.3) | 451 (57.6) | |
>3 | 3355 (52.1) | 3147 (53.4) | 208 (33.4) | |
Marital status (N, %) | <0.001 | |||
Unmarried or other | 5350 (65.6) | 4941 (66.4) | 409 (54.5) | |
Married or living with a partner | 3241 (34.4) | 2876 (33.6) | 365 (45.5) | |
Alcohol consumption (N, %) | <0.001 | |||
≥12 drinks/year | 6028 (74.8) | 5567 (75.8) | 461 (61.1) | |
<12 cups/year | 2563 (25.2) | 2250 (24.2) | 313 (38.9) | |
Smoking status (N, %) | 0.047 | |||
Yes | 4115 (48.2) | 3700 (47.8) | 415 (53.2) | |
No | 4476 (51.8) | 4117 (52.2) | 359 (46.8) | |
Hypertension (N, %) | <0.001 | |||
Yes | 2876 (29.8) | 2407 (27.7) | 469 (59.4) | |
No | 5715 (70.2) | 5410 (72.3) | 305 (40.6) | |
Diabetes (N, %) | <0.001 | |||
Yes | 963 (8.0) | 767 (6.9) | 196 (22.5) | |
No | 7628 (92.0) | 7050 (93.1) | 578 (77.5) | |
Sleep time (N, %) | <0.001 | |||
<7 | 3330 (36.4) | 3060 (36.6) | 270 (33.4) | |
7–9 | 5030 (61.3) | 4570 (61.4) | 460 (61.1) | |
>9 | 231 (2.2) | 187 (2.0) | 44 (5.4) | |
Falling asleep time [min, mean (SD)] | 21.36 (19.12) | 21.21 (19.03) | 23.42 (20.21) | 0.050 |
Sleep trouble (N, %) | <0.001 | |||
Yes | 1945 (24.3) | 1698 (23.5) | 247 (34.6) | |
No | 6646 (75.7) | 6119 (76.5) | 527 (65.4) | |
Sleep disorder (N, %) | 0.515 | |||
Yes | 619 (7.3) | 550 (7.3) | 69 (7.9) | |
No | 7972 (92.7) | 7267 (92.7) | 705 (92.1) | |
Sleep patterns (N, %) | <0.001 | |||
Healthy sleep | 4121 (48.7) | 3780 (49.0) | 341 (43.9) | |
Intermediate sleep | 3115 (35.5) | 2846 (35.6) | 269 (34.5) | |
Poor sleep | 1355 (15.8) | 1191 (15.4) | 164 (21.6) |
Sleep Pattern (Col%) | ||||
---|---|---|---|---|
Healthy | Intermediate | Poor | p-Value | |
Number | 3791 (48.7) | 3387 (35.5) | 1413 (15.8) | |
Gender (N, %) | 0.003 | |||
Male | 1888 (49.6) | 1685 (49.5) | 610 (41.8) | |
Female | 1903 (50.4) | 1702 (50.5) | 803 (58.2) | |
Age [years, mean (SD)] | 45.47 (16.70) | 45.66 (16.67) | 49.75 (15.41) | <0.001 |
Ethnicity (N, %) | <0.001 | |||
Mexican American | 832 (9.5) | 574 (7.5) | 150 (4.2) | |
Other Hispanic | 285 (4.3) | 214 (3.7) | 103 (3.4) | |
Non-Hispanic White | 1917 (72.8) | 1569 (69.2) | 791 (76.7) | |
Non-Hispanic Black | 614 (8.0) | 898 (14.2) | 318 (11.1) | |
Other | 143 (5.4) | 132 (5.5) | 51 (4.6) | |
Education (N, %) | <0.001 | |||
Less than 9th grade | 482 (6.3) | 356 (5.3) | 159 (6.0) | |
9th–11th grade | 614 (11.5) | 588 (13.3) | 215 (11.8) | |
High school graduate or equivalent | 868 (22.9) | 842 (25.7) | 368 (27.8) | |
Some college or AA degree | 982 (28.7) | 952 (31.3) | 432 (33.9) | |
College graduate or above | 845 (30.6) | 649 (24.3) | 239 (20.4) | |
BMI (N, %) | <0.001 | |||
<25 kg/m 2 | 1229 (35.9) | 996 (31.3) | 329 (25.7) | |
25–30 kg/m 2 | 1392 (34.7) | 1171 (35.1) | 418 (28.6) | |
>30 kg/m 2 | 1170 (29.4) | 1220 (33.6) | 666 (45.6) | |
Economic level (N, %) | 0.001 | |||
