Sleep onset latency is related with reduced bone mineral density in elderly people with insomnia: a retrospective study

Abstract

PurposeInconsistent outcome about association between insufficient sleep and bone mineral density (BMD) has been reported. The present study aimed to determine whether BMD was associated with score of Pittsburgh Sleep Quality Index (PSQI).MethodsA total of 410 patients (mean age 81.6±5.9 years) attending our hospital for evaluation of sleep were retrospectively studied. Dual-Energy X-ray Absorptiometry was used to measure BMD and T-score at femoral neck and lumbar spines over L2–L4 regions. Subjective sleep status was evaluated by the PSQI questionnaires. The Mann–Whitney U test and chi-square analysis were used to compare continuous variables and categorical variables, respectively. Spearman correlation test was conducted to find the relationship between BMD and other clinical factors. Multinomial logistic regressions analysis was performed to analyze independent factors predicting BMD.ResultsMajority of the participants with osteoporosis (OP) were female and had lower body mass index (BMI) and higher sleep onset latency score. Spearman correlation test showed that gender, BMI, score of total PSQI, and sleep onset latency were significantly related to BMD and T-score in femoral neck and lumbar region L2–L4. Finally, multinomial logistic regression analysis demonstrated that gender and age were independent factors for OP and osteopenia and that after adjustment for gender, age, and BMI, sleep onset latency of <15 minutes (OR: 0.38; 95% CI: 0.15–0.96; P=0.04) and 16–30 minutes (OR: 0.37; 95% CI: 0.17–0.79; P=0.01) were less likely to have reduced BMD.ConclusionThere was a significant association between BMD and sleep onset latency, suggesting that, in elderly patients with sleep problem, BMD measurement and intervention for OP might be valuable.

A cross-sectional analysis of the association between sleep duration and osteoporosis risk in adults using 2005–2010 NHANES

“…Considering that sleep duration decreases with age 30 , age may be a factor affecting BMD. However, the age criteria of assessing a population also vary in the literature, and include > 18 years 8 , 12 , 20–66 years 11 , middle-age (> 40 years 4 , 5 , 35 ; 45 years 2 , 3 , 13 , 36 ; and 50 years 7 , 9 , 20 ), and the elderly (> 60 years 6 , 10 , 14 , 34 ; and 69 years 37 ). The sleep pattern also differs between genders 38 .…”

“…The level of disagreement between subjective and objective measurements of sleep duration increased with male gender, poor cognitive function, and functional disability, particularly among older subjects 47 . Due to other confounding factors, including sleep onset 10 and sleep apnea 25 , any potential changes in sleep duration during follow-up remained undetected. A verified questionnaire scale of sleep quality is warranted for future studies, as these biases could lead to misclassification and underestimation of the association between sleep and bone density.…”

“…In the literature, conclusions about the effect of sleep on bone density in a clinical setting vary depending on the definition of normal sleep duration, sleep quality, selected population, and diagnostic tools for bone density. Both long 2 – 10 or short 4 , 5 , 7 , 8 , 11 – 13 self-reported sleep duration have been associated with low bone mineral density (BMD)/osteoporosis or fracture in the literature. Some, studies have not reported an association between sleep duration and BMD 14 , 15 .…”

“…Some, studies have not reported an association between sleep duration and BMD 14 , 15 . However, in these studies, the diagnostic methods used for osteoporosis varied considerably, including self-reported osteoporosis fracture, BMD by ultrasonic bone densitometry, peripheral quantitative computed tomography, or dual-energy X-ray absorptiometry (DXA) 2 – 10 . The gold-standard technique for the diagnosis of osteoporosis is based on BMD at either lumbar spine or hip by DXA technique 16 .…”

Sharing Pathological Mechanisms of Insomnia and Osteoporosis, and a New Perspective on Safe Drug Choice

“…A research study demonstrated that sleep deprivation could increase cortisol concentration, which might decrease bone formation and bone mineral density (BMD) 17. Moreover, there have reported that short sleep or long regulated in elevated pro-inflammatory cytokines, which subsequently increased osteoclast activity that insomnia is related to osteoporosis 1819202122…”