Association between objective sleep duration and bone mineral density in older postmenopausal women from the Study of Osteoporotic Fractures (SOF)

Swanson, Chad M.; Pj, Blatchford; Orwoll, E.; Cauley, JA; Es, LeBlanc; Ha, Fink; Wright, KP; Me, Wierman; Wm, Kohrt; Kl, Stone

doi:10.1007/s00198-019-05007-5

Cited by 19 publications

(26 citation statements)

References 41 publications

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“…1). We previously identified no difference in BTM levels in postmenopausal women sleeping < 6 vs 7-8 h/night [24]. Therefore, for the current BTM analysis, we chose sleep durations that would create a larger gap between the groups to minimize the risk of misclassification and make the short sleep duration more similar to the sleep restriction imposed in prior intervention studies [6].…”

Section: Study Design and Participant Selectionmentioning

confidence: 99%

“…Human data are limited to mostly cross-sectional studies showing no association [11,12] or that both short [13][14][15][16][17][18][19][20][21][22][23] and long [13][14][15][16][17][24][25][26][27][28][29][30] sleep durations are associated with low BMD (as reviewed in [31]). Of the 20 studies published to date on the association between sleep duration and BMD in humans [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], women comprised the majority of participants. All studies of men used subjective (self-reported) sleep duration and focused primarily on middle-aged adults when it is older men who are at highest risk of bone loss and fracture, and potential effect modifiers, such as vitamin D status, were not considered.…”

Section: Introductionmentioning

confidence: 99%

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Sleep duration and bone health measures in older men

et al. 2020

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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.

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Section: Study Design and Participant Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep duration and bone health measures in older men

et al. 2020

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“…In a related study by Swanson et al [7] the authors tried to use objective measures of sleep duration to determine if this factor has any association with bone mineral density that might increase fracture risk, either directly, or more commonly subsequent to a fall. To this end, nocturnal sleep duration, assessed objectively as well as subjectively, was not independently associated with bone mineral density in the postmenopausal women who constituted the sample.…”

Section: Resultsmentioning

confidence: 99%

“…According to the data, therefore, even though there is no universal agreement, sleep disturbances, that are common in older adults, may have a bearing on the development of some fractures, if for example chronic sleep problems predispose the individual to osteoporosis and poor bone and muscle health [31], along with confusion or deficient reflex responses. Swanson et al [7] too imply that adequate sleep is important for numerous biological processes and the functioning of several body systems including optimal bone health. Shulman et al [17] further report that at follow-up, poor sleep is independently associated with poor emotional status, that may impact fracture healing processes, as well as general personal safety, that could have a bearing on hip fractures and their outcomes, while according to Andrade [20] drugs that are used to induce sleep where sleep problems prevail, these should be used judiciously or substituted by nonpharmacologic interventions for insomnia to avoid any potential falls or fracture risk.…”

Section: Discussionmentioning

confidence: 99%

“…Other work indicates that even though no association between measures of bone mineral density and sleep quality or duration may exist [7], many studies have shown that those individuals who consistently experience less than eight hours of sleep may, in turn, suffer from exhaustion as well as irritability, and have less ability to concentrate. They may also be more prone to suffer from arterial disease (especially those that sleep less than four hours), which can lead to an increased falls risk.…”

Section: Introductionmentioning

confidence: 99%

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Sleep Disturbances and Hip Fractures

Marks

2020

JARH

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Hip fractures, which remain highly prevalent among the elderly and produce enormous social and economic costs, have not truly abated in prevalence despite years of research that outlines a multitude of preventable risk factors and intervention programs. This review aimed to examine if sleep disturbances have a bearing on the risk of incurring a hip fracture directly or indirectly, among older adults. The specific aim was to explore and summarize what we know, and how this might inform future research and practice. To this end, PUBMED, Web of Science, Scopus, and Google Scholar data bases were searched to uncover available data representing the topic of sleep in relation to hip fractures among the elderly. Articles of note were scrutinized and summarized in narrative form. Results showed very few studies on the topic prevail, even with no restriction on years examined, and of these, discordant, rather than any solid uniform conclusions prevail. It is concluded there is a need to explore this topic carefully, including both the direct, as well as the indirect impact of sleep that may place an older adult at heightened risk for a fall and hip fracture injury as well as subsequent fractures.

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Self‐Reported Sleep Disturbances over the Menopausal Transition and Fracture Risk: The Study of Women's Health Across the Nation

et al. 2023

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Sleep disturbances are common and may impact fracture risk directly by influencing bone turnover or indirectly through shared risk factors or mediators. To investigate the association between self‐reported sleep disturbances across the menopausal transition (MT) and fractures, we prospectively studied 3101 women enrolled in the Study of Women's Health Across the Nation (SWAN). At each of 14 study visits spaced approximately 18 months apart, a standardized validated scale ascertained trouble falling asleep, waking up several times during the night, and waking up earlier than planned. Two time‐varying exposures were modeled: presence of any of the three disturbances at least three times per week and waking up several times during the night at least three times per week. Base models adjusted for fixed (race/ethnicity, study site) and time‐varying characteristics (age, body mass index, and MT stage). Fully adjusted models also included time‐varying bone beneficial and detrimental medications, smoking, alcohol, physical activity, diabetes, depression and sleep medications, and depressive symptoms. Women who experienced a fracture were more likely to report a greater frequency of having trouble falling asleep, waking up several times, and/or waking up earlier: 35% versus 30% at baseline, p = 0.02. In the base models, women who had any of the three sleep disturbances at least three times per week had a higher risk of any fracture, odds ratio (OR) = 1.23 (95% confidence intervals, 1.02, 1.48) and nontraumatic fracture, OR = 1.36 (1.03, 1.80). These associations were largely attenuated to nonsignificance in the fully adjusted model. Sensitivity analyses limiting our sample to 2315 SWAN women enrolled in the bone mineral density (BMD) centers yielded similar results. Additional adjustment for femoral neck BMD had no effect on our results. In conclusion, self‐reported sleep disturbances were associated with an increased risk of fractures, but these associations likely reflect shared risk factors or factors in the causal pathway. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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Association between objective sleep duration and bone mineral density in older postmenopausal women from the Study of Osteoporotic Fractures (SOF)

Cited by 19 publications

References 41 publications

Sleep duration and bone health measures in older men

Sleep duration and bone health measures in older men

Sleep Disturbances and Hip Fractures

Self‐Reported Sleep Disturbances over the Menopausal Transition and Fracture Risk: The Study of Women's Health Across the Nation

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