Sleep disruptions and bone health: what do we know so far?

Abstract

Purpose of review This review briefly summarizes the growing body of literature addressing the skeletal consequences of sleep and circadian disruption. Recent findings The most recent data in the field suggest that the diurnal variation in bone turnover markers are because of endogenous circadian rhythmicity linked to clock genes in all bone cells; in a small human intervention study, cumulative sleep restriction with concurrent circadian disruption negatively alter bone turnover markers in a way that could explain the lower BMD and increased fracture risk identified in some prior night shift work studies; abnormal sleep duration and obstructive sleep apnea are associated with low BMD and increased fracture risk in some but not all studies. Summary Normal physiology and some animal and human intervention studies suggest that sleep and circadian disruptions, such as night shift work, abnormal sleep durations and obstructive sleep apnea are detrimental to skeletal health. However, additional research in this area is needed to determine which sleep/circadian disturbances are most detrimental to skeletal health, the reversibility of such impairments, and underlying mechanisms.

Association of Self-Reported Sleep Characteristics and Hip Fracture: Observational and Mendelian Randomization Studies

“…The mechanisms underlying the association of sleep traits with incidental fractures are still unknown. Previous studies have suggested that impaired cognitive function or depression, falls, decreased muscle strength, bone mineral density (BMD), and comorbidities may mediate this association [ 11 , 31 , 33 , 45 , 46 ]. For example, short/long sleep duration was frequently comorbid with falls, osteoporosis, pain, mental disorders, and obstructive sleep apnea [ 45 , 47 ].…”

Association Between Sleep Duration and Osteoporosis in Older Adults: A Cross-Sectional Study in Taiwan

“…Additionally, sleep in uences bone metabolism by in uencing the rhythmicity of bone cells, sympathetic tone, in ammation, metabolic balance, and physical activity. Sleep duration is closely associated with the circadian rhythm, as evident from the internal rhythm in bone turnover markers and the presence of clock genes within bone cells [23][24][25]. Animal models with the knockout of clock genes indicate the importance of the circadian rhythm in maintaining optimal skeletal health.…”

“…Animal models with the knockout of clock genes indicate the importance of the circadian rhythm in maintaining optimal skeletal health. Disruptions in sleep or circadian rhythms may therefore adversely affect bone health [24].…”

Skeletal health in diabetes

“…However, alerts from these devices, hypoglycemia and hyperglycemia are known to disrupt sleep in people with T1D. Swanson [8] reviewed recent publications demonstrating that sleep disruptions may be associated with low bone formation and increased fracture risk. In that issue, two reviews were dedicated on highlighting chronic hyperglycemia leading to increased advanced glycation endproducts (AGEs) accumulation and its possible implication on tissue material properties and skeletal fragility in people with diabetes [9,10].…”