Self-reported Sleep Quality and Bone Outcomes in Older Adults: Findings from the Hertfordshire Cohort Study

Abstract

Sleep duration may be associated with risk of osteoporosis, with suggestions that too little or indeed too much sleep may be detrimental to bone health. In this study, we considered whether perceived sleep quality is also associated with bone health in older adults. We explored this association in a cohort of 443 older community-dwelling UK adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as > 5 on this score system. Bone density, shape and microarchitecture were assessed using dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and high-resolution pQCT (HRpQCT). Thirty-seven percent of men and 43% of women had a PSQI score greater than 5, indicative of poor perceived sleep. We found that quality of sleep was associated with altered bone microarchitecture. In men, poor sleep quality was associated with lower radial trabecular (4% slice, p < 0.04) and cortical (66% slice, p = 0.02) bone mineral density, as well as decreased tibial cortical density (p < 0.02) and increased porosity (p < 0.04), but increased size of the tibia (p < 0.04). In women, poor perceived sleep quality was associated with thinner (p < 0.03) and less dense (p < 0.04) cortices of the radius, but greater tibial trabecular number (p < 0.02) and lower separation (p < 0.04). Relationships with DXA parameters were non-significant after adjustment for confounders. Taking sleep medications was associated with decreased tibial size (38% and 66% slices) and strength in women (all p < 0.05), but not in men. Perceived sleep quality was associated with altered bone density and microarchitecture in older adults, and these differences varied according to biological sex and site. Further work is indicated to investigate possible mechanisms underlying these observations.

Quality of Life in Women With Postmenopausal Osteoporosis - Pilot Studies in the Łódź Province

“…Moreover, awakening from sleep through pain affects the mental state of the patients. The existing literature describes that women in Sweden, after a compression fracture of their spine, complained about sleep problems at night, woke up with severe pain, and many of them took sleeping pills for better rest [31]. We have not shown a statistically signi cant relationship between sleep length and QUALEFFO 41.…”

Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities

“…Along with differences in PA, we also found differences in the relative time spent sleeping. A recent review suggested that shorter and longer sleepers are at greater risk of developing muscle failure and lower values of BMD, when considering sleep in isolation [ 67 , 68 ]. Conversely, when the whole 24 h day was considered, no relationship between sleep duration and musculoskeletal health was found.…”

Quality of Life in Women With Postmenopausal Osteoporosis - Pilot Studies in The Łódź Province

“…[ 30] In the current study, we have noted that taking sleeping pills deteriorates quality of life. These observations can be explained by an earlier study, which suggests that the use of sleeping pills in women may be associated with worse bone health and should be considered when reviewing older patients [29].…”

“…This study indicates that one of the factors related to the perception of general health is sleep. Poor quality of sleep (sleep disorders) may be associated with osteoporosis [28], by affecting the bone microarchitecture [29]. It is known that a good night's sleep is a key factor in maintaining quality of life.…”