Nocturnal sleep duration and bone mineral density: a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) 2007–2014

Abstract

Background This study aimed to investigate the association between sleep duration and bone mineral density (BMD) and determine whether vitamin D (VD) status influenced the association between sleep duration and BMD. Methods National Health and Nutrition Examination Survey 2007–2014 participants aged ≥ 40 years were included in this study. BMD testing was conducted with dual-energy X-ray absorptiometry examinations. Moreover, all individuals were divided into four groups according to self-reported nocturnal sleep duration (7–8 h; 6 h; < 6 h; and > 8 h). In addition, the differences in BMD between the normal sleep duration group and other groups were calculated using multiple linear regression models. Results Overall, the median age of the overall study population was 55.00 years old, with 46.97% of men distributed. Participants sleeping > 8 h/night had lower BMDs than those sleeping 7–8 h/night. Moreover, the association between unhealthy sleep duration (especially > 8 h/night) and low BMD was more pronounced in older individuals, men, postmenopausal women, and subjects with inadequate VD intakes (< 15.00 µg/day) or deficient/insufficient serum 25-hydroxyvitamin D (< 75.00 nmol/L). Conclusions In conclusion, unhealthy sleep duration, especially long sleep duration, was associated with decreased BMD, particularly among individuals aged > 60 years, men, or postmenopausal women. Moreover, VD status might influence the association between sleep duration and BMD, especially in the context of inadequate VD intake or deficient/insufficient serum 25-hydroxyvitamin D levels. However, given the limitations of the present study, further investigation is warranted to confirm this association and to explore potential mechanisms.

Sleep characteristics and parameters of bone turnover and strength in the adult population: results from the Study of Health in Pomerania‐TREND

“…In addition, short sleep was related to an increased fracture risk (Cauley et al, 2019), and both, short and long sleep (≤ 5 or ≥ 10 h) were accompanied by an increased risk of falls (Cauley et al, 2019). Long sleep duration (> 8 h) was further reported to be related to reduced bone mineral density among nearly 4400 National Health and Nutrition Examination Survey (NHANES) participants (Tang et al, 2022). In another study, Lucassen et al (2017) found that lower sleep quality and late sleep onset, as assessed by the PSQI, present risk factors for osteopenia and sarcopenia in middle‐aged (aged 45–65 years) men and women.…”

“…Previously and in contrast to our results, relationships of sleep characteristics with bone mineral density, ultrasound‐based parameters, or fractures have been documented (Bevilacqua et al, 2020; Cauley et al, 2019; Chen et al, 2014; Fu et al, 2011; Lucassen et al, 2017; Ochs‐Balcom et al, 2020; Sasaki et al, 2016; Sforza et al, 2013; Specker et al, 2007; Swanson et al, 2021; Tang et al, 2022; Terzi & Yilmaz, 2016). Yet, most previous studies (Bevilacqua et al, 2020; Cauley et al, 2019; Chen et al, 2014; Fu et al, 2011; Lucassen et al, 2017; Ochs‐Balcom et al, 2020; Sasaki et al, 2016; Sforza et al, 2013; Specker et al, 2007; Swanson et al, 2021; Tang et al, 2022; Terzi & Yilmaz, 2016) assessed sleep characteristics solely by self‐reports using standardised or study‐specific questionnaires.…”

“…Long sleep duration (> 8 h) was further reported to be related to reduced bone mineral density among nearly 4400 National Health and Nutrition Examination Survey (NHANES) participants (Tang et al, 2022). In another study, Lucassen et al (2017) found that lower sleep quality and late sleep onset, as assessed by the PSQI, present risk factors for osteopenia and sarcopenia in middle-aged (aged 45-65 years) men and women.…”

Serum Vitamin D3 Concentration, Sleep, and Cognitive Impairment among Older Adults in China

“…The relationship of VD3 deficiency with sleep among older adults has also been explored. Plenty of literature has found that low levels of VD3 are related to short or long sleep durations, decreased sleep efficiency, and sleep fragmentation [38][39][40][41][42][43][44]. For instance, based on 207 women aged 55 years or older in Macao, China, one study found that both short and long sleep durations were significantly associated with VD3 deficiency [40].…”