<1 | 682 (11.2) | 593 (11.4) | 321 (15.9) | |
1–3 | 1556 (33.5) | 1500 (38.9) | 584 (35.1) | |
>3 | 1553 (55.3) | 1294 (49.7) | 508 (49.0) | |
Marital status (N, %) | <0.001 | |||
Unmarried or other | 1278 (31.1) | 1340 (35.8) | 614 (39.9) | |
Married or living with a partner | 2504 (68.9) | 2047 (64.2) | 799 (60.1) | |
Alcohol consumption (N, %) | 0.009 | |||
≥12 drinks/year | 2684 (75.6) | 2385 (75.5) | 959 (71.3) | |
<12 cups/year | 1107 (24.4) | 1002 (24.5) | 454 (28.7) | |
Smoking status (N, %) | <0.001 | |||
Yes | 1692 (44.7) | 1612 (48.6) | 811 (56.6) | |
No | 2099 (55.3) | 1775 (51.4) | 602 (43.4) | |
Hypertension (N, %) | <0.001 | |||
Yes | 1024 (24.3) | 1119 (29.7) | 732 (44.9) | |
No | 2767 (75.7) | 2268 (70.3) | 680 (55.1) | |
Diabetes (N, %) | <0.001 | |||
Yes | 340 (6.3) | 356 (7.0) | 267 (14.8) | |
No | 3451 (93.7) | 3031 (93.0) | 1146 (85.1) | |
Cataract surgery (N, %) | ||||
Yes | 289 (5.3) | 310 (6.9) | 175 (9.1) | <0.001 |
No | 3502 (94.7) | 3077 (93.1) | 1238 (90.9) |
Variable | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
PR (95%CI) | p-Value | PR (95%CI) | p-Value | PR (95%CI) | p-Value | |
Sleep duration (continuous) | 1.15 (1.07, 1.24) | <0.001 | 0.99 (0.94, 1.05) | 0.834 | 1.00 (0.94, 1.06) | 0.996 |
Sleep duration (multi-category) | ||||||
7–8 h | ref | ref | ref | ref | ||
<7 h | 1.00 (0.78, 1.27) | 0.97 | 1.12 (0.91, 1.38) | 0.284 | 1.07 (0.87, 1.32) | 0.463 |
>8 h | 2.26 (1.77, 2.90) | <0.001 | 1.21 (0.97, 1.51) | 0.083 | 1.17 (0.91, 1.49) | 0.196 |
Sleep disorder | ||||||
No | ref | ref | ref | |||
Yes | 1.10 (0.83, 1.45) | 0.514 | 1.16 (0.88, 1.53) | 0.273 | 1.11 (0.82, 1.50) | 0.455 |
Sleep trouble | ||||||
No | ref | ref | ref | |||
Yes | 1.65 (1.46, 1.86) | <0.001 | 1.46 (1.29, 1.66) | <0.001 | 1.40 (1.22, 1.62) | <0.001 |
Sleep patterns | ||||||
Healthy sleep | ref | ref | ref | |||
Intermediate sleep | 1.29 (1.06, 1.57) | 0.0117 | 1.27 (1.09, 1.49) | 0.004 | 1.24 (1.05, 1.46) | 0.017 |
Poor sleep | 1.70 (1.38, 2.10) | <0.001 | 1.46 (1.23, 1.74) | <0.001 | 1.36 (1.13, 1.64) | 0.004 |
Healthy Sleep | Intermediate Sleep | Poor Sleep | p for Interaction | ||||
---|---|---|---|---|---|---|---|
Subgroup | PR (95%CI) | p-Value | PR (95%CI) | p-Value | |||
Age (years) | 0.249 | ||||||
<60 | 51/5796 | ref | 2.13 (0.91, 4.99) | 0.076 | 2.46 (0.95, 6.35) | 0.061 | |
≥60 | 723/2795 | ref | 1.18 (0.95, 1.47) | 0.116 | 1.29 (1.04, 1.61) | 0.025 | |
Gender | 0.867 | ||||||
Male | 364/4183 | ref | 1.19 (0.85, 1.66) | 0.291 | 1.39 (0.93, 2.08) | 0.102 | |
Female | 410/4408 | ref | 1.27 (1.06, 1.53) | 0.015 | 1.37 (1.12, 1.69) | 0.006 | |
Ethnicity | 0.832 | ||||||
Mexican American | 59/1556 | ref | 0.90 (0.53, 1.52) | 0.660 | 1.55 (1.02, 2.34) | 0.040 | |
Other Hispanic | 40/602 | ref | 1.60 (0.60, 4.27) | 0.270 | 1.57 (0.25, 9.95) | 0.561 | |
