Sleep duration and bone health measures in older men

Abstract

The associations between objective measures of sleep duration and bone outcomes in older men are unknown. No consistent, significant association was identified between sleep duration and bone mineral density (BMD) in the current analysis. However, future research should determine if vitamin D status modifies this relationship. Introduction Prior studies, predominantly in women, reported that long and short self-reported sleep duration are associated with lower BMD. Associations between actigraphy-determined sleep duration and BMD or bone turnover markers (BTMs) in older men are unknown. Methods Men in The Osteoporotic Fractures in Men (MrOS) Study with wrist actigraphy and concurrent BMD assessment but without comorbidities affecting bone health were included. Sleep duration was considered as a continuous (N = 1926) and dichotomized variable where men were classified as getting the recommended (7-8 h/night; N = 478) or short (< 6 h/night; N = 577) sleep. The cross-sectional association between BMD, BTMs, and sleep duration was examined using a t test or linear regression, where appropriate, in unadjusted and adjusted models. Results There were no clinically or statistically significant differences in BMD at the L-spine, total hip, or femoral neck between men getting the recommended vs. short sleep duration, using actigraphy or self-reported sleep duration (all p ≥ 0.07). When sleep duration was considered as a continuous variable, femoral neck BMD was higher in men with longer self-reported sleep duration (β = 0.006 ±0.003, p = 0.02), but this was not significant after further adjustment. In men with low 25OHD (< 20 ng/mL), longer actigraphy-determined sleep duration was associated with higher total hip BMD (β = 0.016 ± 0.008; p = 0.04). Sleep duration and BTMs were not associated.

Relevance of Sleep Disturbances to Orthopaedic Surgery

“…A recent cross-sectional study of >11,000 postmenopausal women showed that those reporting a short sleep time (£5 hours of sleep) had lower BMD and more osteoporosis in the hip and other body parts than those in the reference group ( ‡7 hours of sleep) after adjusting for covariates 46 . However, recent longitudinal and cross-sectional studies did not confirm this association 47,48 . Insomnia and OSA could affect BMD 10,49 .…”

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

“…Some previous studies demonstrated that unhealthy sleep duration was associated with decreased BMD or increased risk of osteoporosis [9,10,[30][31][32]. For example, Ochs-Balcom et al observed that women with short sleep duration (≤ 5 h/per night) showed lower BMD and higher risk of low bone mass and osteoporosis than individuals with a 7-h sleep duration [30].…”

“…Wang et al found that post-menopausal women with long sleep duration (> 10 h/day) showed a higher risk of osteoporosis than those with normal sleep duration (8–9 h/day) [ 8 ]. However, it should be noted that there is still no reliable conclusion because some studies found that long or short sleep durations might not contribute to decreased BMD [ 9 , 10 ]. For example, Swanson et al observed that nocturnal sleep duration was not independently associated with hip BMD among postmenopausal women irrespective of the method of assessment of sleep duration (objective or subjective) [ 9 ].…”

“…For example, Swanson et al observed that nocturnal sleep duration was not independently associated with hip BMD among postmenopausal women irrespective of the method of assessment of sleep duration (objective or subjective) [ 9 ]. Another study by Swanson et al found that there were no significant differences in hip or spine BMD between older men with short sleep duration (< 6 h) or recommended sleep duration (7–8 h) [ 10 ]. These controversial findings (abnormal sleep duration might be associated with low BMD or it might not) indicate that more studies on the impact of sleep duration on bone health are needed and suggest that other potential factors might influence the association between sleep duration and BMD.…”

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

“…Recent publications on the relationship between sleep duration and BMD were the first to use wrist actigraphy instead of self-report on questionnaire to establish sleep duration. The association between BMD and objectively measured sleep duration was evaluated using the Osteoporotic Fractures in Men (MrOS) Study and the SOF cohorts [67,68 ▪ ]. Although no significant association was identified between objectively determined nighttime sleep duration and BMD in either cohort, these articles did raise two potential considerations for future research [67,68 ▪ ].…”