Cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness in European children and adolescents

Abstract

In this large perspective cohort among European children and adolescents, we observed that daytime napping was positively associated with bone stiffness, while short or long sleep duration combined with poor sleep quality was associated with less bone stiffness. Our findings are important for obtaining optimal bone stiffness in childhood. Introduction To examine the cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness index (SI) in European children and adolescents. Methods Four thousand eight hundred seventy-one children aged 2-11 years from the IDEFICS study and 861 children aged 6-15 years from the subsequent I.Family study were included. Sleep duration (i.e., nocturnal sleep and daytime napping) and sleep quality (i.e., irregularly bedtime routine, have difficulty falling asleep and trouble getting up in the morning) were reported by self-administrated questionnaires. Nocturnal sleep duration was converted into age-specific z-scores, and total sleep duration was classified into short, adequate, and long based on the National Sleep Recommendation. Calcaneal SI of both feet were measured using quantitative ultrasound. Linear mixed-effects models with country as a random effect were used, with adjustments for sex, age, pubertal status, family socioeconomic status, physical activity, screen time, body mass index, and daylight duration. Results Nocturnal sleep duration z-scores were positively associated with SI percentiles among participants with adequate sleep duration at baseline. Moreover, the positive association between daytime napping and SI percentiles was more pronounced in participants with adequate sleep duration at baseline, while at 4-year follow-up was more pronounced in participants with short sleep duration. In addition, extreme sleep duration at baseline predicted lower SI percentiles after 4 years in participants with poor sleep quality. Conclusion The positive associations between nocturnal sleep, daytime napping and SI depended on total sleep duration. Longterm detrimental effect of extreme sleep duration on SI only existed in individuals with poor sleep quality.

Sleep Quality and Duration in European Adolescents (The AdolesHealth Study): A Cross-Sectional, Quantitative Study

“…Sleep disorders in adolescents have received significant attention due to their high prevalence and their negative effects on health outcomes [ 16 ]. Cross-sectional studies conducted on adolescent populations report sleep disorders and deterioration of daytime functions due to poor sleep quality or insufficient hours of sleep [ 17 ]. Combining the current tendency of late bedtime with not getting enough sleep due to early school hours and screen time exposure before bedtime and before sleep onset [ 18 ], reduces significantly the opportunity to obtain enough sleep of adequate quality [ 19 ].…”

Chronobiology and Chronotherapy of Osteoporosis

“…(40) In addition, continuous light exposure has been shown to diminish bone volume and density in mice. (107) This could be the result of a disrupted circadian clock in combination with sleep deprivation, as sleep duration positively correlates to bone stiffness in humans, (108) and short sleep is associated with low bone mineral density. (109,110) These studies collectively support a causal relationship between environmental circadian disruption and osteoporosis.…”

Relationship between sleep pattern and bone mineral density in patients with osteoporotic fracture

“…Sleep characteristics including sleep duration, insomnia, obstructive sleep apnea, and daytime napping were reported to associate with BMD, falls, or osteoporotic fractures. 6 – 10 Nevertheless, the previous studies did not consider the joint complexity and associations between the individual sleep characteristics, while participants with one sleep behavior were generally prone to own another behavior in real-world settings. 11 , 12 Furthermore, evidence investigating sleep pattern in relation to BMD in elderly participants who experienced osteoporotic fracture was lacking and sparse in the literature.…”