Non-Hispanic white | 547/4277 | ref | 1.26 (1.06, 1.49) | 0.011 | 1.39 (1.14, 1.70) | 0.003 | |
Non-Hispanic black | 109/1830 | ref | 1.15 (0.82, 1.62) | 0.389 | 1.28 (0.88, 1.87) | 0.185 | |
Other | 19/326 | ref | 0.92 (0.23, 3.73) | 0.896 | 1.21 (0.25, 5.72) | 0.798 | |
Education | 0.939 | ||||||
Less than 9th grade | 162/997 | ref | 1.16 (0.74, 1.82) | 0.486 | 1.05 (0.75, 1.47) | 0.761 | |
9th–11th grade | 127/1417 | ref | 1.41 (0.92, 2.17) | 0.109 | 1.71 (1.03, 2.84) | 0.040 | |
High school graduate or equivalent | 204/2078 | ref | 1.29 (0.99, 1.68) | 0.062 | 1.55 (1.04, 2.31) | 0.033 | |
Some college or AA degree | 166/2366 | ref | 1.15 (0.83, 1.60) | 0.379 | 1.31 (0.79, 2.18) | 0.275 | |
College graduate or above | 155/1773 | ref | 1.30 (0.79, 2.15) | 0.281 | 1.37 (0.69, 2.71) | 0.338 | |
BMI | 0.062 | ||||||
<25 kg/m2 | 236/2554 | ref | 1.36 (1.05, 1.75) | 0.023 | 1.32 (0.91, 1.93) | 0.133 | |
25–30 kg/m2 | 292/2981 | ref | 1.37 (0.99, 1.89) | 0.058 | 1.13 (0.82, 1.55) | 0.432 | |
>30 kg/m2 | 246/3056 | ref | 0.79 (0.54, 1.16) | 0.208 | 1.48 (1.02, 2.41) | 0.040 | |
Economic level | 0.465 | ||||||
<1 | 115/1596 | ref | 0.86 (0.48, 1.53) | 0.576 | 1.33 (0.68, 2.64) | 0.374 | |
1–3 | 451/3640 | ref | 1.21 (1.00, 1.47) | 0.052 | 1.32 (1.02, 1.71) | 0.040 | |
>3 | 208/3355 | ref | 1.45 (1.03, 2.04) | 0.034 | 1.41 (0.90, 2.21) | 0.119 | |
Marital status | 0.562 | ||||||
Unmarried or other | 365/3241 | ref | 1.10 (0.88, 1.39) | 0.361 | 1.21 (0.89, 1.66) | 0.198 | |
Married or living with a partner | 409/5350 | ref | 1.33 (1.08, 1.64) | 0.011 | 1.44 (1.02, 2.04) | 0.040 | |
Alcohol consumption | 0.751 | ||||||
≥12 drinks/year | 461/6028 | ref | 1.17 (0.94, 1.44) | 0.142 | 1.31 (1.02, 1.69) | 0.034 | |
<12 cups/year | 313/2563 | ref | 1.33 (1.00, 1.76) | 0.047 | 1.43 (1.04, 1.97) | 0.032 | |
Smoking status | 0.551 | ||||||
Yes | 415/4115 | ref | 1.20 (0.91, 1.56) | 0.173 | 1.45 (1.13, 1.87) | 0.007 | |
No | 359/4476 | ref | 1.26 (1.04, 1.54) | 0.024 | 1.28 (0.93, 1.72) | 0.127 | |
Hypertension | 0.785 | ||||||
Yes | 469/2876 | ref | 1.24 (1.01, 1.52) | 0.044 | 1.29 (0.97, 1.70) | 0.072 | |
No | 305/5715 | ref | 1.20 (0.90, 1.60) | 0.188 | 1.46 (0.96, 2.22) | 0.075 | |
Diabetes | 0.965 | ||||||
Yes | 196/963 | ref | 1.18 (0.86, 1.60) | 0.271 | 1.32 (0.91, 1.91) | 0.123 | |
No | 578/7628 | ref | 1.24 (1.01, 1.52) | 0.043 | 1.36 (1.06, 1.73) | 0.020 |
Subgroup | PR (95%CI) | p-Value | p for Interaction | |
---|---|---|---|---|
Age (years) | 0.338 | |||
<60 | 51/5796 | 1.84 (1.00, 3.41) | 0.049 | |
≥60 | 723/2795 | 1.30 (1.12, 1.51) | 0.002 | |
Gender | 0.448 | |||
Male | 364/4183 | 1.29 (0.98, 1.70) | 0.070 | |
Female | 410/4408 | 1.50 (1.29, 1.74) | <0.001 | |
Ethnicity | 0.617 | |||
Mexican American | 59/1556 | 2.37 (1.39, 4.03) | 0.004 | |
