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Research Article: Cross-sectional associations of nighttime sleep and daytime nap duration with myopia in preschool children: the mediating role of body mass index

Date Published: 2026-07-07

Abstract:
To investigate the associations of nighttime sleep and daytime nap duration with myopia in preschool children, and to examine the mediating role of body mass index (BMI). This cross-sectional study included 695 children aged 3–7?years. Sleep duration, demographics, family factors, and lifestyle were assessed via a self-administered questionnaire. Ophthalmic examinations followed national myopia screening guidelines. Multivariate logistic regression, restricted cubic splines, and mediation analysis were used to evaluate the associations and the mediating effect of BMI. The prevalence of myopia was 21.29%. After adjusting for confounders, both daytime nap duration [OR?=?0.87, ( p =?0.012)] and nighttime sleep duration [OR?=?0.48, ( p =?0.031)] were negatively associated with myopia risk. A protective inflection point was identified at 38?min for daytime napping. BMI partially mediated the associations of daytime nap and nighttime sleep with myopia, accounting for 24.79 and 28.16% of the total effects, respectively. Both nighttime sleep and daytime nap duration were inversely associated with myopia risk in preschool children, with BMI playing a partial mediating role. Ensuring adequate nighttime sleep and appropriate daytime napping may represent an effective strategy for early myopia prevention.

Introduction:
Myopia, the most common form of refractive error, has emerged as a major global public health concern ( 1 ). By 2050, its prevalence is expected to affect nearly 5 billion people, with high myopia accounting for 1 billion cases ( 2 ). High myopia carries a high risk of irreversible blinding complications—such as glaucoma, retinal detachment, and macular degeneration—imposing substantial health and economic burdens on individuals and society ( 3 ). In recent years, myopia has shown a trend toward earlier onset,…

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