Other Hispanic | 40/602 | 1.41 (0.36, 5.54) | 0.564 | |
Non-Hispanic white | 547/4277 | 1.43 (1.23, 1.66) | <0.001 | |
Non-Hispanic black | 109/1830 | 1.02 (0.67, 1.47) | 0.969 | |
Other | 19/326 | 2.63 (0.52, 13.19) | 0.218 | |
Education | 0.611 | |||
Less than 9th grade | 162/997 | 1.16 (0.86, 1.56) | 0.321 | |
9th–11th grade | 127/1417 | 1.63 (1.14, 2.33) | 0.010 | |
High school graduate or equivalent | 204/2078 | 1.59 (1.16, 2.18) | 0.006 | |
Some college or AA degree | 166/2366 | 1.55 (1.06, 2.27) | 0.027 | |
College graduate or above | 155/1773 | 1.22 (0.79, 1.88) | 0.350 | |
BMI | 0.495 | |||
<25 kg/m 2 | 236/2554 | 1.26 (0.97, 1.63) | 0.075 | |
25–30 kg/m 2 | 292/2981 | 1.36 (1.02, 1.81) | 0.040 | |
>30 kg/m 2 | 246/3056 | 1.63 (1.19, 2.24) | 0.005 | |
Economic level | 0.948 | |||
<1 | 115/1596 | 1.32 (0.81, 2.14) | 0.238 | |
1–3 | 451/3640 | 1.38 (1.13, 1.68) | 0.004 | |
>3 | 208/3355 | 1.44 (1.10, 1.89) | 0.012 | |
Marital status | 0.901 | |||
Unmarried or other | 409/5350 | 1.43 (1.08, 1.87) | 0.015 | |
Married or living with a partner | 365/3241 | 1.33 (1.05, 1.67) | 0.020 | |
Alcohol consumption | 0.319 | |||
≥12 drinks/year | 461/6028 | 1.34 (1.11, 1.61) | 0.005 | |
<12 cups/year | 313/2563 | 1.53 (1.20, 1.96) | 0.002 | |
Smoking status | 0.443 | |||
Yes | 415/4115 | 1.35 (1.10, 1.66) | 0.008 | |
No | 359/4476 | 1.49 (1.18, 1.89) | 0.003 | |
Hypertension | 0.599 | |||
Yes | 469/2876 | 1.34 (1.13, 1.58) | 0.002 | |
No | 305/5715 | 1.50 (1.11, 2.03) | 0.013 | |
Diabetes | 0.433 | |||
Yes | 196/963 | 1.54 (1.14, 2.07) | 0.008 | |
No | 578/7628 | 1.36 (1.15, 1.60) | 0.002 |
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Wang, C.; Bao, N.; Jiang, Z. The Association Between Sleep Health and a History of Cataract Surgery in the United States Based on the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Healthcare 2025, 13, 1136. https://doi.org/10.3390/healthcare13101136
Wang C, Bao N, Jiang Z. The Association Between Sleep Health and a History of Cataract Surgery in the United States Based on the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Healthcare. 2025; 13(10):1136. https://doi.org/10.3390/healthcare13101136
Chicago/Turabian StyleWang, Chuanxi, Ning Bao, and Zhengxuan Jiang. 2025. "The Association Between Sleep Health and a History of Cataract Surgery in the United States Based on the National Health and Nutrition Examination Survey (NHANES) 2005–2008" Healthcare 13, no. 10: 1136. https://doi.org/10.3390/healthcare13101136
APA StyleWang, C., Bao, N., & Jiang, Z. (2025). The Association Between Sleep Health and a History of Cataract Surgery in the United States Based on the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Healthcare, 13(10), 1136. https://doi.org/10.3390/healthcare13101136